Chapter 16 : Biofilms and Hospital-Acquired Infections

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Biofilms and Hospital-Acquired Infections, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817718/9781555818944_Chap16-1.gif /docserver/preview/fulltext/10.1128/9781555817718/9781555818944_Chap16-2.gif


Many hospital-acquired infections (HAIs) are due to biofilms. Characterizing and identifying biofilm infections are the first steps toward their eradication. This will enable novel strategies to be devised aimed toward the management and control of biofilms. The main nosocomial infections caused by biofilms are bacteremia, urinary tract infections (UTI), and pneumonia. The majority of biofilm-related infections occur in medical and surgical specialties that utilize the greatest number of indwelling devices, e.g., dialysis catheters in renal medicine, ''long lines'' in oncology, prosthetic joints in orthopedic surgery, arterial and venous catheters, and the plethora of lines, urinary catheters, and tracheal tubes found in ICU patients. In particular, central venous catheters (CVCs) are one of the leading causes of nosocomial infection and primary episodes of bacteremia, and urinary catheters are the most frequently colonized devices, albeit usually with less serious sequelae. A mouse model was used to investigate skin graft biofilms. The results showed a decrease in graft associated biofilm that could be isolated from the wound after longer durations of infection. In this study, the researchers attribute this to low nutrients surrounding the biofilm and to host immune response. Biofilm-related infections will inevitably increase with the numbers of indwelling devices used unless more effective strategies can be devised to prevent their colonization by microorganisms. Such strategies could include novel applications of antibiotics and more prophylactic antibiotic use with inherent risks of generating resistant organisms.

Citation: Ebrey R, Shea Hamilton M, Cairns G, Lappin-Scott H. 2004. Biofilms and Hospital-Acquired Infections, p 294-313. In Ghannoum M, O'Toole G (ed), Microbial Biofilms. ASM Press, Washington, DC. doi: 10.1128/9781555817718.ch16
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

Electron micrograph showing MRSA attached to the surface of urinary catheter (Courtesy of S. M. Jones).

Citation: Ebrey R, Shea Hamilton M, Cairns G, Lappin-Scott H. 2004. Biofilms and Hospital-Acquired Infections, p 294-313. In Ghannoum M, O'Toole G (ed), Microbial Biofilms. ASM Press, Washington, DC. doi: 10.1128/9781555817718.ch16
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2

Electron micrograph showing VRE attached to the surface of urinary catheter (Courtesy of S. M. Jones).

Citation: Ebrey R, Shea Hamilton M, Cairns G, Lappin-Scott H. 2004. Biofilms and Hospital-Acquired Infections, p 294-313. In Ghannoum M, O'Toole G (ed), Microbial Biofilms. ASM Press, Washington, DC. doi: 10.1128/9781555817718.ch16
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 3

Examples of multilumen intravascular catheters.

Citation: Ebrey R, Shea Hamilton M, Cairns G, Lappin-Scott H. 2004. Biofilms and Hospital-Acquired Infections, p 294-313. In Ghannoum M, O'Toole G (ed), Microbial Biofilms. ASM Press, Washington, DC. doi: 10.1128/9781555817718.ch16
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 4

Micrographs of (a) and (b) biofilm stained using hexidium iodide and visualized under epifluorescence (Phillips, Brading, and Lappin-Scott, unpublished data).

Citation: Ebrey R, Shea Hamilton M, Cairns G, Lappin-Scott H. 2004. Biofilms and Hospital-Acquired Infections, p 294-313. In Ghannoum M, O'Toole G (ed), Microbial Biofilms. ASM Press, Washington, DC. doi: 10.1128/9781555817718.ch16
Permissions and Reprints Request Permissions
Download as Powerpoint


1. An, Y. H.,, and R. J. Friedman. 1998. Concise review of mechanisms of bacterial adhesion to biomaterial surfaces. J. Biomed. Mater. Res. 43:338348.
2. Anderson, R. L.,, A. K. Highsmith,, and B. W. Holland. 1986. Comparison of the standard pour plate procedure and the ATP and Limulus amoebocyte lysate procedures for the detection of microbial contamination in intravenous fluids. J. Clin. Microbiol. 23:465468.
3. Anonymous. 2000. NINSS Surveillance of Hospital-Acquired Bacteraemia in English Hospitals 1997-2000. Public Health Laboratory Service, London, United Kingdom.
4. Anonymous. 2001. National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-June 2001, issued August 2001. Am. J. Infect. Control 29:40421.
5. Anonymous. 2002. Acinetobacter spp. and Enterococcus spp. bacteraemia: England and Wales, 2001. Commun. Dis. Rep. CDR Wkly. 12:18.
6. Archibald, L. K.,, and R. P. Gaynes. 1997. Hospital-acquired infections in the United States: the importance of interhospital comparisons. Infect. Dis. Clin. N. Am. 11:245255.
7. Arciola, C. R.,, S. Collamati,, E. Donati,, and L. Montanaro. 2001. A rapid PCR method for the detection of slime-producing strains of Staphylococcus epidermidis and S. aureus in periprosthesis infections. Diagn. Mol. Pathol. 10:130137.
8. Baldassarri, L.,, R. Cecchini,, L. Bertuccini,, M. G. Ammendolia,, F. Iosi,, C. R. Arciola,, L. Montanaro,, G. Gherardi,, G. Dicuonzo,, G. Orefici,, and R. Creti. 2001. Enterococcus spp. produces slime and survives in rat peritoneal macrophages. Med. Microbiol. Immunol. 190:113120.
9. Benenson, A. S. 1995. Control of Communicable Diseases Manual, 16th ed. American Public Health Association, Washington, D.C.
10. Bergamini, T. M., , R. A. Corpus, Jr.,, K. R. Brittian, , J. C. Peyton, , and W. G. Cheadle. 1994. The natural history of bacterial graft infection. J. Surg. Res. 56:393396.
11. Bisno, A. L.,, and F. A. Waldvogel (ed.). 1994. Infections Associated with Indwelling Medical Devices, 2nd ed. American Society for Microbiology, Washington, D.C.
12. Bisno, A. L., 1995. Nonsuppurative poststreptococcal sequelae: rhematic fever and glomerulonephritis, p. 17991810. In G. J. Mandell, , J. E. Bennett, , and R. Dolin (ed.), Mandell, Douglas and Bennett’s Principles and Practice of Infectious Disease , 4th ed. Churchhill Livingstone Inc., New York, N.Y.
13. Bjorn, M. J.,, P. A. Sokol,, and B. H. Iglewski. 1979. Influence of iron on yields of extracellular products in Pseudomonas aeruginosa cultures. J. Bacteriol. 138:193200.
14. Blot, S.,, K. Vandewoude,, D. De Bacquer,, and F. Colardyn. 2002. Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: clinical outcome and length of hospitalization. Clin. Infect. Dis. 34: 16001606.
15. Bollinger, N.,, D. J. Hassett,, B. Iglewski,, J. W. Costerton,, and T. R. McDermott. 2001. Gene expression in Pseudomonas aeruginosa: evidence of iron override effects on quorum sensing and biofilmspecific gene regulation. J. Bacteriol. 183:19901996.
16. Braunwald, E., 1997. Valvular heart disease, p. 10071066. In E. Braunwald (ed.), Heart Disease, 5th ed. W.B. Saunders Co., Philadelphia, Pa.
17. Carrel, T.,, T. Nguyen,, B. Kipfer,, and U. Althaus. 1998. Definitive cure of recurrent prosthetic endocarditis using silver-coated St. Jude Medical heart valves: a preliminary case report. J. Heart Valve Dis. 7:531533.
18. Casadevall, A.,, and L. A. Pirofski. 2000. Hostpathogen interactions: basic concepts of microbial commensalism, colonization, infection, and disease. Infect. Immun. 68:65116518.
19. Chow, J. W.,, L. A. Thal,, M. B. Perri,, J. A. Vazquez,, S. M. Donabedian,, D. B. Clewell,, and M. J. Zervos. 1993. Plasmid-associated hemolysin and aggregation substance production contribute to virulence in experimental enterococcal endocarditis. Antimicrob. Agents Chemother. 37: 24742477.
20. Ciresi, D. L.,, R. M. Albrecht,, P. A. Volkers,, and D. J. Scholten. 1996. Failure of antiseptic bonding to prevent central venous catheter-related infection and sepsis. Am. Surg. 62:641646.
21. Combes, A.,, C. Figliolini,, J.-L. Trouillet,, N. Kassis,, M. Wolff,, C. Gibert,, and J. Chastre. 2002. Incidence and outcome of polymicrobial ventilator-associated pneumonia. Chest 121:16181623.
22. Costerton, J. W. 2001. Cystic fibrosis pathogenesis and the role of biofilms in persistent infection. Trends Microbiol. 9:5052.
23. Costerton, J. W.,, P. S. Stewart,, and E. P. Greenberg. 1999. Bacterial biofilms: a common cause of persistent infections. Science 284:13181322.
24. Cramton, S. E.,, M. Ulrich,, F. Götz,, and G. Döring. 2001. Anaerobic conditions induce expression of polysaccharide intercellular adhesion in Staphylococcus aureus and Staphylococcus epidermidis. Infect. Immun. 69:40794085.
25. Cucarella, C.,, M. A. Tormo,, E. Knecht,, B. Amorena,, I. Lasa,, T. J. Foster,, and J. R. Penades. 2002. Expression of the biofilm-associated protein interferes with host protein receptors of Staphylococcus aureus and alters the infective process. Infect. Immun. 70:31803186.
26. Darouiche, R. O. 2001. Device-associated infections: a macroproblem that starts with microadherence. Clin. Infect. Dis. 33:15671572.
27. Darouiche, R. O.,, A. Dhir,, A. J. Miller,, G. C. Landon,, I. I. Raad,, and D. M. Musher. 1994. Vancomycin penetration into biofilm covering infected prostheses and effect on bacteria. J. Infect. Dis. 170:720723.
28. Darouiche, R. O.,, I. I. Raad,, S. O. Heard,, J. I. Thornby,, O. C. Wenker,, A. Gabrielli,, J. Berg,, N. Khardori,, H. Hanna,, R. Hachem,, R. L. Harris,, and G. Mayhall. 1999. A comparison of two antimicrobial-impregnated central venous catheters. N. Engl. J. Med. 340:18.
29. Davey, M. E.,, and G. A. O’Toole. 2000. Microbial biofilms: from ecology to molecular genetics. Microbiol. Mol. Biol. Rev. 64:847867.
30. Dezfulian, C.,, J. Lavelle,, B. K. Nallamothu,, S. R. Kaufman,, and S. Saint. 2003. Rates of infection for single-lumen versus multilumen central venous catheters: a meta-analysis. Crit. Care Med. 9:23852390.
31. Di Martino, P.,, A. Merieau,, R. Phillips,, N. Orange,, and C. Hulen. 2002. Isolation of an Escherichia coli strain mutant unable to form biofilm on polystyrene and to adhere to human pneumocyte cells: involvement of tryptophanase. Can. J. Microbiol. 48:132137.
32. Dixon, G. 2002. Sources of surgical infection. Surgery 20:179185.
33. Donlan, R. M. 2001a. Biofilm formation: a clinically relevant microbiological process. Clin. Infect. Dis. 33:13871392.
34. Donlan, R. M. 2001b. Biofilms and device-associated infections. Emerg. Infect. Dis. 7:277281.
35. Donlan, R. M.,, and J. W. Costerton. 2002. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin. Microbiol. Rev. 15:167193.
36. Donlan R., , R. Murga, , and L. Carson,. 1999. Growing biofilms in intravenous fluids, p. 2329. In J. Wimpenny, , P. Gilbert, , J. Walker, , M. Brading, , and R. Bayston (ed.), Biofilms, the Good, the Bad and the Ugly. BioLine Press, Cardiff, United Kingdom.
37. Doyle, R. J. 2000. Contribution of the hydrophobic effect to microbial infection. Microbes Infect. 2: 391400.
38. Ducel, G.,, J. Fabry,, and L. Nicolle . 2002. Prevention of Hospital-Acquired Infections: A Practical Guide, 2nd ed. WHO/CDS/CSR/EPH/2002/12. World Health Organization, Geneva, Switzerland.
39. Ducel, G.,, J. J. Haxhe,, F. Tanner,, and M. Zumoffen. 1979. Guide Pratique pour la Lutte Contre l’Infection Hospitalière. WHO/BAC/79.1. World Health Organization, Geneva, Switzerland.
40. Edmond, M. B.,, J. F. Ober,, D. L. Weinbaum,, M. A. Pfaller,, T. Hwang,, M. D. Sanford,, and R. P. Wenzel. 1995. Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection. Clin. Infect. Dis. 20:11261133.
41. Evans, E.,, M. R. Brown,, and P. Gilbert. 1994. Iron chelator, exopolysaccharide and protease production in Staphylococcus epidermidis: a comparative study of the effects of specific growth rate in biofilm and planktonic culture. Microbiology 140:153157.
42. Failla, M. L.,, C. D. Benedict,, and E. D. Weinberg. 1975. Bacterial and fungal growth in total parenteral nutrition solutions. Antonie Van Leeuwenhoek 41:319328.
43. Fitzgerald, R. H., Jr.,, D. R. Nolan, , D. M. Ilstrup, , R. E. Van Scoy, , J. A. Washington, , and M. B. Coventry. 1977. Deep wound sepsis following total hip arthroplasty. J. Bone Joint Surg. Am. Vol. 59:847855.
44. Fletcher, J. M.,, S. P. Nair,, J. M. Ward,, B. Henderson,, and M. Wilson. 2001. Analysis of the effect of changing environmental conditions on the expression patterns of exported surface-associated proteins of the oral pathogen Actinobacillus actinomycetemcomitans. Microb. Pathog. 30: 359368.
45. Freestone, P. P. E.,, R. D. Haigh,, P. H. Williams,, and M. Lyte. 1999. Stimulation of bacterial growth by heat-stable, norepinephrine-induced autoinducers. FEMS Microbiol. Lett. 172: 5360.
46. Fridkin, S. K.,, and R. P. Gaynes. 1999. Antimicrobial resistance in intensive care units. Clin. Chest Med. 20:303316.
47. Fridkin, S. K.,, S. F. Welbel,, and R. A. Weinstein. 1997. Magnitude and prevention of nosocomial infections in the intensive care unit. Infect. Dis. Clin. N. Am. 11:479496.
48. Froude, J.,, A. Gibofsky,, D. R. Buskirk,, A. Khanna,, and J. B. Zabriskie. 1989. Crossreactivity between streptococcus and human tissue: a model of molecular mimicry and autoimmunity. Curr. Top. Microbiol. Immunol. 145:526.
49. Fujita, K.,, H. A. Lilly,, and G. A. Ayliffe. 1982. Spread of resistant gram-negative bacilli in a burns unit. J. Hosp. Infect. 3:2937.
50. Gil, R. T.,, J. A. Kruse,, M. C. Thill-Baharozian,, and R. W. Carlson. 1989. Triple- vs singlelumen central venous catheters. A prospective study in a critically ill population. Arch. Intern. Med. 149: 11391143.
51. Gilbert, P.,, J. Das,, and I. Foley. 1997. Biofilm susceptibility to antimicrobials. Adv. Dent. Res. 11: 160167.
52. Goldman, D. A.,, and W. C. Huskins. 1997. Control of nosocomial antimicrobial-resistant bacteria: a strategic priority for hospitals worldwide. Clin. Infect. Dis. 24:S139S145.
53. Gordts, B.,, H. Van Landuyt,, M. Ieven,, P. Vandamme,, and H. Goossens. 1995. Vancomycin-resistant enterococci colonizing the intestinal tracts of hospitalized patients. J. Clin. Microbiol. 33:28422846.
54. Götz, F. 2002. Staphylococcus and biofilms. Mol. Microbiol. 43:13671378.
55. Guzman, C. A.,, C. Pruzzo,, G. LiPira,, and L. Calegari. 1989. Role of adherence in pathogenesis of Enterococcus faecalis urinary tract infection and endocarditis. Infect. Immun. 57:18341838.
56. Guzman, C. A.,, C. Pruzzo,, M. Plate,, M. C. Guardati,, and L. Calegari. 1991. Serum dependent expression of Enterococcus faecalis adhesins involved in the colonization of heart cells. Microb. Pathog. 11:399409.
57. Hachem, R.,, and I. Raad. 2002. Failure of oral antimicrobial agents in eradicating gastrointestinal colonization with vancomycin-resistant enterococci. Infect. Control Hosp. Epidemiol. 23:4344.
58. Hancock, L. E.,, and M. S. Gilmore,. 2000. Pathogenicity of enterococci, p. 251258. In V. A. Fischetti, , R. P. Novick, , J. J. Ferretti, , D. A. Portnoy, , and J. A. Rood (ed.), Gram-Positive Pathogens. ASM Press, Washington, D.C.
59. Hanna, H.,, and I. Raad. 2001. New approaches for prevention of intravascular catheter-related infections. Infect. Med. 18:3848.
60. Hiramatsu, K.,, N. Aritaka,, H. Hanaki,, S. Kawasaki,, Y. Hosoda,, S. Hori,, Y. Fukuchi,, and I. Kobayashi. 1997. Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet 350:16701673.
61. Høiby, N.,, A. Fomsgaard,, E. T. Jensen,, H. K. Johansen,, G. Kronborg,, S. S. Pedersen,, T. Pressler,, and A. Kharazmi,. 1995. The immune response to bacterial biofilms, p. 233250. In H. M. Lappin-Scott, and J. W. Costerton (ed.), Microbial Biofilms. Cambridge, University Press, Cambridge, United Kingdom.
62. Huebner, J.,, G. B. Pier,, J. N. Maslow,, E. Muller,, H. Shiro,, M. Parent,, A. Kropec,, R. D. Arbeit,, and D. A. Goldmann. 1994. Endemic nosocomial transmission of Staphylococcus epidermidis bacteremia isolates in a neonatal intensive care unit over 10 years. J. Infect. Dis. 169:526531.
63. Illingworth, B. L.,, K. Tweden,, R. F. Schroeder,, and J. D. Cameron. 1998. In vivo efficacy of silver-coated (Silzone) infection-resistant polyester fabric against a biofilm-producing bacteria, Staphylococcus epidermidis. J. Heart Valve Dis. 7:524530.
64. Isiklar, Z. U.,, R. O. Darouiche,, G. C. Landon,, and T. Beck. 1996. Efficacy of antibiotics alone for orthopaedic device related infections. Clin. Orthop. 332:184189.
65. Jakobsen, C. J.,, V. Hansen,, J. J. Jensen,, and N. Grabe. 1989. Bacterial contamination of subclavian vein catheters: an intralumical culture method. J. Hosp. Infect. 13:253260.
66. Jones, S. M.,, M. Morgan,, T. J. Humphrey,, and H. Lappin-Scott. 2001. Effect of vancomycin and rifampicin on meticillin-resistant Staphylococcus aureus biofilms. Lancet 357:4041.
67. Jonsson, K.,, C. Signas,, H. P. Muller,, and M. Lindberg. 1991. Two different genes encode fibronectin binding proteins in Staphylococcus aureus. The complete nucleotide sequence and characterization of the second gene. Eur. J. Biochem. 202: 10411048.
68. Kamal, G. D.,, M. A. Pfaller,, L. E. Rempe,, and P. J. Jebson. 1991. Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. JAMA 265: 23642368.
69. Karchmer, A. W.,, and G. W. Gibbons,. 1994. Infections of prosthetic heart valves and vascular grafts. p. 213249. In A. L. Bisno, and F. A. Waldvogel (ed.), Infections Associated with Indwelling Medical Devices, 2nd ed. American Society for Microbiology. Washington, D.C.
70. Kennedy, H. F.,, D. Morrison,, M. E. Kaufmann,, M. S. Jackson,, J. Bagg,, B. E. Gibson,, C. G. Gemmell,, and J. R. Michie. 2000. Origins of Staphylococcus epidermidis and Streptococcus oralis causing bacteraemia in a bone marrow transplant patient. J. Med. Microbiol. 49:367370.
71. Kite, P.,, B. M. Dobbins,, M. H. Wilcox,, W. N. Fawley,, A. J. Kindon,, D. Thomas,, M. J. Tighe,, and M. J. McMahon. 1997. Evaluation of a novel endoluminal brush for the in situ diagnosis of catheter related sepsis. J. Clin. Pathol. 50:278282.
72. Kunin, C. M.,, and R. C. McCormack. 1966. Prevention of catheter-induced urinary-tract infections by sterile closed drainage. N. Engl. J. Med. 274:11551161.
73. Ledingham, I. M. 1988. Prevention and management of infections with gram-negative bacteria in intensive care units. Br. J. Clin. Pract. Suppl. 57:45.
74. Lowy, F. D. 1998. Staphylococcus aureus infections. N. Engl. J. Med. 339:520532.
75. Luppens, S. B. I.,, M. W. Reij,, R. W. L. van der Heijden,, F. M. Rombouts,, and T. Abee. 2002. Development of a standard test to assess the resistance of Staphylococcus aureus biofilm cells to disinfectants. Appl. Environ. Microbiol. 68:41944200.
76. Lyczak, J. B.,, C. L. Cannon,, and G. B. Pier. 2002. Lung infection associated with cystic fibrosis. Clin. Microbiol. Rev. 15:194222.
77. Lyte, M.,, and S. Ernst. 1992. Catecholamine induced growth of gram-negative bacteria. Life Sci. 50:203212.
78. Mack, D.,, M. Nedelmann,, A. Krokotsch,, A. Schwarzkopf,, J. Heesemann,, and R. Laufs. 1994. Characterization of transposon mutants of biofilm-producing Staphylococcus epidermidis impaired in the accumulative phase of biofilm production: genetic identification of a hexosamine-containing polysaccharide intercellular adhesin. Infect. Immun. 62:32443253.
79. Mack, D.,, N. Siemssen,, and R. Laufs. 1992. Parallel induction by glucose of adherence and a polysaccharide antigen specific for plastic-adherent Staphylococcus epidermidis: evidence for functional relation to intercellular adhesion. Infect. Immun. 60:20482057.
80. Maki, D. G., 1992. Infections due to infusion therapy, p. 849898. In J. V. Bennett, and P. S. Brachman (ed.), Hospital Infections, 3rd ed. Little, Brown & Co., Boston, Mass.
81. Maki, D. G.,, L. Cobb,, J. K. Garman,, J. M. Shapiro,, M. Ringer,, and R. B. Helgerson. 1988. An attachable silver-impregnated cuff for prevention of infection with central venous catheters: a prospective randomised multicenter trial. Am. J. Med. 85:307316.
82. Maki, D. G.,, and W. T. Martin. 1975. Nationwide epidemic of septicemia caused by contaminated infusion products. IV. Growth of microbial pathogens in fluids for intravenous infusions. J. Infect. Dis. 131:267272.
83. Maki, D. G.,, and L. A. Mermel,. 1998. Infections due to infusion therapy, p. 689724. In J. V. Bennett, and P. S. Brachman (ed.), Hospital Infections, 4th ed. Lippincott-Raven, Philadelphia, Pa.
84. Maki, D. G.,, M. Ringer,, and C. J. Alvarado. 1991. Prospective randomised trial of povidoneiodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 338:339343.
85. Maki, D. G.,, C. E. Weise,, and H. W. Sarafin. 1977. A semiquantitative culture technique for identifying intravenous-catheter-related infections. N. Engl. J. Med. 296:13051309.
86. Mason, D. J.,, S. Shanmuganathan,, F. C. Mortimer,, and V. A. Gant. 1998. A fluorescent gram stain for flow cytometry and epifluorescence microscopy. Appl. Environ. Microbiol. 64:26812685.
87. Matsumura, S.,, and A. E. Simor. 1998. Treatment of endocarditis due to vancomycin-resistant Enterococcus faecium with quinupristin/dalfopristin, doxycycline, and rifampin: a synergistic drug combination. Clin. Infect. Dis. 27:15541556.
88. McCabe, K.,, M. D. Mann,, and M. D. Bowie. 1994. pH changes during in vitro adherence of Escherichia coli to HeLa cells. Infect. Immun. 62: 51645167.
89. Menzies, B. E.,, and I. Kourteva. 2000. Staphylococcus aureus α-toxin induces apoptosis in endothelial cells. FEMS Immunol. Med. Microbiol. 29:3945.
90. Michel, L.,, J. C. McMichan,, and J. L. Bachy. 1979. Microbial colonization of indwelling central venous catheters: statistical evaluation of potential contaminating factors. Am. J. Surg. 137:745748.
91. Mylonakis, E.,, and S. B. Calderwood. 2001. Infective endocarditis in adults. N. Engl. J. Med. 345:13181330.
92. Navarre, W. W.,, and O. Schneewind. 1994. Proteolytic cleavage and cell wall anchoring at the LPXTG motif of surface proteins in Gram-positive bacteria. Mol. Microbiol. 14:115121.
93. Neal, C. P.,, P. P. E. Freestone,, A. F. Maggs,, R. D. Haigh,, P. H. Williams,, and M. Lyte. 2001. Catecholamine inotropes as growth factors for Staphylococcus epidermis and other coagulase-negative staphylococci. FEMS Microbiol. Lett. 194: 163169.
94. Nickel, J. C. 1992. Bacterial biofilms and catheters: a key to understanding bacterial strategies in catheter-associated urinary tract infection. Can. J. Infect. Dis. 3:261267.
95. Nickel, J. C.,, J. Downey,, and J. W. Costerton. 1992. Movement of Pseudomonas aeruginosa along catheter surfaces. A mechanism in pathogenesis of catheter-associated infection. Urology 39:9398.
96. Nickel, J. C.,, S. K. Grant,, K. Lam,, M. E. Olson,, and J. W. Costerton. 1991. Bacteriologically stressed animal model of new closed catheter drainage system with microbicidal outlet tube. Urology 38:280289.
97. O’Gara, J. P.,, and H. Humphreys. 2001. Staphylococcus epidermidis biofilms: importance and implications. J. Med. Microbiol. 50:582587.
98. Olmsted, S.,, G. Dunny,, S. Erlandsen,, and C. L. Wells. 1994. A plasmid-encoded surface protein on Enterococcus faecalis augments its internalization by cultured intestinal epithelial cells. J. Infect. Dis. 170:15491556.
99. Patti, J. M.,, and M. Höök. 1994. Microbial adhesins recognizing extracellular matrix macromolecules. Curr. Opin. Cell Biol. 6:752758.
100. Pemberton, L. B.,, V. Ross,, P. Cuddy,, H. Kremer,, T. Fessler,, and E. McGurk. 1996. No difference in catheter sepsis between standard and antiseptic central venous catheters. A prospective randomized trial. Arch. Surg. 131:986989.
101. Plowman, R.,, N. Graves,, M. Griffin,, J. A. Roberts,, A. V. Swan,, B. D. Cookson,, and L. Taylor. 2000. The Socio-Economic Burden of Hospital Acquired Infection. Public Health Laboratory Service, London, United Kingdom.
102. Powell, C.,, K. A. Kudsk,, P. A. Kulich,, J. A. Mandelbaum,, and P. J. Fabri. 1988. Effect of frequent guidewire changes on triple-lumen catheter sepsis. J. Parenter. Enteral Nutr. 12:462464.
103. Prager, R. L., , and J. Silva, Jr. 1984. Colonization of central venous catheters. South. Med. J. 77:458461.
104. Prouty, A. M.,, W. H. Schwesinger,, and J. S. Gunn. 2002. Biofilm formation and interactions with the surfaces of gallstones by Salmonella spp. Infect. Immun. 70:26402649.
105. Raad, I. 1998. Intravascular-catheter-related infections. Lancet 351:893898.
106. Raad, I. I. 1997. Vascular catheters impregnated with antimicrobial agents: present knowledge and future direction. Infect. Control Hosp. Epidemiol. 18:227229.
107. Raad, I. I.,, and G. P. Bodey. 1992. Infectious complications of indwelling vascular catheters. Clin. Infect. Dis. 15:197208.
108. Raad, I.,, J. W. Costerton,, U. Sabharwal,, M. Sacilowski,, E. Anaissie,, and G. P. Bodey. 1993. Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and duration of placement. J. Infect. Dis. 168:400407.
109. Raad, I. I.,, and R. O. Darouiche. 1996. Catheter-related septicemia: risk reduction. Infect. Med. 3: 807823.
110. Raad, I.,, R. Darouiche,, R. Hachem,, M. Mansouri,, and G. P. Bodey. 1996. The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J. Infect. Dis. 173: 418424.
111. Raad, I.,, R. Darouiche,, R. Hachem,, M. Sacilowski,, and G. P. Bodey. 1995. Antibiotics and prevention of microbial colonization of catheters. Antimicrob. Agents Chemother. 39:23972400.
112. Raad, I. I.,, M. Luna,, S. A. Khalil,, J. W. Costerton,, C. Lam,, and G. P. Bodey. 1994. The relationship between the thrombotic and infectious complications of central venous catheters. JAMA 271:10141016.
113. Raymond, D. P.,, S. J. Pelletier,, T. D. Crabtree,, H. L. Evans,, T. L. Pruett,, and R. G. Sawyer. 2003. Impact of antibiotic-resistant Gram-negative bacilli infections on outcome in hospitalized patients. Crit. Care Med. 31:10351041.
114. Richards, M. J.,, J. R. Edwards,, D. H. Culver,, and R. P. Gaynes. 1999. Nosocomial infections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit. Care Med. 27:887892.
115. Rose, H. D.,, and J. B. Babcock. 1975. Colonization of intensive care unit patients with gram-negative bacilli. Am. J. Epidemiol. 101:495501.
116. Rowbury, R. J. 1995. An assessment of environmental factors influencing acid tolerance and sensitivity in Escherichia coli, Salmonella spp. and other enterobacteria. Lett. Appl. Microbiol. 20:333337.
117. Rupp, M. E.,, J. S. Ulphani,, P. D. Fey,, and D. Mack. 1999. Characterization of Staphylococcus epidermidis polysaccharide intercellular adhesin/ hemagglutinin in the pathogenesis of intravascular catheter-associated infection in a rat model. Infect. Immun. 67:26562659.
118. Saint, S.,, D. L. Veenstra,, and B. A. Lipsky. 2000. The clinical and economic consequences of nosocomial central venous catheter-related infection: are antimicrobial cathethers useful? Infect. Control Hosp. Epidemiol. 21:375380.
119. Sandoe, J. A. T.,, and C. M. Longshaw. 2001. Ventriculoperitoneal shunt infection caused by Staphylococcus lugdunensis. Clin. Microbiol. Infect. 7: 385387.
120. Shankar, V.,, A. S. Baghdayan,, M. M. Huycke,, G. Lindahl,, and M. S. Gilmore. 1999. Infectionderived Enterococcus faecalis strains are enriched in esp, a gene encoding a novel surface protein. Infect. Immun. 67:193200.
121. Sherertz, R. J.,, D. M. Forman,, and D. D. Solomon. 1989. Efficacy of dicloxacillin-coated polyurethane catheters in preventing subcutaneous Staphylococcus aureus infection in mice. Antimicrob. Agents Chemother. 33:11741178.
122. Sherertz, R. J.,, W. A. Carruth,, A. A. Hampton,, M. P. Byron,, and D. D. Solomon. 1993. Efficacy of antibiotic-coated catheters in preventing subcutaneous Staphylococcus aureus infection in rabbits. J. Infect. Dis. 167:98106.
123. Shiono, A.,, and Y. Ike. 1999. Isolation of Enterococcus faecalis clinical isolates that efficiently adhere to human bladder carcinoma T24 cells and inhibition of adhesion by fibronectin and trypsin treatment. Infect. Immun. 67:15851592.
124. Stewart, P. S.,, and J. W. Costerton. 2001. Antibiotic resistance of bacteria in biofilms. Lancet 358: 135138.
125. Stickler, D. J. 1996. Bacterial biofilms and the encrustation of urethral catheters. Biofouling 9: 293305.
126. Stickler, D. J.,, L. Ganderton,, J. King,, and C. Winters. 1993. Proteus mirabilis biofilms and the encrustation of urethral catheters. Urol. Res. 21: 407411.
127. Stickler, D. J.,, N. Morris,, M. Moreno,, and N. Sabbuba. 1998. Studies on the formation of crys talline bacterial biofilms on urethral catheters. Eur. J. Clin. Microbiol. Infect. Dis. 17:649652.
128. Stoddart, J. C. 1974. Gram-negative infections in the ICU. Crit. Care Med. 2:1722.
129. Stollerman, G. H. 1991. Rheumatogenic streptococci and autoimmunity. Clin. Immunol. Immunopathol. 61:131142.
130. Stoodley, P.,, D. DeBeer,, and H. M. Lappin- Scott. 1997. Influence of electrical fields and pH on biofilm structure as related to the bioelectric effect. Antimicrob. Agents Chemother. 41:18761879.
131. Stoodley, P.,, L. Hall-Stoodley,, and H. M. Lappin-Scott. 2001. Detachment, surface migration and other dynamics behaviour in bacterial biofilms relvealed by digital time-lapse imaging. Methods Enzymol. 337:306318.
132. Tighe M. J., , P. Kite, , W. N. Fawley, , D. Thomas, , and M. J. McMahon. 1996. An endoluminal brush to detect the infected central venous catheter in situ: a pilot study. BMJ 313:15281529.
133. Toledo-Arana, A.,, J. Valle,, C. Solano,, M. J. Arrizubieta,, C. Cucarella,, M. Lamata,, B. Amorena,, J. Leiva,, J. R. Penades,, and I. Lasa. 2001. The enterococcal surface protein Esp, is involved in Enterococcus faecalis biofilm formation. Appl. Environ. Microbiol. 67:45384545.
134. Toltzis, P.,, and J. L. Blumer. 1995. Antibioticresistant gram-negative bacteria in the critical care setting. Pediatr. Clin. N. Am. 42:687702.
135. Tunney, M. M.,, S. Patrick,, M. D. Curran,, G. Ramage,, D. Hanna,, J. R. Nixon,, S. P. Gorman,, R. I. Davis,, and N. Anderson. 1999. Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PCR amplification of the bacterial 16S rRNA gene. J Clin. Microbiol. 37:32813290.
136. Ward, K. H.,, M. E. Olson,, K. Lam,, and J. W. Costerton. 1992. Mechanisms of persistent infection associated with peritoneal implants J. Med. Microbiol. 36:406413.
137. Wells, C. L.,, E. A. Moore,, J. A. Hoag,, H. Hirt,, G. M. Dunny,, and S. L. Erlandsen. 2000. Inducible expression of Enterococcus faecalis aggregation substance protein facilitates bacterial internalization by cultured enterocytes. Infect. Immun. 68:71907194.
138. Wilcox, M. H., 1994. Treating medical device associated infections, p. 155158. In J. Wimpenny, , W. Nichols, , D. Stickler, , and H. Lappin-Scott (ed.), Bacterial Biofilms and Their Control in Medicine and Industry. BioLine Press, Cardiff, United Kingdom.
139. Zimmerli, W.,, F. A. Waldvogel,, P. Vaudaux,, and U. E. Nydegger. 1982. Pathogenesis of foreign body infection: description and characteristics of an animal model. J. Infect. Dis. 146:487497.


Generic image for table

Summary of the natural history of classical and biofilm-related infections

Citation: Ebrey R, Shea Hamilton M, Cairns G, Lappin-Scott H. 2004. Biofilms and Hospital-Acquired Infections, p 294-313. In Ghannoum M, O'Toole G (ed), Microbial Biofilms. ASM Press, Washington, DC. doi: 10.1128/9781555817718.ch16

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error