Implications and emerging control strategies for ventilator-associated infections

Abstract

Ventilator-associated pneumonia (VAP) remains a major burden to the healthcare system and intubated patients in intensive care units. In fact, VAP is responsible for at least 50% of prescribed antibiotics to patients who need mechanical ventilation. One of the factors contributing to VAP pathogenesis is believed to be rapid colonization of biofilm-forming pathogens such as Pseudomonas aeruginosa and Staphylococcus aureus on the surface of inserted endotracheal tubes. These biofilms serve as a protective environment for bacterial colonies and provide enhanced resistance towards many antibiotics. This review presents and discusses an overview of current strategies to inhibit the colonization and formation of biofilm on endotracheal tubes, including antibiotic treatment, surface modification and antimicrobial agent incorporation onto endotracheal tube materials.

Discovery of cahuitamycins as biofilm inhibitors derived from a convergent biosynthetic pathway

“…Therefore, a precision medicine is urgently required for vulnerable patients to avoid potential life-threatening infections. Recently, developing biofilm inhibitors has become a priority compared with biofilm disruption due to the advantage provided by preventing subsequent dispersion of cells that may have acquired drug resistance 10 11 12 . Although biofilm control by drug targeting has become a high priority objective 7 13 , marine microbes as a source of novel chemical entities remain relatively underexplored 14 15 .…”

Advances in Pulmonary Drug Delivery Targeting Microbial Biofilms in Respiratory Diseases

“…Bacteria or fungi that can form biofilms are possibly morphic and can germinate on surfaces such as medical devices, endotracheal tubes and tracheostomy tubes [13,14]. It has been observed that biofilms are dependent on the fabricated material of such devices [15]. Biofilms cause serious diseases and are a cause of worry for patients with severe respiratory diseases like CF and chronic obstructive pulmonary disease (COPD) [16].…”

Preventing Pseudomonas aeruginosa Biofilms on Indwelling Catheters by Surface-Bound Enzymes

“…Indwelling central venous catheters (CVCs) are routinely used to administer medications, blood products, and nutritional fluids to patients, for both temporary and long-term use . The clean surfaces of newly implanted catheters are highly susceptible to microbial colonization. − The exopolysaccharide component of the matrix impairs antibiotic penetration , and provides a barrier against phagocytosis by host immune cells . Within biofilms, microbes are up to 1000 times more tolerant to antimicrobials than planktonic cells. ,,, As a result, device-related biofilm infections are difficult to treat using systemic antibiotics and often require device extraction and replacement.…”