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Sandell M, Ericsson A, Al-Saadi J, Södervall B, Södergren E, Grass S, Sanchez J, Holmin S. A novel noble metal stent coating reduces in vitro platelet activation and acute in vivo thrombosis formation: a blinded study. Sci Rep 2023; 13:17225. [PMID: 37821529 PMCID: PMC10567768 DOI: 10.1038/s41598-023-44364-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023] Open
Abstract
Inherent to any stenting procedure is the prescription of dual antiplatelet therapy (DAPT) to reduce the platelet response. Clinical guidelines recommend 6-12 months of DAPT, depending on stent type, clinical picture and patient factors. Our hypothesis is that a nanostructured noble metal coating has the potential to reduce protein deposition and platelet activation. These effects would reduce subsequent thrombo-inflammatory reactions, potentially mitigating the need for an extensive DAPT in the acute phase. Here, a noble metal nanostructure coating on stents is investigated. Twelve pigs underwent endovascular implantation of coated and non-coated stents for paired comparisons in a blinded study design. The non-coated control stent was placed at the contralateral corresponding artery. Volumetric analysis of angiographic data, performed by a treatment blinded assessor, demonstrated a significant thrombus reduction for one of the coatings compared to control. This effect was already seen one hour after implantation. This finding was supported by in vitro data showing a significant reduction of coagulation activation in the coated group. This novel coating shows promise as an implant material addition and could potentially decrease the need for DAPT in the early phases of stent implementation.
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Affiliation(s)
- Mikael Sandell
- Division of Micro and Nanosystems, KTH Royal Institute of Technology, Malvinas väg 10, 114 28, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- MedTechLabs, Stockholm, Sweden
| | - Anna Ericsson
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Jonathan Al-Saadi
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Billy Södervall
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Erika Södergren
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Stefan Grass
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Javier Sanchez
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
- Department of Clinical Sciences, Danderyd Hospital, 182 88, Stockholm, Sweden
| | - Staffan Holmin
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
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2
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Malhotra A, Chauhan SR, Rahaman M, Tripathi R, Khanuja M, Chauhan A. Phyto-assisted synthesis of zinc oxide nanoparticles for developing antibiofilm surface coatings on central venous catheters. Front Chem 2023; 11:1138333. [PMID: 37035110 PMCID: PMC10076889 DOI: 10.3389/fchem.2023.1138333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
Medical devices such as Central Venous Catheters (CVCs), are routinely used in intensive and critical care settings. In the present scenario, incidences of Catheter-Related Blood Stream Infections (CRBSIs) pose a serious challenge. Despite considerable advancements in the antimicrobial therapy and material design of CVCs, clinicians continue to struggle with infection-related complications. These complications are often due colonization of bacteria on the surface of the medical devices, termed as biofilms, leading to infections. Biofilm formation is recognized as a critical virulence trait rendering infections chronic and difficult to treat even with 1,000x, the minimum inhibitory concentration (MIC) of antibiotics. Therefore, non-antibiotic-based solutions that prevent bacterial adhesion on medical devices are warranted. In our study, we report a novel and simple method to synthesize zinc oxide (ZnO) nanoparticles using ethanolic plant extracts of Eupatorium odoratum. We investigated its physio-chemical characteristics using Field Emission- Scanning Electron Microscopy and Energy dispersive X-Ray analysis, X-Ray Diffraction (XRD), Photoluminescence Spectroscopy, UV-Visible and Diffuse Reflectance spectroscopy, and Dynamic Light Scattering characterization methods. Hexagonal phase with wurtzite structure was confirmed using XRD with particle size of ∼50 nm. ZnO nanoparticles showed a band gap 3.25 eV. Photoluminescence spectra showed prominent peak corresponding to defects formed in the synthesized ZnO nanoparticles. Clinically relevant bacterial strains, viz., Proteus aeruginosa PAO1, Escherichia coli MTCC 119 and Staphylococcus aureus MTCC 7443 were treated with different concentrations of ZnO NPs. A concentration dependent increase in killing efficacy was observed with 99.99% killing at 500 μg/mL. Further, we coated the commercial CVCs using green synthesized ZnO NPs and evaluated it is in vitro antibiofilm efficacy using previously optimized in situ continuous flow model. The hydrophilic functionalized interface of CVC prevents biofilm formation by P. aeruginosa, E. coli and S. aureus. Based on our findings, we propose ZnO nanoparticles as a promising non-antibiotic-based preventive solutions to reduce the risk of central venous catheter-associated infections.
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Affiliation(s)
- Akshit Malhotra
- Department of Microbiology, Tripura University, Suryamaninagar, Tripura, India
- Invisiobiome, New Delhi, India
| | - Suchitra Rajput Chauhan
- Centre for Advanced Materials and Devices (CAMD), School of Engineering and Technology, BML Munjal University, Gurgaon, Haryana, India
| | - Mispaur Rahaman
- Central Instrumentation Centre, Tripura University, Suryamaninagar, Tripura, India
| | - Ritika Tripathi
- Centre for Advanced Materials and Devices (CAMD), School of Engineering and Technology, BML Munjal University, Gurgaon, Haryana, India
| | - Manika Khanuja
- Centre for Nanoscience and Nanotechnology, Jamia Millia Islamia, New Delhi, India
| | - Ashwini Chauhan
- Department of Microbiology, Tripura University, Suryamaninagar, Tripura, India
- *Correspondence: Ashwini Chauhan,
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3
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Caldara M, Belgiovine C, Secchi E, Rusconi R. Environmental, Microbiological, and Immunological Features of Bacterial Biofilms Associated with Implanted Medical Devices. Clin Microbiol Rev 2022; 35:e0022120. [PMID: 35044203 PMCID: PMC8768833 DOI: 10.1128/cmr.00221-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The spread of biofilms on medical implants represents one of the principal triggers of persistent and chronic infections in clinical settings, and it has been the subject of many studies in the past few years, with most of them focused on prosthetic joint infections. We review here recent works on biofilm formation and microbial colonization on a large variety of indwelling devices, ranging from heart valves and pacemakers to urological and breast implants and from biliary stents and endoscopic tubes to contact lenses and neurosurgical implants. We focus on bacterial abundance and distribution across different devices and body sites and on the role of environmental features, such as the presence of fluid flow and properties of the implant surface, as well as on the interplay between bacterial colonization and the response of the human immune system.
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Affiliation(s)
- Marina Caldara
- Interdepartmental Center on Safety, Technologies, and Agri-food Innovation (SITEIA.PARMA), University of Parma, Parma, Italy
| | - Cristina Belgiovine
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Scuola di Specializzazione in Microbiologia e Virologia, Università degli Studi di Pavia, Pavia, Italy
| | - Eleonora Secchi
- Institute of Environmental Engineering, ETH Zürich, Zürich, Switzerland
| | - Roberto Rusconi
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele–Milan, Italy
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4
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Stærk K, Grønnemose RB, Palarasah Y, Kolmos HJ, Lund L, Alm M, Thomsen P, Andersen TE. A Novel Device-Integrated Drug Delivery System for Local Inhibition of Urinary Tract Infection. Front Microbiol 2021; 12:685698. [PMID: 34248906 PMCID: PMC8267894 DOI: 10.3389/fmicb.2021.685698] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Catheter-associated urinary tract infection (CAUTI) is a frequent community-acquired infection and the most common nosocomial infection. Here, we developed a novel antimicrobial catheter concept that utilizes a silicone-based interpenetrating polymer network (IPN) as balloon material to facilitate a topical slow-release prophylaxis of antibacterial agents across the balloon to the urinary bladder. Methods: The balloon material was achieved by modifying low shore hardness silicone tubes with a hydrogel interpenetrating polymer in supercritical CO2 using the sequential method. Release properties and antibacterial efficacy of the IPN balloon treatment concept was investigated in vitro and in a porcine CAUTI model developed for the study. In the latter, Bactiguard Infection Protection (BIP) Foley catheters were also assessed to enable benchmark with the traditional antimicrobial coating principle. Results: Uropathogenic Escherichia coli was undetectable in urinary bladders and on retrieved catheters in the IPN treatment group as compared to control that revealed significant bacteriuria (>105 colony forming units/ml) as well as catheter-associated biofilm. The BIP catheters failed to prevent E. coli colonization of the bladder but significantly reduced catheter biofilm formation compared to the control. Conclusion: The IPN-catheter concept provides a novel, promising delivery route for local treatment in the urinary tract.
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Affiliation(s)
- Kristian Stærk
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Rasmus Birkholm Grønnemose
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Yaseelan Palarasah
- Department of Cancer and Inflammation Research, University of Southern Denmark, Odense, Denmark
| | - Hans Jørn Kolmos
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Lars Lund
- Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Thomas Emil Andersen
- Research Unit of Clinical Microbiology, University of Southern Denmark and Odense University Hospital, Odense, Denmark
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5
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Koskinen K, Penttinen R, Örmälä-Odegrip AM, Giske CG, Ketola T, Jalasvuori M. Systematic Comparison of Epidemic and Non-Epidemic Carbapenem Resistant Klebsiella pneumoniae Strains. Front Cell Infect Microbiol 2021; 11:599924. [PMID: 33708644 PMCID: PMC7940544 DOI: 10.3389/fcimb.2021.599924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Over the past few decades, extensively drug resistant (XDR) resistant Klebsiella pneumoniae has become a notable burden to healthcare all over the world. Especially carbapenemase-producing strains are problematic due to their capability to withstand even last resort antibiotics. Some sequence types (STs) of K. pneumoniae are significantly more prevalent in hospital settings in comparison to other equally resistant strains. This provokes the question whether or not there are phenotypic characteristics that may render certain K. pneumoniae more suitable for epidemic dispersal between patients, hospitals, and different environments. In this study, we selected seven epidemic and non-epidemic carbapenem resistant K. pneumoniae isolates for extensive systematic characterization for phenotypic and genotypic qualities in order to identify potential factors that precede or emerge from epidemic successfulness. Studied characteristics include growth rates and densities in different conditions (media, temperature, pH, resource levels), tolerance to alcohol and drought, inhibition between strains, ability to compensate pH, as well as various genomic features. Overall, there are clear differences between isolates, yet, only drought tolerance was found to notably associate with non-epidemic K. pneumoniae strains. We further report a preliminary study on the potential to control K. pneumoniae ST11 with an antimicrobial component produced by a non-epidemic K. pneumoniae. This component initially restricts bacterial growth, but stable resistance develops rapidly in vitro.
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Affiliation(s)
- Katariina Koskinen
- Department of Biological and Environmental Science, Nanoscience Center, University of Jyväskylä, Jyväskylä, Finland
| | | | - Anni-Maria Örmälä-Odegrip
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian G Giske
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Tarmo Ketola
- Department of Biological and Environmental Science, Nanoscience Center, University of Jyväskylä, Jyväskylä, Finland
| | - Matti Jalasvuori
- Department of Biological and Environmental Science, Nanoscience Center, University of Jyväskylä, Jyväskylä, Finland
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6
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Rocca DM, Aiassa V, Zoppi A, Silvero Compagnucci J, Becerra MC. Nanostructured Gold Coating for Prevention of Biofilm Development in Medical Devices. J Endourol 2020; 34:345-351. [PMID: 31842619 DOI: 10.1089/end.2019.0686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Bacterial biofilms on medical devices (MDs) can cause deadly infections due to their resistance to antibiotics. Technology to prevent this kind of complication is urgently needed because they impact not only patients' lives but also hospital budgets. In this article, the creation and testing of an easy-to-produce antibiofilm (more precisely antibiofouling) coating are described for the first time. This coating can be applied to catheters, prostheses, and other plastic pieces, even after they have been manufactured. Rapid and ecofriendly synthesis of nanostructured gold coating was done in situ in just 15 minutes. Complete characterization and microbiological analysis of its antibiofouling capacity are presented. The coating prevents biofilm formation of pathogenic clinical isolates and ATCC strains on MDs, possibly due to its complex nanostructured gold surface. If the next generation of MDs is coated with this kind of antibiofouling technology, biofilm-related infections could be dramatically reduced. Graphical Abstract [Figure: see text].
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Affiliation(s)
- Diamela M Rocca
- Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Virginia Aiassa
- Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.,Unidad de Investigación y Desarrollo en Tecnología Farmacéutica - UNITEFA, CONICET, Córdoba, Argentina
| | - Ariana Zoppi
- Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.,Unidad de Investigación y Desarrollo en Tecnología Farmacéutica - UNITEFA, CONICET, Córdoba, Argentina
| | - Jazmin Silvero Compagnucci
- Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto Multidisciplinario de Biología Vegetal - IMBIV, CONICET, Córdoba, Argentina
| | - M Cecilia Becerra
- Departamento de Ciencias Farmacéuticas, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto Multidisciplinario de Biología Vegetal - IMBIV, CONICET, Córdoba, Argentina
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7
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KESMEZ Ö. Preparation of anti-bacterial biocomposite nanofibers fabricated by electrospinning method. JOURNAL OF THE TURKISH CHEMICAL SOCIETY, SECTION A: CHEMISTRY 2019. [DOI: 10.18596/jotcsa.590621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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8
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Björling G, Johansson D, Bergström L, Strekalovsky A, Sanchez J, Frostell C, Kalman S. Evaluation of central venous catheters coated with a noble metal alloy-A randomized clinical pilot study of coating durability, performance and tolerability. J Biomed Mater Res B Appl Biomater 2017; 106:2337-2344. [PMID: 29106034 PMCID: PMC6175140 DOI: 10.1002/jbm.b.34041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/08/2017] [Accepted: 10/16/2017] [Indexed: 11/07/2022]
Abstract
The use of Central Venous Catheters (CVCs) commonly results in complications. Coatings with silver or metal alloys can reduce the risk associated with the use of CVC. We have evaluated the durability of a noble metal coated CVC (the Bactiguard Infectious Protection, BIP CVC) and compared with an uncoated CVC for clinical tolerability (Adverse Events, AEs) and performance, in order to create a baseline for a large future study. Patients undergoing major surgery, randomised at a 2:1 ratio to BIP CVC (n = 22) or standard CVC (n = 12), were catheterized 9 ‐ 12 days, respectively. Adverse events, microbial colonization and metal release were measured. Findings: There were no AEs in the BIP CVC‐group, but 5 AEs occurred in 4 patients (1 patient had 2 AEs) in the standard CVC‐group, p = 0.011 (whereof 3 were catheter related). The BIP CVC showed an initial release of coating metals in blood (gold, silver and palladium), which rapidly decreased and were far below Permitted Paily Exposure (PDE) for chronical use. The levels of silver concentration were far below those needed to develop microbial resistance. The performance was equal, and there was no difference concerning microbial colonization, for the two CVCs. Conclusion: In this pilot study the BIP CVC had significantly lower AEs and showed a comparable performance to the standard CVC. The coating was durable throughout the study length (up to 16 days) and toxicological evaluation showed good safety margins. Larger studies are needed. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2337–2344, 2018.
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Affiliation(s)
- Gunilla Björling
- The Swedish Red Cross University College, Stockholm, Sweden.,Danderyd Hospital, Division of Anaesthesia and Intensive Care, Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Anton Strekalovsky
- Department Anesthesia and Intensive Care, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Javier Sanchez
- Danderyd Hospital, Division of Anaesthesia and Intensive Care, Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.,Bactiguard® AB, Stockholm, Sweden, Sweden
| | - Claes Frostell
- Danderyd Hospital, Division of Anaesthesia and Intensive Care, Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Sigridur Kalman
- Department Anesthesia and Intensive Care, Karolinska University Hospital Huddinge, Stockholm, Sweden.,CLINTEC, Karolinska Institutet, Stockholm, Sweden
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