A Narrative Review of Experimental Assessment to Study Vascular Biomaterials Infections and Infectability

Mathilde Puges; Fatima M'Zali; Sabine Pereyre; Cécile Bébéar; Charles Cazanave; Xavier Bérard

doi:10.1016/j.ejvsvf.2023.05.002

A Narrative Review of Experimental Assessment to Study Vascular Biomaterials Infections and Infectability

EJVES Vasc Forum. 2023 May 12:59:49-55. doi: 10.1016/j.ejvsvf.2023.05.002. eCollection 2023.

Authors

Mathilde Puges¹, Fatima M'Zali², Sabine Pereyre^{3

4}, Cécile Bébéar^{3

4}, Charles Cazanave^{1

3}, Xavier Bérard⁵

Affiliations

¹ Department of Infectious and Tropical Diseases, CHU de Bordeaux, Bordeaux, France.
² Aquitaine Microbiologie, UMR 5234 CNRS, University of Bordeaux, Bordeaux, France.
³ Mycoplasma and Chlamydia Human Infections, University of Bordeaux, USC EA 3671, Bordeaux, France.
⁴ Department of Bacteriology, CHU de Bordeaux, Bordeaux, France.
⁵ Department of Vascular Surgery, CHU de Bordeaux, Bordeaux, France.

Abstract

Objective: Many experimental studies have been conducted to evaluate vascular and endovascular graft infections (VGEIs) and infectability in order to elaborate strategies to prevent or to treat their occurrence. A systematic literature search was conducted to collect and summarise key features of infection and infectability assessment techniques in VGEI experimental models.

Methods: The literature search was conducted using the Medline and Cochrane databases, with no limit on the date of publication, until 10 August 2021. Ex vivo, in vitro, and in vivo animal studies on VGEIs, published in English or French, were selected. Cross references retrieved from selected articles on PubMed database were also included in the search. Data were collected on the techniques and the protocols performed for vascular graft infection and infectability assessment.

Results: A total of 243 studies were included in the review: 55 in vitro studies, 169 animal studies, 17 combining the two models, and two ex vivo studies. Many experimental techniques were performed, with a lot of protocol discrepancies. The main experiments conducted were bacterial culture, with (n = 82 studies) or without sonication (n = 120), histopathology (n = 69), scanning electron microscopy (n = 36), and graft diffusion tests (n = 28). These techniques were used to answer different research questions corresponding to different graft infection steps, such as microbial adhesion and/or viability, biofilm biomass or organisation, human cell reaction, or antimicrobial activity.

Conclusion: Many experimental tools are available to study VGEIs, but to improve their reproducibility and scientific reliability research protocols must be standardised and include sonication of grafts before microbiological culture. Moreover, the key role of the biofilm in VGEI physiopathology must be taken into account in future studies.

Keywords: Biofilm; Infectability; Review; Vascular biomaterials; Vascular graft and endograft infections.

Publication types

Review