Interactions between the foreign body reaction and Staphylococcus aureus biomaterial-associated infection: Winning strategies in the derby on biomaterial implant surfaces

Colin W K Rosman, Jan Maarten van Dijl, Jelmer Sjollema*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)
136 Downloads (Pure)

Abstract

Biomaterial-associated infections (BAIs) are an increasing problem where antibiotic therapies are often ineffective. The design of novel strategies to prevent or combat infection requires a better understanding of how an implanted foreign body prevents the immune system from eradicating surface-colonizing pathogens. The objective of this review is to chart factors resulting in sub-optimal clearance of Staphylococcus aureus bacteria involved in BAIs. To this end, we first describe three categories of bacterial mechanisms to counter the host immune system around foreign bodies: direct interaction with host cells, modulation of intercellular communication, and evasion of the immune system. These mechanisms take place in a time frame that differentiates sterile foreign body reactions, BAIs, and soft tissue infections. In addition, we identify experimental interventions in S. aureus BAI that may impact infectious mechanisms. Most experimental treatments modulate the host response to infection or alter the course of BAI through implant surface modulation. In conclusion, the first week after implantation and infection is crucial for the establishment of an S. aureus biofilm that resists the local immune reaction and antibiotic treatment. Although established and chronic S. aureus BAI is still treatable and manageable, the focus of interventions should lie on this first period.

Original languageEnglish
Pages (from-to)624-640
Number of pages17
JournalCritical Reviews in Microbiology
Volume48
Issue number5
Early online date6-Dec-2021
DOIs
Publication statusPublished - 2022

Keywords

  • Staphylococcus aureus
  • foreign body reaction
  • biofilm
  • biomaterial-associated infection
  • PERIPROSTHETIC JOINT INFECTION
  • FIBRONECTIN-BINDING PROTEINS
  • IMMUNE-RESPONSE
  • UNITED-STATES
  • KNEE ARTHROPLASTY
  • SUPPRESSOR-CELLS
  • HOST RESPONSE
  • MOUSE MODEL
  • S. AUREUS
  • BIOFILMS

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