Device-associated infections: A macroproblem that starts with microadherence
Device-associated infections: A macroproblem that starts with microadherence
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DOI：
10.1086/323130
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发表时间：
2001-11-01
影响因子：
11.8
通讯作者：
Darouiche, RO
中科院分区：
文献类型：
--
作者：
Darouiche, RO
医疗器械是造成很大一部分医院感染的原因，尤其是危重患者。与设备相关的感染可能会导致重大的医疗和经济后遗症。留置装置的细菌定植可能是装置感染和故障的前奏。设备相关感染的发病机制集中在细菌、设备和宿主之间的多方面相互作用。细菌因素可能是感染发病机制中最重要的因素，而设备因素最适合为了预防感染而进行修改。所研究的细菌受体中的一些（但不是全部）满足所提出的科赫假设的“粘附/感染”版本。传统的表面改性预防方法主要集中在设备的抗菌涂层上，并在预防设备相关感染方面取得了不同的临床成功。应该进一步研究生物膜修饰和细菌干扰等更新的创新方法的潜在保护作用。
Medical devices are responsible for a large portion of nosocomial infections, particularly in critically ill patients. Device-associated infections can cause major medical and economic sequelae. Bacterial colonization of the indwelling device can be a prelude to both infection and malfunction of the device. The pathogenesis of device-associated infection centers around the multifaceted interaction among the bacteria, the device, and the host. Bacterial factors are probably the most important in pathogenesis of infection, whereas device factors are the most amenable to modification with the objective of preventing infection. Some, but not all, of the studied bacterial receptors satisfy the proposed "adherence/infection" version of Koch's postulates. Traditional surface-modifying preventive approaches have largely focused on antimicrobial coating of devices and resulted in variable clinical success in preventing device-associated infections. The potential protective role of newer innovative approaches, such as biofilm modification and bacterial interference, ought to be further investigated.