Diversity and dynamics of clinical biofilms in ventricular assist device driveline infections and in vitro modelling
Yue Qu A B , David McGiffin C and Anton Y. Peleg A B D *A Infection Program, Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Clayton, Vic. 3800, Australia.
B Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic. 3004, Australia.
C Department of Cardiothoracic Surgery, The Alfred and Monash University, Melbourne, Vic. 3004, Australia.
D Centre to Impact AMR, Monash University, Clayton, Vic. 3800, Australia.
Dr Yue Qu is a senior research fellow at the Department of Infectious Diseases, the Alfred Hospital and Monash University. His expertise is in translational research and contributed significantly to the field of medical device-related biofilm infections, from disease pathogenesis to prevention and treatment. His research has a broad coverage of bacterial and fungal pathogens, and different disease models, including bloodstream infections, vaginal candidiasis, VAD driveline infections, and many other medical device-related infections. |
Prof. David McGiffin spent most of his career at the University of Alabama at Birmingham, where his major focus was thoracic transplantation, mechanical circulatory support and pulmonary endarterectomy. He returned to Australia in 2013 as Head of the Department of Cardiothoracic Surgery and Transplantation at the Alfred and Professor of Cardiothoracic Surgery at Monash University. He established a pulmonary endarterectomy program for chronic thromboembolic pulmonary hypertension at the Alfred, now the major referral program for Australia and New Zealand. |
Prof. Anton Peleg FAAHMS is Director of the Department of Infectious Diseases at The Alfred Hospital and Monash University, Leader in the Centre to Impact Antimicrobial Resistance (AMR), Monash University, and Theme Leader for Infection and Immunity at the Monash Academic Health Research and Translational Centre. He completed his infectious diseases clinical training in Australia and then went to the USA and worked at the Harvard-affiliated hospitals, Beth Israel Deaconess Medical Center and Massachusetts General Hospital. He is a clinician–scientist with a research program that spans fundamental, translational and clinical research. |
Microbiology Australia 44(2) 83-87 https://doi.org/10.1071/MA23024
Submitted: 11 April 2023 Accepted: 4 May 2023 Published: 18 May 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the ASM. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
The important role of microbial biofilms in medical device-related infections is well established. Intervention strategies developed from in vitro biofilm studies often fail to prevent or cure device-related infections, possibly due to limited relevance of the simplified in vitro biofilm models to the much more complex clinical reality. It is important to use in vitro biofilm assays that closely mimic the dynamically changing clinical environment. This review uses ventricular assistant device driveline infections as a model of disease to demonstrate the morphological diversity and dynamics of clinical biofilms that are important for disease pathogenesis. We also provide insights into how to develop in vitro assays to address the complexity of device-related infections, focusing on pathogen-device interactions, infectious microenvironment, and selection of representative microorganisms and biomaterials.
Keywords: biofilm formation, biofilm migration, drip-flow reactor, driveline infections, infectious microenvironment, tunnel-based biofilms.
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