Int J Artif Organs ( 2011; : 9) 929-946 34
TITANIUM OXIDE AND ANTIBACTERIAL SURFACES IN BIOMEDICAL DEVICES
Device-related infections: a clinical demand driving material science researchAn increasing number of clinical procedures requires the use of biomedical devices, whose widespread presence in modern therapeutic treatments is driving the demand for better performances and longer reliability. One of the major issues of both short-term devices and implantable prostheses is represented by device-related infections (DRIs) Accepted: August 31, 2011 rEViEW due to bacterial colonization and proliferation (1). About half of the 2 million cases of nosocomial infections that occur each year in the United States are associated with indwelling devices (2): these infections generally require a longer period of antibiotic therapy and repeated surgical procedures, resulting in potential risks for the patient and increased costs for the healthcare system. The planktonic bacteria that colonize a device surface tend to form a biofilm and the sessile bacterial cells, enclosed in a self-produced polymeric matrix of this kind, can withstand host immune responses and generally show extraordinary antibiotic resistance (3). Eventually, bacteria rapid multiply and disperse in planktonic form, giving rise