Biofilm-associated infections of hemodialysis catheters
Summary:
Hemodialysis catheter-related bloodstream infections (CRBSIs), primarily driven by microbial colonization and biofilm formation, represent a major cause of morbidity and mortality in patients with end-stage renal disease. Key pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa employ sophisticated virulence mechanisms, including microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) and quorum-sensing (QS) systems, to establish resilient biofilms. Surface modification technologies-encompassing antibacterial coatings, antithrombotic modifications, antibiofilm technologies, surface topological optimization, and tip design innovations-offer promising “anti-colonization” strategies to prevent infections. Notably, while tunneled and non-tunneled catheters exhibit distinct biofilm dynamics and clinical risk profiles, emerging multifunctional coatings demonstrate the potential for enhancing long-term catheter safety and performance. However, the clinical translation of these innovations requires overcoming challenges related to biocompatibility, long-term durability, and scalable manufacturing, necessitating interdisciplinary collaboration.
Reference:
Zhou Q-Q, Wan Y. Mechanisms of microbial colonization in biofilm-associated infections of hemodialysis catheters and advances in surface modification technologies. Clin Microbiol Rev. 2026 Jan 23:e0028325. doi: 10.1128/cmr.00283-25. Epub ahead of print. PMID: 41575222.