Immune Responses to Indwelling Medical Devices

Abstract

Implanted medical devices have offered clinical hope to patients who either have critical illnesses or have more chronic problems such as joint destruction. No doubt, these devices have saved many lives and improved the quality of life of hundreds of thousands of people. Indeed, the use of indwelling devices has reached epic proportions in human medicine over the last three decades. One of the unintended consequences has been an accompanying rise in the infection rate in patients, which is directly related to the presence of these devices in humans. This is problematic because the devices are colonized by communities of microorganisms, termed biofilms, that are highly resistant to antimicrobial challenge and to destruction from the human host and its defenses. Over the past decade, there has been much progress on understanding how and why these communities are less susceptible to antimicrobial agents. However, many questions regarding the resistance of these communities to human host defenses are still unanswered. This chapter discusses the current knowledge of how the human immune system responds not only to the presence of indwelling medical devices, but also to the communities that colonize them.