Biofilm Formation on Indwelling Medical Devices: A Review of Health and Economic Implications.

Indwelling medical devices represent an impressive stride in modern surgical practice and are widely used in procedures that support the body's natural physiological functions. The global demand for these devices has surged, primarily driven by a range of clinical and demographic factors. However, their widespread use also carries risks, as foreign devices can introduce pathogens into the body during surgery and implantation. Shortly after implantation, host-derived conditioning films rapidly coat the device surface, creating a foundation for bacterial attachment and subsequent biofilm formation. Biofilms are complex communities of microbial cells embedded within extracellular polysaccharide matrices on device surfaces. Bacteria within biofilms exhibit high resistance to antibiotics and host immune defenses, posing significant challenges for detection and diagnosis, largely due to the protective structural barrier and associated physiological changes. Biofilm-associated device infections are persistent, chronic, and difficult to treat, often leading to treatment failure and recurrent infections. Recurring device-related infections and repeated surgical interventions impose severe pain and substantial financial burdens on patients. Moreover, biofilms can induce device "corrosion," compromising biocompatibility with surrounding tissues and shortening implant lifespan. Overall, bacterial attachment and biofilm formation on medical devices are notorious problems, causing device-associated infections, device malfunction, and significant economic losses. Therefore, this review is aimed at providing an overview of biofilm formation on indwelling medical devices and its implications on health and economy.