Infections associees aux implants orthopediques Infections associated with orthopedic implanted devices

摘要

Objectives. - Description of problems related to biomaterials such as biomaterial-related infection. Joint replacements constitute the second most common cause of implant failure, with serious consequences. Infections. - Chronically infected replacements cannot be treated without removal of the implant, as the biof?lm mode of growth protects the bacteria against antibiotics. Several clinical and experimental factors have shown that antibiotics are more effective when given prophy- lactically than after implant-related infections are established. Impaired host defenses mecha- nisms negatively impact on antibiotic diffusion and penetration. Biofilms and bacteria. — Alterations and metabolic properties of microbial organisms colonizing implants also contribute to their decreased susceptibility to bactericidal antibiotics. Although prolonged antibiotic exposure and prosthesis extraction are successful in eradicating the infection, recovery is suboptimal and often leaves patients with long-term functionnal impair- ment. New therapeutic strategies. - Not any new antimicrobial has been developped to target bacterial biofilm, but new developments in prevention of these infections are described and there is a need to modification and improvement of biomaterials or new targeting drugs.