The Approaching Zero Roadmap Initiative is an interdisciplinary effort led by Stevens Institute of Technology, Syracuse University, and Binghamton University to develop a convergent perspective of medical-device-associated infection and identify an impactful set of steps which can be pursued to create a trajectory that increasingly pushes its rate of occurrence towards zero over the coming decade and beyond.
Key stakeholders discuss the landscape of implant infection during the 2019 Bacteria-Material Interactions Conference.
Implant infection has emerged as a compelling cause of failure associated with tissue-contacting biomedical devices. All such devices are susceptible to infection. Among them are: hip and knee prostheses; heart valves; pacemakers; cochlear implants; shunts; surgical mesh; sutures; as well as next-generation tissue-engineering constructs; among many others.
Implant infections are caused when microbes colonize a device surface and develop into a biofilm. Because biofilms are highly resistant to antibiotics, implant infections are extremely difficult to eliminate. They are often resolved only by removing the device, eliminating the remaining tissue-based infection, and then re-implanting a new device as part of one or more subsequent revision surgeries. The consequences can be significant. In the case of a prosthetic joint infection, for example, the revision process can take many months and many tens of thousands of dollars, and the complications can spiral into compromised life styles and, in some cases, death.
The CDC estimates that the annual cost of healthcare-acquired infections - the great majority of which involve some form of tissue-contacting device - is approximately $30-$40B in the United States alone.
The Approaching Zero Roadmap Initiative
The Approaching Zero Roadmap Initiative, led by Syracuse University (Dacheng Ren), Binghamton University (Karin Sauer), and Stevens Institute of Technology (Matt Libera), aims to develop a convergent perspective of medical-device-associated infection and identify an impactful set of steps which can be pursued to create a trajectory that increasingly pushes its rate of occurrence towards zero over the coming decade and beyond
This roadmap initiative is assembling a diverse array of stakeholders with different perspectives, challenges, technical language, and operational constraints to determine how to:
Prevent device infection from occurring: This thrust includes near-term challenges associated with the development and deployment of next-generation infection-resisting materials and devices.
Detect an infected device: This thrust includes the identification of novel biomarkers coupled with new imaging and spectroscopic platforms aimed to inform clinical diagnostics.d infection and new methods to resolve device colonization by antibiotic-resistant biofilms.
Cure the device-infection problem altogether: This far-reaching thrust includes advanced concepts associated with biofilm science, the immune response, and personalized medicine.
This initiative is partially supported by the award of an Engineering Research Center (ERC) planning grant.