Background

The management of implanted medical devices infections is turning more and more to an international challenge, in the communities as well as hospitals. Microorganisms involved in these infections are usually not only virulent, but also multi-resistant. Furthermore, the isolation of metabolic variants known as small colony variants (SCVs) have been frequently associated with persistent and relapsing infections, such as OM or prosthetic joint infections (PJI), the clinical causes of these recurrent infections are diagnostic and therapeutic failures. At least three aspects characterize the microbiology of these infections: (i) the isolation of a wide range of pathogens; (ii) production of biofilm, and (iii) low predictivity by traditional microbiological diagnostics.
The risk of DAI is continuously increasing due to an increasing number of implanted medical devices. Each class of device requires a separate therapy scheme and the management of infections relies on a basic understanding of the pathogenesis and the microbial population.

The following Challenges have been identified (selected)

• in use of a standardized murine subcutaneous biomaterial associated infection model to serve as a standard model for testing across all delivery platforms;
• early identification of DAI with improved diagnostics tools;
• investigation of possible genetic predispositions for increased risk of DAI;
• development of standard guides for treating DAI in various classes of devices and patient co-morbidities/predispositions;
• diagnosis of DAI by sonication and Real Time-PCR;
• Antimicrobial Susceptibility Testing (AST) of biofilm producing organisms;
• management and treatment for PJIs by "Microbiological Case Report Form" (CRF).