Infection-free medical devices would saves lives!

An often overlooked consequence of an ageing population is an increase of health care associated infections (HCAI). Such infections do not only result in a reduced quality of life for the individual as well as their relatives. Furthermore, it also puts stress on the health care system and contributes to the development of antibiotic resistance. In Europe the direct costs for these infections are estimated, by WHO, to €7 billion annually. A large portion of these infection relate to microbial colonization of different types of medical devices. Today, most research and development aiming to reduce the infection rate for medical devices are not managing to bring efficient solutions to this global problem to the market and the level of interdisciplinary work is not sufficient built into current research projects to effectively target this problem. Thus, most solutions that appear today cannot survive the test of complex real-life contexts.

In order to achieve real breakthrough in this area it is of essential importance that the interdisciplinary of the research is dramatically increased. We need research that actively involved both, clinicians, industry, materials scientists, materials design and product design, physicists, chemists and pharmacists, molecular biologists, researchers working on animal testing and clinical testing etc throughout the research, from its starting point to the finished product. Furthermore, we need to better incorporate these different parts into the same research problems and research questions. Only then will we be able to reach the goal of bringing an end to the highly complex and demanding problem of infection of medical devices.

We need medical devices that have an improved product design better working with the body’s own defence systems, that can locally prevent, treat and/or abolish microbial infection in a way that does not harm the body or our environment, that have the materials properties needed to function in a robust way for long periods of time and in clinical settings, they need to be comfortable for the patient to have, they also need to be possible to manufacture and produce in a sustainable way. We need to improve the way we monitor and test materials for their biological function so that the lab tests (in vitro and ex vivo testing) accurately and reliably predicts what later can be seen in animal models and clinical trials.

In order to succeed on all these fronts, a high and fully integrated level of interdisciplinary research is required, with scientists from all sectors of our society including academia, hospitals, and industry. These types of research consortia are lacking today. However, this could be achieved by stimulating the European research area with research funding in this area. The European Union has already funded a trans-domain collaboration in science and technology action in this research area (COST Action TD 1305 – ipromedai, improved protection of medical devices against infection) that has, since its launch two years ago, started the work to construct a network of required actors for this combined research. However in order to launch this work on a full scale and carry out research in this highly international and interdisciplinary area research funding is needed. Today this funding is completely lacking meaning that although there are good teams available they cannot fund these types of highly interdisciplinary, large and long term research endeavours. National funding and bilateral funding cannot accomplish to fund these kinds of consortia as they most often only fund researchers in the home country for very short periods of time. To fully attack the complexity of the problem with infection of medical devices it would be highly beneficial that researchers and industry from nations with different types of health care systems are involved. A multi-national research consortium would be able to take into account the variability of infections across a large geographical area and come up with solutions that can be implemented globally, helping to solve the large problem of device-related infection and at the same time giving European industries an edge for the global market.

Infection-free medical devices would benefit all levels of the European society, it would reduce suffering for patients in hospital, facilitate health care procedures, reduce the cost for society both within the health care systems as well as the cost from loss of work for patients and their family or care takers. We have today most pieces of the puzzle but currently there is no way to bring them together to produce well-functioning infection-free medical devices. This is why funding in this area is desperately needed.