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Molecular Approaches for Studying Medical Device-Associated Biofilms: Techniques, Challenges, and Future Prospects

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Antimicrobial Coatings and Modifications on Medical Devices

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Abstract

Bacteria dwelling within medical device-associated biofilms are remarkably difficult to treat with antibiotics or antimicrobials. To better engineer and develop strategies to control these medical device-based biofilms, considerable interest has been focused on developing new types of diagnostic methods to study the architecture of, and metabolism within, such biofilms. Traditional studies of biofilm formation on medical devices have been carried out using selective plating techniques with destructive samples. However, selective plating is based on cultivation methods that may underestimate the overall extent of the population and only provides cell population measures over the spatially averaged population instead of providing an insight on the local scale of the population. Molecular-based approaches, especially coupled with other tools such as microscopy, flow cytometry, etc., have revolutionized the ability to rapidly detect, identify, and evaluate microorganisms in medical device-associated biofilms. Compared with conventional culture methods, molecular techniques not only can provide species information for bacteria present in biofilms but also help to understand the function and activities of the medical device-associated biofilms.

Examples of such molecular analysis methods include 16S rRNA gene sequencing, denaturing gradient gel electrophoresis (DGGE), terminal restriction fragment length polymorphism (T-RFLP), denaturing high-performance liquid chromatography (DHPLC), and pyrosequencing. In addition, the application of DNA probes (checkerboard DNA-DNA hybridization) or 16S rRNA probes hybridization (FISH) coupled with microscopy allows the detection and enumeration of bacterial species with the additional function of multi-parametric analysis. Other innovative methods, including flow cytometry (FCM), fluorescence-activated cell sorting (FACS), and imaging flow cytometry (IFCM), have also paved the way for new possibilities in biofilm research through gaining a wide range of data on specific proteins related to biofilm function and biochemical measurement. Further, the combination of molecular-based techniques with immunological approaches creates new possibilities in medical device-associated biofilm research through understanding the function and activities of taxa present in the biofilms, rather than just recognizing microbes. However, these approaches are not perfect as they still possess some weaknesses, including high cost, time-consuming nature, lower specificity, potential for artificial results, and high requirements for user expertise in instrument operation and sample processing, etc. Despite many big challenges ahead, molecular-based techniques for the analysis of medical device-associated biofilms are likely to become more important in determining taxa present in biofilms as well as help to understand the function and pathogenicity of microbial populations within biofilms. The combined usage of molecular-based experimental approaches with other methods, such as immunological analysis and microscopy, will further broaden its applications in clinically relevant diagnosis and treatment of biofilm infections associated with medical devices.

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  1. College of Chemical Engineering and Materials Science, Tianjin University of Science and Technology, Tianjin, China

    Hongyan Ma

  2. NAMSA, Berlin, Germany

    Kristy N. Katzenmeyer-Pleuss

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    Zheng Zhang

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    Victoria E. Wagner

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Ma, H., Katzenmeyer-Pleuss, K.N. (2017). Molecular Approaches for Studying Medical Device-Associated Biofilms: Techniques, Challenges, and Future Prospects. In: Zhang, Z., Wagner, V. (eds) Antimicrobial Coatings and Modifications on Medical Devices. Springer, Cham. https://doi.org/10.1007/978-3-319-57494-3_4

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