PDF(Pubmed)
Abstract：
Penile prosthesis implantation is an effective treatment for erectile dysfunction (ED) with high patient satisfaction and effectiveness. Unfortunately, infections remain a dreaded complication, often necessitating device removal and imposing a substantial healthcare cost. Biofilms are communities of microorganisms encased in a self-produced polymeric matrix that can attach to penile prostheses. Biofilms have been demonstrated on the majority of explanted prostheses for both infectious and non-infectious revisions and are prevalent even in asymptomatic patients. Biofilms play a role in microbial persistence and exhibit unique antibiotic resistance strategies that can lead to increased infection rates in revision surgery. Biofilms demonstrate physical barriers through the development of an extracellular polymeric substance (EPS) that hinders antibiotic penetrance and the bacteria within biofilms demonstrate reduced metabolic activity that weakens the efficacy of traditional antibiotics. Despite these challenges, new methods are being developed and investigated to prevent and treat biofilms. These treatments include surface modifications, biosurfactants, tissue plasminogen activator (tPA), and nitric oxide (NO) to prevent bacterial adhesion and biofilm formation. Additionally, novel antibiotic treatments are currently under investigation and include antimicrobial peptides (AMPs), bacteriophages, and refillable antibiotic coatings. This article reviews biofilm formation, the challenges that biofilms present to conventional antibiotics, current treatments, and experimental approaches for biofilm prevention and treatment.
摘要：
阴茎假体植入是治疗勃起功能障碍（ED）的有效方法，患者满意度和有效性高。不幸的是,感染仍然是一个可怕的并发症，通常需要移除设备并带来可观的医疗保健成本。生物膜是包裹在自身产生的聚合物基质中的微生物群落，可以附着在阴茎假体上。对于感染性和非感染性修正，生物膜已在大多数外植假体上得到证实，即使在无症状患者中也很普遍。生物膜在微生物持久性中起作用，并表现出独特的抗生素抗性策略，可导致翻修手术中感染率增加。生物膜通过发展阻碍抗生素外显的胞外聚合物(EPS)而表现出物理障碍,并且生物膜内的细菌表现出降低的代谢活性,这削弱了传统抗生素的功效。尽管面临这些挑战,正在开发和研究预防和治疗生物膜的新方法。这些处理包括表面改性，生物表面活性剂,组织纤溶酶原激活剂（tPA），和一氧化氮（NO）以防止细菌粘附和生物膜形成。此外,目前正在研究新的抗生素治疗方法，包括抗菌肽（AMPs），噬菌体,和可再填充的抗生素涂层。本文综述了生物膜的形成,生物膜对传统抗生素的挑战，目前的治疗方法，以及生物膜预防和治疗的实验方法。
