Antimicrobial activity Study of triclosan-loaded WBPU on Proteus mirabilis in vitro

Current material engineering strategies to prevent catheter encrustation in urinary tracts

Catheters and ureteric stents have played a vital role in relieving urinary obstruction in many urological conditions. With the increasing use of urinary catheters/stents, catheter/stent-related complications such as infection and encrustation are also increasing because of their design defects. Long-term use of antibiotics and frequent replacement of catheters not only increase the economic burden on patients but also bring the pain of catheter replacement. This is unfavorable for patients with long indwelling catheters or stents but inconvenient to replace. In recent years, some promising technologies and mechanisms have been used to prevent infection and encrustation, mainly drug loading coatings, functional coatings, biodegradable polymers and metallic materials for urinary devices. Obvious effects in anti-encrustation and anti-infection experiments of the above strategies in vivo or in vitro have been conducted, which is very helpful for further clinical trials. This review mainly introduces catheter/stent technology and mechanisms in the past ten years to address the potential impact of anti-encrustation coating of catheter/stent materials for the prevention of encrustation and to analyze the progress made in this field.

Advancements in release-active antimicrobial biomaterials: A journey from release to relief

Escalating medical expenses due to infectious diseases are causing huge socioeconomic pressure on mankind globally. The emergence of antibiotic resistance has further aggravated this problem. Drug-resistant pathogens are also capable of forming thick biofilms on biotic and abiotic surfaces to thrive in a harsh environment. To address these clinical problems, various strategies including antibacterial agent delivering matrices and bactericidal coatings strategies have been developed. In this review, we have discussed various types of polymeric vehicles such as hydrogels, sponges/cryogels, microgels, nanogels, and meshes, which are commonly used to deliver antibiotics, metal nanoparticles, and biocides. Compositions of these polymeric matrices have been elaborately depicted by elucidating their chemical interactions and potential activity have been discussed. On the other hand, various implant/device-surface coating strategies which exploit the release-active mechanism of bacterial killing are discussed in elaboration. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.

A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections

Urinary and intravascular catheters are two of the most used invasive medical devices; however, microbial colonization of catheter surfaces is responsible for most healthcare-associated infections (HAIs). Several antimicrobial-coated catheters are available, but recurrent antibiotic therapy can decrease their potential activity against resistant bacterial strains. The aim of this Review is to question the actual effectiveness of currently used (coated) catheters and describe the progress and promise of alternative antimicrobial coatings. Different strategies have been reviewed with the common goal of preventing biofilm formation on catheters, including release-based approaches using antibiotics, antiseptics, nitric oxide, 5-fluorouracil, and silver as well as contact-killing approaches employing quaternary ammonium compounds, chitosan, antimicrobial peptides, and enzymes. All of these strategies have given proof of antimicrobial efficacy by modifying the physiology of pathogens or disrupting their structural integrity. The aim for synergistic approaches using multitarget processes and the combination of both antifouling and bactericidal properties holds potential for the near future. Despite intensive research in biofilm preventive strategies, laboratorial studies still present some limitations since experimental conditions usually are not the same and also differ from biological conditions encountered when the catheter is inserted in the human body. Consequently, in most cases, the efficacy data obtained from in vitro studies is not properly reflected in the clinical setting. Thus, further well-designed clinical trials and additional cytotoxicity studies are needed to prove the efficacy and safety of the developed antimicrobial strategies in the prevention of biofilm formation at catheter surfaces.

Functional-modified polyurethanes for rendering surfaces antimicrobial: An overview

Antimicrobial surfaces and coatings are rapidly emerging as primary components in functional modification of materials and play an important role in addressing the problems associated with biofouling and microbial infection. Polyurethane (PU) consisting of alternating soft and hard segments has been one of the most important coating materials that have been widely applied in many fields due to its versatile properties. This review attempts to provide insight into the recent advances in antimicrobial polyurethane coatings or surfaces. According to different classes of antimicrobial components along with their antimicrobial mechanism, the synthesis pathways are presented systematically herein to afford polyurethane with antimicrobial properties. Also, the challenges and opportunities of antimicrobial PU coatings and surfaces are also discussed. This review will be beneficial to the exploitation and the further studies of antimicrobial polyurethane materials for a variety of applications.

Allicin prevents the formation of Proteus-induced urinary crystals and the blockage of catheter in a bladder model in vitro

Stone formation and catheter blockage are major complications of Proteus UTIs. In this study, we investigated the ability of allicin to inhibit P. mirabilis-induced struvite crystallization and catheter blockage using a synthetic bladder model. Struvite crystallization inhibition study was carried out using P. mirabilis lysate as urease enzyme source in synthetic urine (SU). Struvite productions were monitored by phase contrast light microscopy and measurements of pH, Mg²⁺ and Ca²⁺ precipitation and turbidity. A catheter blockage study was performed in a synthetic bladder model mimicking natural UTI in the presence of allicin at sub-MIC concentrations (MIC = 64 μg/ml). The results of crystallization study showed that allicin inhibited pH rise and consequently turbidity and precipitation of ions in a dose-dependent manner. The results of catheter blockage study showed that allicin at sub-MIC concentrations (2, 4, 8 μg/ml) significantly increased the time for catheter blockage to occur to 61, 74 and 92 h respectively compared to allicin-free control (48 h). In a similar way, the results showed that allicin delayed the increase of SU pH level in bladder model in a dose-dependent manner compared to allicin-free control. The results also showed that following the increase of allicin concentration, Mg²⁺ and Ca²⁺ deposition in catheters were much lower compared to allicin-free control, further confirmed by direct observation of the catheters' eyehole and cross sections. We conclude that allicin prevents the formation of Proteus-induced urinary crystals and the blockage of catheters by delaying pH increase and lowering Mg²⁺ and Ca²⁺ deposition in a dose-dependent manner.

Biodegradable ciprofloxacin-incorporated waterborne polyurethane polymers prevent bacterial biofilm formation in vitro

The aim of the present study was to explore whether ciprofloxacin-incorporated waterborne polyurethane (WBPU) polymers have the capacity to inhibit bacterial biofilm formation in vitro. WBPU polymers were incorporated with ciprofloxacin and were cultured with Escherichia coli (E. coli) or Staphylococcus aureus (S. aureus) in media for 2, 4 or 7 days. In another experiment, the WBPU membranes were cultured with Proteus mirabilis (P. mirabilis) in artificial urine for 2, 4 or 7 days. Colony counting, scanning electron microscopy and fluorescence confocal microscopy were utilized to examine bacterial biofilms on the surfaces of membranes. The membranes were further co-cultured with P. mirabilis in a simple model of an artificial catheterized bladder in order to evaluate their ability to control encrustation. The WBPU films with ciprofloxacin effectively inhibited bacterial biofilm formation in the culture medium and in artificial urine. In addition, in artificial urine, the films with ciprofloxacin reduced catheter obstruction. In conclusion, ciprofloxacin-incorporated WBPU polymers are able to effectively inhibit bacterial biofilm formation in vitro.