The microbial infection of biomaterials: A challenge for clinicians and researchers. A short review.

The increasing use of biomaterials and medical devices has led to the development of new families of diseases related precisely to the use of the biomaterials and medical devices themselves. Microbial contamination of the devices is a serious and widespread problem in surgery because it often causes devastating infections and loss of the implanted devices. The methods of contamination in medical devices are dependent on many peculiar factors including the chemistry of the biomaterial, the physical properties of the surface, the design of the medical device, the implanted anatomical site, the extension of surgical invasion, and the time of application. The environment and/or conditions and response of the host also contribute to the development of the colonization and infection. Many bacteria and fungi spp. are involved in biomaterial infections, but most belong to endogenous bacteria or the commensal community of the skin such as Staphylococcus epidermidis and Staphylococcus aureus. Medical device contamination always develops into biofilm formation, which constitutes a protected mode for the bacteria to survive in a hostile environment by optimizing nutrient uptake, as it is sheltered from the removal forces and is protected from the host defense mechanism and from potential toxic or harmful substances including antibiotics. Therefore, studies concerning infections related to implanted materials are of increasing frequency and interest. Both in vitro and in vivo studies are reported to simulate biomaterial infection. We report suggestions concerning useful standards and strategies to re-duce contamination on biomaterials. (Journal of Applied Biomaterials and Biomechanics 2005; 3: 1-10).