Research Topic

Biofilm concept: from Diagnosis to Treatment of Related Prosthetic Infections

About this Research Topic

Implant-related infections represent a serious surgical complication, with high morbidity for the patient and elevated costs for the healthcare system. Such infections are typically due to the presence of bacterial biofilm adhering to implanted biomaterials (e.g. prosthetic implants, endotracheal tubes, intravenous catheters, indwelling urinary catheters, tissue fillers).

Once a biofilm has established, it is difficult to fight the infection, because the bacteria residing into the matrix are protected from the host immune system and from antimicrobials. Consequently, bacterial biofilms make infections more refractory to the treatments, while slowing tissue repair by stimulating chronic inflammation at the implant site.

Preventive measures should point primarily at discouraging biofilm formation by protecting implant surfaces with coatings able to inhibit bacterial adhesion while maintaining the functional activity of host cells for a good implant integration. As the increasing emergence of multidrug-resistant bacteria has compromised the effectiveness of antibiotics, in recent years great interest was directed towards the identification of novel biocompatible molecules capable to interfere with microbial attachment to surfaces. Modification of the physical attributes of implant surface, such as topography or hydrophobicity, is also a desirable option to provide a more persistent form of inhibiting bacterial adhesion.

Numerous experimental in vivo models of biofilm-related infections have been developed to identify targets for diagnostic tests, new therapeutic strategies, antimicrobial compounds and coatings. However, further investigations are need to develop reliable animal models that would more closely mimic different infections and allow evaluation of the efficacy of surgical procedures as well as systemic or local therapies.

A reliable microbiological diagnosis is pivotal for correctly identifying the causative microorganism and appropriately targeting the treatment for implant-related infections. The presence of bacterial biofilm poses a special challenge to the microbiological diagnosis, as this biological structure makes more difficult the isolation and identification of bacteria in clinical samples, and laboratory tests have been commonly developed to identify planktonic bacteria. The need for an efficient method to dislodge bacteria from biofilms has led to the introduction and implementation of mechanical (e.g. sonication) and chemical (e.g. dithiothreitol) methods. To enhance detection of implants-related infections, additional investigative methods are being explored, such as culture-independent molecular techniques.
The purpose of this Research Topic is to provide the reader with an updated and comprehensive overview of implant-related infections, encompassing (but not limited to) all of the above-described aspects. We welcome articles reviewing the current state-of-the-art and providing novel scientific knowledge in view of an improvement in the prevention, diagnosis and treatment of implant-related infections.


Keywords: Biofilm, infection, medical implants, diagnosis, treatment


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Implant-related infections represent a serious surgical complication, with high morbidity for the patient and elevated costs for the healthcare system. Such infections are typically due to the presence of bacterial biofilm adhering to implanted biomaterials (e.g. prosthetic implants, endotracheal tubes, intravenous catheters, indwelling urinary catheters, tissue fillers).

Once a biofilm has established, it is difficult to fight the infection, because the bacteria residing into the matrix are protected from the host immune system and from antimicrobials. Consequently, bacterial biofilms make infections more refractory to the treatments, while slowing tissue repair by stimulating chronic inflammation at the implant site.

Preventive measures should point primarily at discouraging biofilm formation by protecting implant surfaces with coatings able to inhibit bacterial adhesion while maintaining the functional activity of host cells for a good implant integration. As the increasing emergence of multidrug-resistant bacteria has compromised the effectiveness of antibiotics, in recent years great interest was directed towards the identification of novel biocompatible molecules capable to interfere with microbial attachment to surfaces. Modification of the physical attributes of implant surface, such as topography or hydrophobicity, is also a desirable option to provide a more persistent form of inhibiting bacterial adhesion.

Numerous experimental in vivo models of biofilm-related infections have been developed to identify targets for diagnostic tests, new therapeutic strategies, antimicrobial compounds and coatings. However, further investigations are need to develop reliable animal models that would more closely mimic different infections and allow evaluation of the efficacy of surgical procedures as well as systemic or local therapies.

A reliable microbiological diagnosis is pivotal for correctly identifying the causative microorganism and appropriately targeting the treatment for implant-related infections. The presence of bacterial biofilm poses a special challenge to the microbiological diagnosis, as this biological structure makes more difficult the isolation and identification of bacteria in clinical samples, and laboratory tests have been commonly developed to identify planktonic bacteria. The need for an efficient method to dislodge bacteria from biofilms has led to the introduction and implementation of mechanical (e.g. sonication) and chemical (e.g. dithiothreitol) methods. To enhance detection of implants-related infections, additional investigative methods are being explored, such as culture-independent molecular techniques.
The purpose of this Research Topic is to provide the reader with an updated and comprehensive overview of implant-related infections, encompassing (but not limited to) all of the above-described aspects. We welcome articles reviewing the current state-of-the-art and providing novel scientific knowledge in view of an improvement in the prevention, diagnosis and treatment of implant-related infections.


Keywords: Biofilm, infection, medical implants, diagnosis, treatment


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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31 May 2018 Manuscript

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Manuscripts can be submitted to this Research Topic via the following journals:

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Topic Editors

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Submission Deadlines

31 May 2018 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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