Bacterial adherence to silver nitrate coated poly-L-lactic acid urological stents in vitro

Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

In Europe, the mean incidence of urinary tract infections in intensive care units is 1.1 per 1000 patient-days. Of these cases, catheter-associated urinary tract infections (CAUTI) account for 98%. In total, CAUTI in hospitals is estimated to give additional health-care costs of £1-2.5 billion in the United Kingdom alone. This is in sharp contrast to the low cost of urinary catheters and emphasizes the need for innovative products that reduce the incidence rate of CAUTI. Ureteral stents and other urinary-tract devices suffer similar problems. Antimicrobial strategies are being developed, however, the evaluation of their efficacy is very challenging. This review aims to provide considerations and recommendations covering all relevant aspects of antimicrobial material testing, including surface characterization, biocompatibility, cytotoxicity, in vitro and in vivo tests, microbial strain selection, and hydrodynamic conditions, all in the perspective of complying to the complex pathology of device-associated urinary tract infection. The recommendations should be on the basis of standard assays to be developed which would enable comparisons of results obtained in different research labs both in industry and in academia, as well as provide industry and academia with tools to assess the antimicrobial properties for urinary tract devices in a reliable way.

Complex poly(lactic acid)-based biomaterial for urinary catheters: II. Biocompatibility

The present paper is focused on the surface and bulk characterization of poly(lactic acid) (PLA)-based composites that contain hydrolyzed collagen as a biological polymer, silver nanoparticles and vitamin E and epoxidized soybean oil as a plasticizer. The bionanocomposites were obtained by melt processing and evaluated for structural and surface characteristics, biocompatibility, functional properties such as antimicrobial and antioxidant activity and hydrolytic degradation behavior. It has been established that the optimal composition to impart functional properties to the PLA matrix is a formulation containing 15% epoxidized soybean oil, 15% hydrolyzed collagen, 5% Pluronic, 5% vitamin E and 0·3% silver nanoparticles. This bionanocomposite inhibits the growth of both Gram-positive bacteria, Escherichia coli and Salmonella typhimurium, and Gram-negative bacteria, Listeria monocytogenes, and reaches 100% radical-scavenging activity. The PLA-based biomaterials obtained in this study are stable in biological media in the short and medium terms and therefore are recommended as multifunctional biomaterials for the manufacture of medical devices, such as urinary catheters.

Silver-polysaccharide nanocomposite antimicrobial coatings for methacrylic thermosets

Bisphenol A glycidylmethacrylate (BisGMA)/triethyleneglycol dimethacrylate (TEGDMA) thermosets are receiving increasing attention as biomaterials for dental and orthopedic applications; for both these fields, bacterial adhesion to the surface of the implant represents a major issue for the outcome of the surgical procedure. Moreover, the biological behaviour of these materials is influenced by their ability to establish proper interactions between their surface and the eukaryotic cells of the surrounding tissues, which is important for good implant integration. The aim of this work was to develop an antimicrobial non-cytotoxic coating for methacrylic thermosets by means of a nanocomposite material based on a lactose-modified chitosan and antibacterial silver nanoparticles. The coating was characterized by UV-vis spectrophotometry, optical microscopy, transmission electron microscopy (TEM) and scanning electron microscopy (SEM). In vitro tests were employed for a biological characterization of the material: antimicrobial efficacy tests were carried out with both Gram+ and Gram- strains. Osteoblast-like cell-lines, primary human fibroblasts and adipose-derived stem cells, were used for LDH cytotoxicity assays and Alamar blue cell proliferation assays. Cell morphology and distribution were evaluated by SEM and confocal laser scanning microscopy. In vitro results showed that the nanocomposite coating is effective in killing both bacterial strains and that this material does not exert any significant cytotoxic effect towards tested cells, which are able to firmly attach and proliferate on the surface of the coating. Such biocompatible antimicrobial polymeric films containing silver nanoparticles may have good potential for surface modification of medical devices, especially for prosthetic applications in orthopedics and dentistry.

Bacterial adhesion, cell adhesion and biocompatibility of Nafion films

We investigated bioadhesion (bacterial and cell adhesion) and biocompatibility of poly(tetrafluoroethylene-co-perfluoro-3,6-dioxa-4-methyl-7-octenesulfonic acid) (Nafion) and compared the results with those obtained with poly(vinylidene fluoride-co-hexafluoropropylene) (PVFHFP). When incubated with bacteria for 4 h to 7 days, Nafion film exhibited scarce bacterial adhesion at 6 h, after which the adhesion gradually increasing to relatively low levels. In contrast, significant bacterial adhesion to PVFHFP film was observed at 4 h, and much higher adhesion levels were shown thereafter. Although HEp-2 human cells adhered normally to both films, reaching confluence in 7-8 days, the cells adhered to Nafion appeared more lively and stable than those to PVFHFP. Subcutaneous implantation in mice revealed that Nafion elicited a mild acute inflammatory reaction without chronic inflammation or tissue necrosis, indicating excellent biocompatibility in mice. PVFHFP, however, provoked a moderate and prolonged acute inflammatory response. These differences in the biological characteristics of Nafion and PVFHFP films may be attributable to the differences in the chemical and physical natures of these polymer films. Nafion film provided a sufficiently solid support, expressing a high surface charge density and good water-wettability. In summary, Nafion is suitable for use in biomedical applications that require biocompatibility with a reduced possibility of post-operative infections.

Multifunctional silane polymers for persistent surface derivatization and their antimicrobial properties

We demonstrate a versatile methodology combining both covalent surface anchoring and polymer cross-linking that is capable of forming long-lasting coatings on reactive and nonreactive surfaces. Polymers containing reactive methoxysilane groups form strong Si-O-Si links to oxide surfaces, thereby anchoring the polymer chains at multiple points. The interchain cross-linking of the methoxysilane groups provides additional durability to the coating and makes the coatings highly resistant to solvents. By tailoring the chemical structure of the polymer, we were able to control the surface energy (wetting) of a variety of surfaces over a wide range of water contact angles of 30-140 degrees . In addition, we synthesized covalently linked layer-by-layer polymeric assemblies from these novel methoxysilane polymers. Finally, antibacterial agents, such as silver bromide nanoparticles and triiodide ions, were introduced into these functional polymers to generate long-lasting and renewable antiseptic coatings on glass, metals, and textiles.

Comparison of bacterial adherence to polylactides, silicone, and titanium

CONCLUSIONS

Less bacterial adherence occurred on uncoated polylactide and silicone than on uncoated titanium surfaces. Albumin coating was an effective method to inhibit bacterial adherence to all these surfaces. As regards bacterial adherence, polylactides are at least as safe implant materials as silicone and titanium.

OBJECTIVES

We compared adherence of Staphylococcus aureus and Pseudomonas aeruginosa to four implant materials and studied the inhibitory effect of albumin on adherence. The aims were to discover any differences between materials and to study the effectiveness of albumin coating.

MATERIALS AND METHODS

Eight plates of polylactide A and B, silicone, and titanium were exposed to S. aureus and P. aeruginosa. Four of these plates were uncoated and four were coated with albumin. A total of 64 plates were included in the study. The bacteria were stained with acridine orange, and 10 photomicrographs of each plate allowed quantification of the surface area covered with bacteria.

RESULTS

The most adherence occurred on titanium without coating. Albumin coating of the surface significantly reduced bacterial adherence to each material. Differences between materials with albumin coating were relatively small. Of the bacteria, P. aeruginosa had the greater capacity to adhere to a surface.

Silver Bromide Nanoparticle/Polymer Composites: Dual Action Tunable Antimicrobial Materials

We present a simple method of fabricating highly potent dual action antibacterial composites consisting of a cationic polymer matrix and embedded silver bromide nanoparticles. A simple and novel technique of on-site precipitation of AgBr was used to synthesize the polymer/nanoparticle composites. The synthesized composites have potent antibacterial activity toward both gram-positive and gram-negative bacteria. The materials form good coatings on surfaces and kill both airborne and waterborne bacteria. Surfaces coated with these composites resist biofilm formation. These composites are different from other silver-containing antibacterial materials both in the ease of synthesis and in the use of a silver salt nanoparticle instead of elemental silver or complex silver compounds. We also demonstrate the ability to tune the release of biocidal Ag(+) ions from these composites by controlling the size of the embedded AgBr nanoparticles. These composites are potentially useful as antimicrobial coatings in a wide variety of biomedical and general use applications.

Technology insight: Novel ureteral stent materials and designs

Ureteral stents are an important tool for aiding upper urinary tract drainage, but can cause significant patient morbidity. Common problems include stent-induced pain, hematuria, dysuria, infection, and encrustation. From a urologist's perspective, stents must be easy to maneuver in the urinary tract, radiopaque, and affordable. Since the development of the modern day stent in 1978, stents have evolved to include softer biomaterials that are more resistant to encrustation and infection. An ideal biomaterial is one that is not affected by its environment and does not elicit reactive changes in surrounding tissues. To date, the ideal biomaterial or stent does not exist. This review discusses developments that address the issues of infection, biofilm formation, encrustation, and patient comfort. Stent materials including polyurethane, silicone, biodegradable substances and new combination polymers are reviewed, in addition to novel stent coatings such as heparin, hydrogel, and silver nitrate. Ureteral stent technologies currently lag behind vascular stents, particularly drug-eluting stents, but new developments will continue to improve these essential urological tools.