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. 2021 Mar 11;11:5746. doi: 10.1038/s41598-021-84826-1

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© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Ex vivo model to simulate pathogenesis of indwelling device-associated infection. (A) Proposed route by which bacterial cells penetrate the skin-device interface from superficial to deep tissue. (B) Schematic of ex vivo model. Bacterial cells inoculated on distal side of skin-device interface migrate to proximal side. Migration was monitored by fluorescence microscopy, confocal microscopy, and IVIS bioluminescence. Different interventions are evaluated to determine the comparative time of microbial translocation. (C) Photographic images of ex vivo model. Left: Initial inoculation of E. coli RP437/pRSH103. Right: E. coli RP437/pRSH103 biofilm on distal and proximal sides of agar 96 h post-inoculation (D) Photographic images from of ex vivo model using 3D-printed molds. Left: Initial inoculation of E. coli Xen14. Right: E. coli Xen14 96 h post-inoculation (areas of growth roughly outlined in dotted red line for clarity). (E) Schematic showing three scenarios studied in this work: bacterial interactions with tissue-control catheter interface, tissue-non-eluting catheter interface, and tissue-eluting catheter interface.