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Bouhrour N, Nibbering PH, Bendali F. Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens. Pathogens 2024; 13:393. [PMID: 38787246 PMCID: PMC11124157 DOI: 10.3390/pathogens13050393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Medical devices such as venous catheters (VCs) and urinary catheters (UCs) are widely used in the hospital setting. However, the implantation of these devices is often accompanied by complications. About 60 to 70% of nosocomial infections (NIs) are linked to biofilms. The main complication is the ability of microorganisms to adhere to surfaces and form biofilms which protect them and help them to persist in the host. Indeed, by crossing the skin barrier, the insertion of VC inevitably allows skin flora or accidental environmental contaminants to access the underlying tissues and cause fatal complications like bloodstream infections (BSIs). In fact, 80,000 central venous catheters-BSIs (CVC-BSIs)-mainly occur in intensive care units (ICUs) with a death rate of 12 to 25%. Similarly, catheter-associated urinary tract infections (CA-UTIs) are the most commonlyhospital-acquired infections (HAIs) worldwide.These infections represent up to 40% of NIs.In this review, we present a summary of biofilm formation steps. We provide an overview of two main and important infections in clinical settings linked to medical devices, namely the catheter-asociated bloodstream infections (CA-BSIs) and catheter-associated urinary tract infections (CA-UTIs), and highlight also the most multidrug resistant bacteria implicated in these infections. Furthermore, we draw attention toseveral useful prevention strategies, and advanced antimicrobial and antifouling approaches developed to reduce bacterial colonization on catheter surfaces and the incidence of the catheter-related infections.
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Affiliation(s)
- Nesrine Bouhrour
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
| | - Peter H. Nibbering
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands;
| | - Farida Bendali
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
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Rajaramon S, Shanmugam K, Dandela R, Solomon AP. Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review. Front Cell Infect Microbiol 2023; 13:1134433. [PMID: 37560318 PMCID: PMC10407108 DOI: 10.3389/fcimb.2023.1134433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/04/2023] [Indexed: 08/11/2023] Open
Abstract
Healthcare settings have dramatically advanced the latest medical devices, such as urinary catheters (UC) for infection, prevention, and control (IPC). The continuous or intermittent flow of a warm and conducive (urine) medium in the medical device, the urinary catheter, promotes the formation of biofilms and encrustations, thereby leading to the incidence of CAUTI. Additionally, the absence of an innate immune host response in and around the lumen of the catheter reduces microbial phagocytosis and drug action. Hence, the review comprehensively overviews the challenges posed by CAUTI and associated risks in patients' morbidity and mortality. Also, detailed, up-to-date information on the various strategies that blended/tailored the surface properties of UC to have anti-fouling, biocidal, and anti-adhesive properties to provide an outlook on how they can be better managed with futuristic solutions.
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Affiliation(s)
- Shobana Rajaramon
- Quorum Sensing Laboratory, Centre for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, India
| | - Karthi Shanmugam
- Quorum Sensing Laboratory, Centre for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, India
| | - Rambabu Dandela
- Department of Industrial and Engineering Chemistry, Institute of Chemical Technology, Bhubaneswar, Odisha, India
| | - Adline Princy Solomon
- Quorum Sensing Laboratory, Centre for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, India
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Arakkal A, Sirajunnisa P, Sailaja GS. Natural rubber latex films with effective growth inhibition against S. aureus via surface conjugated gentamicin. J BIOACT COMPAT POL 2023. [DOI: 10.1177/08839115231153823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Hospital-associated infections and related complications are of extreme concern in the healthcare sector since biofilms generated over material surfaces not only create turbulence in the healthcare practices followed but also ruin the device performance, and increased medication, leading to significant chances of drug resistance. Natural rubber latex (NRL) being the first choice for the manufacture of several conventional biomedical devices, it is essential to ensure the surfaces of the same are inherently inactive against most microorganisms. This study presents NRL film surface conjugated with a well-known antibiotic, gentamicin through an amide linkage to generate antibacterial activity to the surface with a significant growth inhibition rate, especially against Staphylococcus aureus. The NRL films were surface-oxidized under controlled acidic conditions to generate carboxyl groups exploring the unsaturation of the base monomer unit. The carboxyl group reacts with the amine groups of gentamicin facilitating its surface conjugation. The surface anchoring was authenticated by FTIR-ATR complimented further by contact angle measurement as a function of hydrophilicity and elemental analysis by EDX spectroscopy. The antibacterial efficacy of modified NRL films was evaluated using antibacterial drop test and the results indicated a substantial growth inhibition rate (>60%) against Pseudomonas aeruginosa and Staphylococcus aureus. The study could be further optimized and proposed as a viable route for the conjugation of active molecules over inert polymer molecules.
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Affiliation(s)
- Aswin Arakkal
- Department of Polymer Science & Rubber Technology, Cochin University of Science and Technology, Kochi, Kerala, India
| | - Paramban Sirajunnisa
- Department of Polymer Science & Rubber Technology, Cochin University of Science and Technology, Kochi, Kerala, India
| | - Gopalakrishnanchettiar Sivakamiammal Sailaja
- Department of Polymer Science & Rubber Technology, Cochin University of Science and Technology, Kochi, Kerala, India
- Inter-University Centre for Nanomaterials and Devices, Cochin University of Science and Technology, Kochi, Kerala, India
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Recent Advances in Antimicrobial Coatings and Material Modification Strategies for Preventing Urinary Catheter-Associated Complications. Biomedicines 2022; 10:biomedicines10102580. [PMID: 36289841 PMCID: PMC9599887 DOI: 10.3390/biomedicines10102580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/28/2022] [Accepted: 10/06/2022] [Indexed: 11/28/2022] Open
Abstract
In recent years, we have witnessed prominent improvements in urinary catheter coatings to tackle the commonly occurring catheter-associated urinary tract infection (CAUTI) in catheterized patients. CAUTIs are claimed to be one of the most frequent nosocomial infections that can lead to various complications, from catheter encrustation to severe septicaemia and pyelonephritis. Besides general prevention hygienic strategies, antimicrobial-coated urinary catheters show great potential in the prevention of urinary catheter-associated complications. The aim of this review is to present and evaluate recent updates on the development of antimicrobial urinary catheters in the context of the aetiology of urinary malfunction. Subsequently, we shed some light on future perspectives of utilizing 3D printing and the surrounding regulatory directions.
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Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections. COATINGS 2019. [DOI: 10.3390/coatings10010023] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Urinary catheters are common medical devices, whose main function is to drain the bladder. Although they improve patients’ quality of life, catheter placement predisposes the patient to develop a catheter-associated urinary tract infection (CAUTI). The catheter is used by pathogens as a platform for colonization and biofilm formation, leading to bacteriuria and increasing the risk of developing secondary bloodstream infections. In an effort to prevent microbial colonization, several catheter modifications have been made ranging from introduction of antimicrobial compounds to antifouling coatings. In this review, we discuss the effectiveness of different coatings in preventing catheter colonization in vitro and in vivo, the challenges in fighting CAUTIs, and novel approaches targeting host–catheter–microbe interactions.
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Laser Processed Antimicrobial Nanocomposite Based on Polyaniline Grafted Lignin Loaded with Gentamicin-Functionalized Magnetite. Polymers (Basel) 2019; 11:polym11020283. [PMID: 30960267 PMCID: PMC6419051 DOI: 10.3390/polym11020283] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/15/2022] Open
Abstract
Composite thin coatings of conductive polymer (polyaniline grafted lignin, PANI-LIG) embedded with aminoglycoside Gentamicin sulfate (GS) or magnetite nanoparticles loaded with GS (Fe₃O₄@GS) were deposited by the matrix-assisted pulsed laser evaporation (MAPLE) technique. The aim was to obtain such nanostructured coatings for titanium-based biomedical surfaces, which would induce multi-functional properties to implantable devices, such as the controlled release of the therapeutically active substance under the action of a magnetic and/or electric field. Thus, the unaltered laser transfer of the initial biomaterials was reported, and the deposited thin coatings exhibited an appropriate nanostructured surface, suitable for bone-related applications. The laser processing of PANI-LIG materials had a meaningful impact on the composites' wettability, since the contact angle values corresponding to the composite laser processed materials decreased in comparison with pristine conductive polymer coatings, indicating more hydrophilic surfaces. The corrosion resistant structures exhibited significant antimicrobial activity against Escherichia coli, Staphylococcus aureus, and Candida albicans strains. In vitro cytotoxicity studies demonstrated that the PANI-LIG-modified titanium substrates can allow growth of bone-like cells. These results encourage further assessment of this type of biomaterial for their application in controlled drug release at implantation sites by external activation.
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Palmieri V, Bugli F, Cacaci M, Perini G, Maio FD, Delogu G, Torelli R, Conti C, Sanguinetti M, Spirito MD, Zanoni R, Papi M. Graphene oxide coatings prevent Candida albicans biofilm formation with a controlled release of curcumin-loaded nanocomposites. Nanomedicine (Lond) 2018; 13:2867-2879. [PMID: 30431405 DOI: 10.2217/nnm-2018-0183] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM Fabrication of graphene oxide (GO)-based medical devices coatings that limit adhesion of Candida albicans, a main issue of healthcare-associated infections. METHODS The GO composites noncovalently functionalized with curcumin (CU), a hydrophobic molecule with active antimicrobial action, polyethylene glycol (PEG) that hinders the absorption of biomolecules or a combination of CU and PEG (GO-CU-PEG) were drop-casted on surfaces and antifungal efficacy was assessed. RESULTS We demonstrate that GO-CU-PEG coatings can reduce fungal adhesion, proliferation and biofilm formation. Furthermore, in an aqueous environment, surfaces release curcumin-PEG nanocomposites that have a minimum inhibitory concentration of 9.25 μg/ml against C. albicans. CONCLUSION Prevention of early cell adhesion and creation of a proximal environment unfavorable for growth make these GO-supported biomaterials attractive for innovative medical device manufacturing.
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Affiliation(s)
- Valentina Palmieri
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Fisica, Largo Francesco Vito 1, 00168, Rome, Italy.,Institute for Complex Systems, National Research Council (ISC-CNR), Via dei Taurini 19, 00185 Rome, Italy
| | - Francesca Bugli
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Microbiologia, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Margherita Cacaci
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Microbiologia, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Giordano Perini
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Fisica, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Flavio De Maio
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Microbiologia, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Giovanni Delogu
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Microbiologia, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Riccardo Torelli
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Microbiologia, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Claudio Conti
- Institute for Complex Systems, National Research Council (ISC-CNR), Via dei Taurini 19, 00185 Rome, Italy
| | - Maurizio Sanguinetti
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Microbiologia, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Marco De Spirito
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Fisica, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Robertino Zanoni
- Dipartimento di Chimica, Università di Roma La Sapienza, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Massimiliano Papi
- Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore. Istituto di Fisica, Largo Francesco Vito 1, 00168, Rome, Italy
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Albu AM, Maior I, Nicolae CA, Bocăneală FL. NOVEL PVA PROTON CONDUCTING MEMBRANES DOPED WITH POLYANILINE GENERATED BY IN-SITU POLYMERIZATION. Electrochim Acta 2016. [DOI: 10.1016/j.electacta.2016.06.098] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fisher LE, Hook AL, Ashraf W, Yousef A, Barrett DA, Scurr DJ, Chen X, Smith EF, Fay M, Parmenter CDJ, Parkinson R, Bayston R. Biomaterial modification of urinary catheters with antimicrobials to give long-term broadspectrum antibiofilm activity. J Control Release 2015; 202:57-64. [PMID: 25639970 DOI: 10.1016/j.jconrel.2015.01.037] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
Abstract
Catheter-associated urinary tract infection (CAUTI) is the commonest hospital-acquired infection, accounting for over 100,000 hospital admissions within the USA annually. Biomaterials and processes intended to reduce the risk of bacterial colonization of the catheters for long-term users have not been successful, mainly because of the need for long duration of activity in flow conditions. Here we report the results of impregnation of urinary catheters with a combination of rifampicin, sparfloxacin and triclosan. In flow experiments, the antimicrobial catheters were able to prevent colonization by common uropathogens Proteus mirabilis, Staphylococcus aureus and Escherichia coli for 7 to 12weeks in vitro compared with 1-3days for other, commercially available antimicrobial catheters currently used clinically. Resistance development was minimized by careful choice of antimicrobial combinations. Drug release profiles and distribution in the polymer, and surface analysis were also carried out and the process had no deleterious effect on the mechanical performance of the catheter or its balloon. The antimicrobial catheter therefore offers for the first time a means of reducing infection and its complications in long-term urinary catheter users.
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Affiliation(s)
- Leanne E Fisher
- Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
| | - Andrew L Hook
- Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK.
| | - Waheed Ashraf
- Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
| | - Anfal Yousef
- Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
| | - David A Barrett
- Centre for Analytical Bioscience, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK.
| | - David J Scurr
- Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK.
| | - Xinyong Chen
- Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK.
| | - Emily F Smith
- Nottingham Nanotechnology & Nanoscience Centre, University of Nottingham, Nottingham NG7 2RD, UK.
| | - Michael Fay
- Nottingham Nanotechnology & Nanoscience Centre, University of Nottingham, Nottingham NG7 2RD, UK.
| | | | - Richard Parkinson
- Nottingham Urology Centre, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK.
| | - Roger Bayston
- Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
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The Urinary Catheter and Its Significant Applications Described by Avicenna (980-1037 AD) in the Canon of Medicine. Urology 2014; 84:993-6. [DOI: 10.1016/j.urology.2014.07.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 07/22/2014] [Accepted: 07/24/2014] [Indexed: 11/20/2022]
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Preparation of PAM/PVA blending films by solution-cast technique and its characterization: a spectroscopic study. IRANIAN POLYMER JOURNAL 2013. [DOI: 10.1007/s13726-013-0211-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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