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Puertas-Segura A, Morena AG, Pérez Rafael S, Ivanova K, Ivanov I, Todorova K, Dimitrov P, Ciardelli G, Tzanov T. Enzymatically Built Nanoenabled Antimicrobial Coating on Urinary Catheters. ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 39039989 DOI: 10.1021/acsami.4c08599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Catheter-associated urinary tract infections represent a major share of nosocomial infections, and are associated with longer periods of hospitalization and a huge financial burden. Currently, there are only a handful of commercial materials that reduce biofilm formation on urinary catheters, mostly relying on silver alloys. Therefore, we combined silver-phenolated lignin nanoparticles with poly(carboxybetaine) zwitterions to build a composite antibiotic-free coating with bactericidal and antifouling properties. Importantly, the versatile lignin chemistry enabled the formation of the coating in situ, enabling both the nanoparticle grafting and the radical polymerization by using only the oxidative activity of laccase. The resulting surface efficiently prevented nonspecific protein adsorption and reduced the bacterial viability on the catheter surface by more than 2 logs under hydrodynamic flow, without exhibiting any apparent signs of cytotoxicity. Moreover, the said functionality was maintained over a week both in vitro and in vivo, whereby the animal models showed excellent biocompatibility.
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Affiliation(s)
- Antonio Puertas-Segura
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Angela Gala Morena
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Silvia Pérez Rafael
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Kristina Ivanova
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Ivan Ivanov
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222 Terrassa, Spain
| | - Katerina Todorova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, 1113 Sofia, Bulgaria
| | - Petar Dimitrov
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, 1113 Sofia, Bulgaria
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Tzanko Tzanov
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222 Terrassa, Spain
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2
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Alfe M, Minopoli G, Tartaglia M, Gargiulo V, Ausanio G. Biocompatible Hybrid Graphenic Thin Coatings on Flexible Substrates through Matrix-Assisted Pulsed Laser Evaporation (MAPLE). ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 39018469 DOI: 10.1021/acsami.4c06000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
This work reports the production of biocompatible thin layers for biomedical applications based on a graphene-like material (GL), a graphene-related material (GRM) obtained from carbon black. GL was combined in a hybrid fashion with polydopamine (pDA), a mussel-inspired water-resistant wet adhesive bonding obtained by the oxidative polymerization of dopamine (DA), and polyvinyl pyrrolidinone (PVP), a nontoxic synthetic polymer with intrinsic adhesion properties, to obtain a tighter adhesion of the thin layer to the substrate (silicone slices). Matrix-assisted pulsed laser evaporation (MAPLE) was used to coat PDMS slices with thin films of GL-pDA and GL-PVP directly from their frozen suspensions in water. The results indicate that the relevant chemical-physical characteristics of both thin films (evidenced by FTIR and AFM) were maintained after MAPLE deposition and that the films exhibit uniformity also at the nanometric level. After deposition, the GL-pDA and GL-PVP films underwent a biological survey toward murine fibroblasts (NIH3T3), human keratinocytes (HaCAT), and human cervical adenocarcinoma epithelial-like (HeLa) cells to assess the feasibility of this approach. Results indicate that both the GL-pDA and GL-PVP films did not perturb the biological parameters evaluated, including cytoskeleton alterations. Both hybrid films enhanced the effects of GL on cellular vitality across all cell lines. Specifically, the GL-pDA film exhibited a more stable effect over time (up to 72 h), whereas the GL-PVP film behaved similarly to the GL film in NIH3T3 and HeLa cell lines after long-term exposure. These promising results make the GL-pDA and GL-PVP films potential candidates for the manufacture of coated flexible devices for biomedical applications.
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Affiliation(s)
- Michela Alfe
- Institute of Sciences and Technologies for Sustainable Energy and Mobility (CNR-STEMS), Via G. Marconi, 4, Naples 80125, Italy
| | - Giuseppina Minopoli
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Pansini, 5, Naples 80131, Italy
| | - Massimiliano Tartaglia
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Pansini, 5, Naples 80131, Italy
| | - Valentina Gargiulo
- Institute of Sciences and Technologies for Sustainable Energy and Mobility (CNR-STEMS), Via G. Marconi, 4, Naples 80125, Italy
| | - Giovanni Ausanio
- Department of Physics "E. Pancini", University of Naples Federico II and Institute for Superconductors Innovative Materials and Devices (CNR-SPIN), via Cinthia 26, Naples 80126, Italy
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3
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Kim HK, Park JH, Jang MJ, Han SJ, Cho YS, Park HH. Flexible and transparent nanohole-patterned films with antibacterial properties against Staphylococcus aureus. J Mater Chem B 2024. [PMID: 38953113 DOI: 10.1039/d4tb00434e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
In this paper, we explore the development of a multi-functional surface designed to tackle the challenges posed by Staphylococcus aureus (S. aureus), a common opportunistic pathogen. Infections caused by S. aureus during surgical procedures highlight the need for effective strategies to inhibit its adhesion, growth, and colonization, particularly on the surfaces of invasive medical devices. Until now, most existing research has focused on nanopillar structures (positive topographies). Uniform nanopillar arrays have been shown to control bacterial behavior based on the spacing between nanopillars. However, nanopillar structures are susceptible to external friction, impact, and force, making it challenging to maintain their antibacterial properties. Therefore, in this study, we investigate the antibacterial behavior of nanohole structures, which offer relatively superior mechanical robustness compared to nanopillars. Moreover, for applications in medical devices such as laparoscopes, there is a pressing need for surfaces that are not only transparent and flexible (or curved) but are also equipped with antibacterial properties. Our study introduces a scalable multi-functional surface that synergistically combines antibacterial and anti-fog properties. This is achieved by fabricating thin films with variously sized holes (ranging from 0.3 μm to 4 μm) using polyurethane acrylate (PUA). We assessed the activity of S. aureus on these surfaces and found that a 1 μm-diameter-hole pattern significantly reduced the presence of live S. aureus, without any detection of dead S. aureus. This bacteriostatic effect is attributed to the restricted proliferation due to the confined area provided by the hole pattern. However, the persistence of some live S. aureus on the surface necessitates further measures to minimize bacterial adhesion and enhance antibacterial effectiveness. To address this challenge, we coated the zwitterionic polymer 2-methacryloyloxyethyl phosphorylcholine (MPC) onto the nanohole pattern surface to reduce S. aureus adhesion. Moreover, in long-term experiments on surfaces, the MPC-coated effectively inhibited the colonization of S. aureus (18 h; 82%, 7 days; 83%, and 14 days; 68% antibacterial rate). By integrating PUA, MPC, and nanohole architectures into a single, flexible platform, we achieved a multi-functional surface catering to transparency, anti-fogging, and anti-biofouling requirements. This innovative approach marks a significant advancement in surface engineering, offering a versatile solution applicable in various fields, particularly in preventing S. aureus contamination in invasive medical devices like laparoscopes. The resultant surface, characterized by its transparency, flexibility, and antibacterial functionality, stands out as a promising candidate for mitigating S. aureus-related risks in medical applications.
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Affiliation(s)
- Hee-Kyeong Kim
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Jeong-Hun Park
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Min-Jun Jang
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Su-Ji Han
- Department of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Young-Sam Cho
- Division of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea.
- MECHABIO Group, Wonkwang University, 460 Ikandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Hyun-Ha Park
- Division of Mechanical Engineering, College of Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea.
- MECHABIO Group, Wonkwang University, 460 Ikandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
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Li B, Pang C, Chen S, Hong L. Long-Lasting Antibacterial PDMS Surfaces Constructed from Photocuring of End-Functionalized Polymers. Macromol Rapid Commun 2024:e2400170. [PMID: 38936823 DOI: 10.1002/marc.202400170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/22/2024] [Indexed: 06/29/2024]
Abstract
A challenge remains in the development of anti-infectious coatings for the inert surfaces of biomedical devices that are prone to bacterial colonization and biofilm formation. Here, a facile photocuring method to construct functionalized polymeric coatings on inert polydimethylsiloxane (PDMS) surfaces, is developed. Using atom transfer radical polymerization (ATRP) initiator bearing thymol group, hydrophilic DMAEMA and benzophenone (BP)-containing monomers are copolymerized to form polymers with end functional groups. An end-functionalized biocidal coating is then constructed on the inert PDMS surface in one step using a photocuring reaction. The functionalized PDMS surfaces show excellent antibacterial and antifouling properties, are capable of completely eradiating MRSA within ≈6 h, and effectively inhibit the growth of biofilms. In addition, they have good stability and long-lasting antibacterial activity in body fluid environments such as 0.9% saline and urine. According to bladder model experiments, the catheter's lifespan can be extended from ≈7 to 35 days by inhibiting the growth and migration of bacteria along its inner surface. The photocuring technique is therefore very promising in terms of surface functionalization of inert biomedical devices in order to minimize the spread of infection.
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Affiliation(s)
- Biao Li
- Faculty of Materials Science and Engineering, Guangdong Provincial Key Laboratory of Luminescence from Molecular Aggregates, South China University of Technology, Guangzhou, 510640, China
| | - Chuming Pang
- Faculty of Materials Science and Engineering, Guangdong Provincial Key Laboratory of Luminescence from Molecular Aggregates, South China University of Technology, Guangzhou, 510640, China
| | - Shiguo Chen
- Nanshan District Key Lab for Biopolymers and Safety Evaluation, Shenzhen Key Laboratory of Polymer Science and Technology, Guangdong Research Center for Interfacial Engineering of Functional Materials, College of Materials Science and Engineering, Shenzhen University, Shenzhen, 518060, P. R. China
| | - Liangzhi Hong
- Faculty of Materials Science and Engineering, Guangdong Provincial Key Laboratory of Luminescence from Molecular Aggregates, South China University of Technology, Guangzhou, 510640, China
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Patra D, Ghosh S, Mukherjee S, Acharya Y, Mukherjee R, Haldar J. Antimicrobial nanocomposite coatings for rapid intervention against catheter-associated urinary tract infections. NANOSCALE 2024; 16:11109-11125. [PMID: 38787647 DOI: 10.1039/d4nr00653d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Catheter-associated urinary tract infections (CAUTIs) pose a significant challenge in hospital settings. Current solutions available on the market involve incorporating antimicrobials and antiseptics into catheters. However, challenges such as uncontrolled release leading to undesirable toxicity, as well as the prevalence of antimicrobial resistance reduce the effectiveness of these solutions. Additionally, conventional antibiotics fail to effectively eradicate entrenched bacteria and metabolically suppressed bacteria present in the biofilm, necessitating the exploration of alternative strategies. Here, we introduce a novel polymer-nanocomposite coating that imparts rapid antimicrobial and anti-biofilm properties to coated urinary catheters. We have coated silicone-based urinary catheters with an organo-soluble antimicrobial polymer nanocomposite (APN), containing hydrophobic quaternized polyethyleneimine and zinc oxide nanoparticles, in a single step coating process. The coated surfaces exhibited rapid eradication of drug-resistant bacteria within 10-15 min, including E. coli, K. pneumoniae, MRSA, and S. epidermidis, as well as drug-resistant C. albicans fungi. APN coated catheters exhibited potent bactericidal activity against uropathogenic strains of E. coli, even when incubated in human urine. Furthermore, the stability of the coating and retention of antimicrobial activity was validated even after multiple washes. More importantly, this coating deterred biofilm formation on the catheter surface, and displayed rapid inactivation of metabolically repressed stationary phase and persister cells. The ability of the coated surfaces to disrupt bacterial membranes and induce the generation of intracellular reactive oxygen species (ROS) was assessed through different techniques, such as electron microscopy imaging, flow cytometry as well as fluorescence spectroscopy and microscopy. The surface coatings were found to be biocompatible in an in vivo mice model. Our simple one-step coating approach for catheters holds significant potential owing to its ability to tackle multidrug resistant bacteria and fungi, and the challenge of biofilm formation. This work brings us one step closer to enhancing patient care and safety in hospitals.
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Affiliation(s)
- Dipanjana Patra
- Chemistry and Physics of Materials Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India
| | - Sreyan Ghosh
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India.
| | - Sudip Mukherjee
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India.
| | - Yash Acharya
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India.
| | - Riya Mukherjee
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India.
| | - Jayanta Haldar
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India.
- School of Advanced Materials, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru-560064, Karnataka, India
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Tüfekçi M, Hamarat S, Çalışkan TD, Özgüzar HF, Meydan AE, Göçmen JS, Evren E, Gökçe Mİ, Goktas H. Long-term antifouling surfaces for urinary catheters. J Mater Chem B 2024; 12:5711-5721. [PMID: 38758163 DOI: 10.1039/d4tb00311j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
The presence of a variety of bacteria is an inevitable/indispensable part of human life. In particular, for patients, the existence and spreading of bacteria lead to prolonged treatment period with many more complications. The widespread use of urinary catheters is one of the main causes for the prevalence of infections. The necessity of long-term use of indwelling catheters is unavoidable in terms of the development of bacteriuria and blockage. As is known, since a permanent solution to this problem has not yet been found, research and development activities continue actively. Herein, polyethylene glycol (PEG)-like thin films were synthesized by a custom designed plasma enhanced chemical vapor deposition (PE-CVD) method and the long-term effect of antifouling properties of PEG-like coated catheters was investigated against Escherichia coli and Proteus mirabilis. The contact angle measurements have revealed the increase of wettability with the increase of plasma exposure time. The antifouling activity of surface-coated catheters was analyzed against the Gram-negative/positive bacteria over a long-term period (up to 30 days). The results revealed that PE-CVD coated PEG-like thin films are highly capable of eliminating bacterial attachment on surfaces with relatively reduced protein attachment without having any toxic effect. Previous statements were supported with SEM, XPS, FTIR spectroscopy, and contact angle analysis.
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Affiliation(s)
- Mustafa Tüfekçi
- Department of Biomedical Engineering, Ankara University, Golbasi, Turkey.
| | - Sena Hamarat
- Department of Biomedical Engineering, Ankara University, Golbasi, Turkey.
| | | | - Hatice Ferda Özgüzar
- Plasma Aided Biomedical Research Group (pabmed) Biomedical Engineering Division, Graduate School of Engineering and Science, TOBB university of Economics and Technology, Ankara, 06560, Turkey
- Department of Materials Engineering, Biomaterials and Tissue Engineering Research Group, KU Leuven, Leuven, 3000, Belgium
| | - Ahmet Ersin Meydan
- Department of Molecular Medicine, Graduate School of Health Sciences, TOBB University of Economics and Technology, Ankara, 06560, Turkey
| | - Julide Sedef Göçmen
- Department of Medical Microbiology, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, 06560, Turkey
| | - Ebru Evren
- Department of Medical Microbiology, Ankara University School of Medicine, Turkey
| | | | - Hilal Goktas
- Department of Biomedical Engineering, Ankara University, Golbasi, Turkey.
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Clasie KA, Deshpande AV, Holland AJ, Jiwane AV, Da Silva VG, Filtness FA, Allen MM, Smith GH. Reduction of Urinary Tract Infection in Pediatric Surgical Patients Using NSQIP-P and Quality Improvement Methodology. J Am Coll Surg 2024; 238:1057-1066. [PMID: 38345219 DOI: 10.1097/xcs.0000000000001037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
BACKGROUND Hospital-acquired urinary tract infections (UTIs) have a detrimental effect on patients, families, and hospital resources. The Sydney Children's Hospital Network (SCHN) participates in the NSQIP-Pediatric (NSQIP-P) to monitor postoperative complications. NSQIP-P data revealed that the median UTI rate at SCHN was 1.75% in 2019, 3.5 times higher than the NSQIP-P target rate of 0.5%. Over three quarters of the NSQIP-P identified patients with UTI also had a urinary catheterization performed intraoperatively. A quality improvement project was conducted between mid-2018 and 2021 to minimize catheter-associated UTIs (CAUTIs) at SCHN. STUDY DESIGN NSQIP-P samples include pediatric (younger than 18 years) surgical patients from an 8-day cycle operative log. NSQIP-P data are statistically analyzed by the American College of Surgeons and provide biannual internationally benchmarked reports. The project used clinical redesign methodology with a 6-phase process for quality improvement projects. RESULTS The objectives of the project were to reduce urinary catheter duration of use, educate parents or carers, and improve catheter care and insertion technique by health staff. The duration of a urinary catheter in situ reduced from a median of 4.5 to 3 days from 2017 to 2021. The median NSQIP-P UTI rate at SCHN was reduced by 47.4% from 1.75% in 2019 to 0.9% in 2022. CONCLUSIONS A multifactorial approach in quality improvement has been shown to be an effective strategy to reduce UTI rates at SCHN, and patient outcomes were improved within a 3-year timeframe. Although this project has reduced UTI rates at SCHN, there remain opportunities for further improvement.
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Affiliation(s)
- Kyla A Clasie
- From the Department of Surgery, Sydney Children's Hospital Network, Sydney, New South Wales, Australia (Clasie)
| | - Aniruddh V Deshpande
- School of Medicine and Public Health, Newcastle University, Newcastle, New South Wales, Australia (Deshpande)
- Departments of Urology (Deshpande, Holland, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Surgery (Deshpande, Holland, Filtness, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Sydney Medical School, Faculty of Health, The University of Sydney, Sydney, New South Wales, Australia (Deshpande, Holland, Smith)
| | - Andrew Ja Holland
- Departments of Urology (Deshpande, Holland, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Surgery (Deshpande, Holland, Filtness, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Department of Paediatric Surgery (Holland)
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Sydney Medical School, Faculty of Health, The University of Sydney, Sydney, New South Wales, Australia (Deshpande, Holland, Smith)
| | - Ashish V Jiwane
- Department of Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia (Jiwane, Da Silva, Allen)
| | - Vanessa G Da Silva
- Department of Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia (Jiwane, Da Silva, Allen)
| | - Fiona A Filtness
- Surgery (Deshpande, Holland, Filtness, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Margaret M Allen
- Department of Surgery, Sydney Children's Hospital, Sydney, New South Wales, Australia (Jiwane, Da Silva, Allen)
| | - Grahame Hh Smith
- Departments of Urology (Deshpande, Holland, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Surgery (Deshpande, Holland, Filtness, Smith), Children's Hospital at Westmead, Sydney, New South Wales, Australia
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Sydney Medical School, Faculty of Health, The University of Sydney, Sydney, New South Wales, Australia (Deshpande, Holland, Smith)
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Lopez C, Trautner BW, Kulkarni PA. Managing External Urinary Catheters. Infect Dis Clin North Am 2024; 38:343-360. [PMID: 38599895 DOI: 10.1016/j.idc.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
This narrative review explores the use of external urinary catheters. These devices are available in various types and materials for male and female patients. The indications for the use of external urinary catheters include managing incontinence linked to overactive bladder and neurogenic lower urinary tract dysfunction. Contraindications to the use of external urinary catheters include urinary obstruction. Proper skin care and proactive infection control measures are necessary to prevent complications. The collection of a urine specimen for culture requires a standardized technique to prevent contamination. Clinician-led patient education on catheter management plays a important role in ensuring patient comfort and safety.
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Affiliation(s)
- Corina Lopez
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Barbara W Trautner
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, 2450 Holcombe Boulevard, Suite 01Y, Houston, TX 77021, USA; Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA
| | - Prathit A Kulkarni
- Medical Care Line, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Mailstop: MCL-111, Houston, TX 77030, USA; Department of Medicine, Infectious Diseases Section, Baylor College of Medicine, Houston, TX, USA.
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9
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Duan X, Xu Y, Zhang Z, Ma X, Wang C, Ma W, Jia F, Pan X, Liu Y, Zhao Y, Li Q, Liu Z, Yang Y. Piezoelectrically-activated antibacterial catheter for prevention of urinary tract infections in an on-demand manner. Mater Today Bio 2024; 26:101089. [PMID: 38779557 PMCID: PMC11109010 DOI: 10.1016/j.mtbio.2024.101089] [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: 02/13/2024] [Revised: 04/13/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Catheter-associated urinary tract infection (CAUTI) is a common clinical problem, especially during long-term catheterization, causing additional pain to patients. The development of novel antimicrobial coatings is needed to prolong the service life of catheters and reduce the incidence of CAUTIs. Herein, we designed an antimicrobial catheter coated with a piezoelectric zinc oxide nanoparticles (ZnO NPs)-incorporated polyvinylidene difluoride-hexafluoropropylene (ZnO-PVDF-HFP) membrane. ZnO-PVDF-HFP could be stably coated onto silicone catheters simply by a one-step solution film-forming method, very convenient for industrial production. In vitro, it was demonstrated that ZnO-PVDF-HFP coating could significantly inhibit bacterial growth and the formation of bacterial biofilm under ultrasound-mediated mechanical stimulation even after 4 weeks. Importantly, the on and off of antimicrobial activity as well as the strenth of antibacterial property could be controlled in an adaptive manner via ultrasound. In a rabbit model, the ZnO-PVDF-HFP-coated catheter significantly reduced the incidence CAUTIs compared with clinically-commonly used catheters under assistance of ultrasonication, and no side effect was detected. Collectively, the study provided a novel antibacterial catheter to prevent the occurrence of CAUTIs, whose antibacterial activity could be controlled in on-demand manner, adaptive to infection situation and promising in clinical application.
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Affiliation(s)
- Xiaofeng Duan
- Department of Urology, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121000, China
| | - Yongde Xu
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zhifa Zhang
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Xinbo Ma
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, No. 51, Fucheng Road, Haidian District, Beijing, 100048, China
| | - Cui Wang
- Beijing Institute of Basic Medical Sciences, No. 27 Taiping Road, Haidian District, Beijing, 100850, China
| | - Wenjing Ma
- Beijing Institute of Basic Medical Sciences, No. 27 Taiping Road, Haidian District, Beijing, 100850, China
| | - Fan Jia
- Department of Urology, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121000, China
| | - Xiaoying Pan
- Department of Urology, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, 130021, China
| | - Yang Liu
- Department of Urology, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, 130021, China
| | - Yantao Zhao
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, No. 51, Fucheng Road, Haidian District, Beijing, 100048, China
| | - Qihong Li
- Department of Stomatology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100071, China
| | - Zhiqiang Liu
- Beijing Institute of Basic Medical Sciences, No. 27 Taiping Road, Haidian District, Beijing, 100850, China
| | - Yong Yang
- Department of Urology, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, 130021, China
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10
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Xie S, Erfani A, Manouchehri S, Ramsey J, Aichele C. Aerosolization of poly(sulfobetaine) microparticles that encapsulate therapeutic antibodies. BIOMATERIALS ADVANCES 2024; 160:213839. [PMID: 38579521 DOI: 10.1016/j.bioadv.2024.213839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/04/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024]
Abstract
Pulmonary delivery of protein therapeutics poses significant challenges that have not been well addressed in the research literature or practice. In fact, there is currently only one commercial protein therapeutic that is delivered through aerosolization and inhalation. In this study, we propose a drug delivery strategy that enables a high-concentration dosage for the pulmonary delivery of antibodies as an aerosolizable solid powder with desired stability. We utilized zwitterionic polymers for their promising properties as drug delivery vehicles and synthesized swellable, biodegradable poly(sulfo-betaine) (pSB) microparticles. The microparticles were loaded with Immunoglobulin G (IgG) as a model antibody. We quantified the microparticle size and morphology, and the particles were found to have an average diameter of 1.6 μm, falling within the optimal range (~1-5 μm) for pulmonary drug delivery. In addition, we quantified the impact of the crosslinker to monomer ratio on particle morphology and drug loading capacity. The results showed that there is a trade-off between desired morphology and drug loading capacity as the crosslinker density increases. In addition, the particles were aerosolized, and our data indicated that the particles remained intact and retained their initial morphology and size after aerosolization. The combination of morphology, particle size, antibody loading capacity, low cytotoxicity, and ease of aerosolization support the potential use of these particles for pulmonary delivery of protein therapeutics.
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Affiliation(s)
- Songpei Xie
- School of Chemical Engineering, Oklahoma State University, Stillwater, OK 74078, United States of America
| | - Amir Erfani
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, United States of America
| | - Saeed Manouchehri
- School of Chemical Engineering, Oklahoma State University, Stillwater, OK 74078, United States of America
| | - Joshua Ramsey
- School of Chemical Engineering, Oklahoma State University, Stillwater, OK 74078, United States of America
| | - Clint Aichele
- School of Chemical Engineering, Oklahoma State University, Stillwater, OK 74078, United States of America.
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11
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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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12
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Liu X, Yu L, Wei J, Huang Y, Yang L, Ning J, Su Q, Li H, Xin J, Jia K. Mussel-Inspired Antimicrobial and Antifouling Coating Constructed by the Combination of Zwitterionic Copolymers and Silver Nanoparticles. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2024; 40:8654-8664. [PMID: 38588599 DOI: 10.1021/acs.langmuir.4c00446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Biofouling and bacterial infections are significant challenges in biomedical devices. In this study, a biocompatible dual-functional coating with antimicrobial and antifouling properties is developed by co-depositing the zwitterionic copolymer and silver nanoparticles via a dopamine-assisted strategy. Inspired by mussel adhesion, the coating exhibits substrate-independent adhesion as a result of the formation of irreversible covalent bonds. The zwitterionic copolymer in the dual coating plays a crucial role in improving surface wettability and reducing protein adsorption and platelet and bacterial adhesion, thereby improving its antifouling property significantly. The silver nanoparticles reduced by self-polymerized polydopamine without the addition of any chemical reductants can effectively improve the antimicrobial activity. Furthermore, as the zwitterion content in the zwitterion polymer increases, the antibacterial and antifouling properties of the coating can be further advanced. The simple and effective approach presented here provides a promising pathway for constructing potent antibacterial and antifouling surfaces, demonstrating great potential for clinical applications in implanted materials.
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Affiliation(s)
- Xingxing Liu
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Longfei Yu
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Jiafeng Wei
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Yinyin Huang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, People's Republic of China
| | - Lan Yang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, People's Republic of China
| | - Junhua Ning
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Qiuping Su
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Huanling Li
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Jinlan Xin
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
| | - Kangle Jia
- Institute of Chemical Engineering, Guangdong Academy of Sciences, Guangzhou, Guangdong 510000, People's Republic of China
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13
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Zhao X, Yang K, Song B, Qiu H, Zhao J, Liu H, Lin Z, Han L, Zhang R. Amphiphilic nanofibrillated cellulose/polyurethane composites with antibacterial, antifouling and self-healing properties for potential catheter applications. Int J Biol Macromol 2024; 263:130407. [PMID: 38417747 DOI: 10.1016/j.ijbiomac.2024.130407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/01/2024]
Abstract
This study focuses on enhancing interventional medical devices, specifically catheters, using a novel composite material. Challenges like corrosion and contamination in vivo, often caused by body fluids' pH, bacteria, and proteins, lead to mechanical damage, bacterial colonization, and biofilm formation on devices like catheters. The objective of this study was to prepare a versatile composite (HFs) by designing polyurethanes (HPU) with an ionic chain extender (HIID) and blending them with amphiphilic nanofibrillated cellulose (Am-CNF). The composite leverages dynamic interactions such as hydrogen bonding and electrostatic forces, as evidenced by Molecular Mechanics (MM) calculations. The H4F0.75 composite exhibited exceptional properties: 99 % length recovery post 600 stretching cycles at 100 % strain, rapid self-healing in artificial urine, high bactericidal activity, and excellent cell viability. Moreover, mechanical aging tests and UV-vis spectral analysis confirmed the material's durability and safety. These findings suggest that the HFs composite holds significant promise for improving catheters' performance in medical applications.
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Affiliation(s)
- Xin Zhao
- School of Materials Science and Chemical Engineering, Ningbo University, Ningbo, Zhejiang 315211, China; Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China
| | - Kai Yang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China
| | - Baiyang Song
- Department of Urology, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo 315010, Zhejiang, China.
| | - Haofeng Qiu
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China
| | - Jiake Zhao
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China
| | - Hongzhi Liu
- School of Materials Science and Engineering, NingboTech University, Ningbo 315100, Zhejiang Province, China
| | - Zhihao Lin
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China
| | - Lijing Han
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China.
| | - Ruoyu Zhang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo 315300, China.
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14
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Zheng H, Csemezová J, Loomans M, Walker S, Gauvin F, Zeiler W. Species profile of volatile organic compounds emission and health risk assessment from typical indoor events in daycare centers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170734. [PMID: 38325455 DOI: 10.1016/j.scitotenv.2024.170734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/19/2024] [Accepted: 02/03/2024] [Indexed: 02/09/2024]
Abstract
Daycare centers (DCCs) play an instrumental role in early childhood development, making them a significant indoor environment for a large number of children globally. Amidst routine DCC activities, young children are exposed to a myriad of volatile organic compounds (VOCs), potentially impacting their health. Therefore, this study aims to investigate the VOC emissions during typical DCCs activities and evaluate respective health risk assessments. Employing a full-scale experimental setup within a well-controlled climate chamber, research was conducted into VOC emissions during three typical DCC events: arts-and-crafts (painting, gluing, modeling), cleaning, and sleeping activities tied to mattresses. The research identified 96 distinct VOCs, grouped into twelve categories, from 20 different events examined. Each event exhibited a unique VOC fingerprint, pinpointing potential source tracers. Also, significant variations in VOC emissions from different events were demonstrated. For instance, under cool & dry conditions, acrylic painting recorded high total VOC concentrations of 808 μg/m3, whereas poster painting showed only 58 μg/m3. Given these disparities, the study emphasizes the critical need for carefully selecting arts-and-crafts materials and cleaning agents in DCCs to effectively reduce VOC exposure. It suggests ventilating new mattresses before use and regular mattress check-ups to mitigate VOCs exposure during naps. Importantly, it revealed that certain events resulted in VOC levels exceeding the 10-5 cancer risk thresholds for younger children. Specifically, tetrachloroethylene and styrene from used mattresses in cool & dry conditions, ethylene oxide from new mattresses in warm & humid conditions, and styrene, during sand modeling in both conditions, were the key compounds contributing to this risk. These findings highlight the critical need for age-specific health risk assessments in DCCs. This study highlights the significance of understanding the profiles of VOC emissions from indoor events in DCCs, emphasizing potential health implications and laying a solid foundation for future investigations in this field.
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Affiliation(s)
- Hailin Zheng
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Júlia Csemezová
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Marcel Loomans
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Shalika Walker
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Florent Gauvin
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Wim Zeiler
- Department of the Built Environment, Eindhoven University of Technology, Eindhoven, the Netherlands
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15
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Duque-Sanchez L, Qu Y, Voelcker NH, Thissen H. Tackling catheter-associated urinary tract infections with next-generation antimicrobial technologies. J Biomed Mater Res A 2024; 112:312-335. [PMID: 37881094 DOI: 10.1002/jbm.a.37630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/21/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
Urinary catheters and other medical devices associated with the urinary tract such as stents are major contributors to nosocomial urinary tract infections (UTIs) as they provide an access path for pathogens to enter the bladder. Considering that catheter-associated urinary tract infections (CAUTIs) account for approximately 75% of UTIs and that UTIs represent the most common type of healthcare-associated infections, novel anti-infective device technologies are urgently required. The rapid rise of antimicrobial resistance in the context of CAUTIs further highlights the importance of such preventative strategies. In this review, the risk factors for pathogen colonization in the urinary tract are dissected, taking into account the nature and mechanistics of this unique environment. Moreover, the most promising next-generation preventative strategies are critically assessed, focusing in particular on anti-infective surface coatings. Finally, emerging approaches in this field and their likely clinical impact are examined.
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Affiliation(s)
- Lina Duque-Sanchez
- Department of Manufacturing, Commonwealth Scientific and Industrial Research Organization (CSIRO), Clayton, Victoria, Australia
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Yue Qu
- Infection and Immunity Program, Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Nicolas H Voelcker
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Melbourne Centre for Nanofabrication, Victorian Node of the Australian National Fabrication Facility, Materials Science and Engineering, Monash University, Clayton, Victoria, Australia
| | - Helmut Thissen
- Department of Manufacturing, Commonwealth Scientific and Industrial Research Organization (CSIRO), Clayton, Victoria, Australia
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16
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Chadha J, Thakur N, Chhibber S, Harjai K. A comprehensive status update on modification of foley catheter to combat catheter-associated urinary tract infections and microbial biofilms. Crit Rev Microbiol 2024; 50:168-195. [PMID: 36651058 DOI: 10.1080/1040841x.2023.2167593] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/01/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
Present-day healthcare employs several types of invasive devices, including urinary catheters, to improve medical wellness, the clinical outcome of disease, and the quality of patient life. Among urinary catheters, the Foley catheter is most commonly used in patients for bladder drainage and collection of urine. Although such devices are very useful for patients who cannot empty their bladder for various reasons, they also expose patients to catheter-associated urinary tract infections (CAUTIs). Catheter provides an ideal surface for bacterial colonization and biofilm formation, resulting in persistent bacterial infection and severe complications. Hence, rigorous efforts have been made to develop catheters that harbour antimicrobial and anti-fouling properties to resist colonization by bacterial pathogens. In this regard, catheter modification by surface functionalization, impregnation, blending, or coating with antibiotics, bioactive compounds, and nanoformulations have proved to be effective in controlling biofilm formation. This review attempts to illustrate the complications associated with indwelling Foley catheters, primarily focussing on challenges in fighting CAUTI, catheter colonization, and biofilm formation. In this review, we also collate scientific literature on catheter modification using antibiotics, plant bioactive components, bacteriophages, nanoparticles, and studies demonstrating their efficacy through in vitro and in vivo testing.
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Affiliation(s)
- Jatin Chadha
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Navdisha Thakur
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Sanjay Chhibber
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Kusum Harjai
- Department of Microbiology, Panjab University, Chandigarh, India
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17
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Teng X, Yao C, McCoy CP, Zhang S. Comparison of Superhydrophilic, Liquid-Like, Liquid-Infused, and Superhydrophobic Surfaces in Preventing Catheter-Associated Urinary Tract Infection and Encrustation. ACS Biomater Sci Eng 2024; 10:1162-1172. [PMID: 38183269 PMCID: PMC10865292 DOI: 10.1021/acsbiomaterials.3c01577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
Over the past decade, superhydrophilic zwitterionic surfaces, slippery liquid-infused porous surfaces, covalently attached liquid-like surfaces, and superhydrophobic surfaces have emerged as the most promising strategies to prevent biofouling on biomedical devices. Despite working through different mechanisms, they have demonstrated superior efficacy in preventing the adhesion of biomolecules (e.g., proteins and bacteria) compared with conventional material surfaces. However, their potential in combating catheter-associated urinary tract infection (CAUTI) remains uncertain. In this research, we present the fabrication of these four coatings for urinary catheters and conduct a comparative assessment of their antifouling properties through a stepwise approach. Notably, the superhydrophilic zwitterionic coating demonstrated the highest antifouling activity, reducing 72.3% of fibrinogen deposition and over 75% of bacterial adhesion (Escherichia coli and Staphylococcus aureus) when compared with an uncoated polyvinyl chloride (PVC) surface. The zwitterionic coating also exhibited robust repellence against blood and improved surface lubricity, decreasing the dynamic coefficient of friction from 0.63 to 0.35 as compared with the PVC surface. Despite the fact that the superhydrophilic zwitterionic and hydrophobic liquid-like surfaces showed great promise in retarding crystalline biofilm formation in the presence of Proteus mirabilis, it is worth noting that their long-term antifouling efficacy may be compromised by the proliferation and migration of colonized bacteria as they are unable to kill them or inhibit their swarming. These findings underscore both the potential and limitations of these ultralow fouling materials as urinary catheter coatings for preventing CAUTI.
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Affiliation(s)
- Xiao Teng
- School of Pharmacy, Queen’s University Belfast, Belfast BT9 7BL, U.K.
| | - Chenghao Yao
- School of Pharmacy, Queen’s University Belfast, Belfast BT9 7BL, U.K.
| | - Colin P. McCoy
- School of Pharmacy, Queen’s University Belfast, Belfast BT9 7BL, U.K.
| | - Shuai Zhang
- School of Pharmacy, Queen’s University Belfast, Belfast BT9 7BL, U.K.
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18
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Morris G, Goodman S, Sorzabal Bellido I, Milanese C, Girella A, Pallavicini P, Taglietti A, Gaboardi M, Jäckel F, Diaz Fernandez YA, Raval R. Temperature and pH Stimuli-Responsive System Delivers Location-Specific Antimicrobial Activity with Natural Products. ACS APPLIED BIO MATERIALS 2024; 7:131-143. [PMID: 38079569 PMCID: PMC10792665 DOI: 10.1021/acsabm.3c00588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024]
Abstract
Smart materials with controlled stimuli-responsive functions are at the forefront of technological development. In this work, we present a generic strategy that combines simple components, physicochemical responses, and easy fabrication methods to achieve a dual stimuli-responsive system capable of location-specific antimicrobial cargo delivery. The encapsulated system is fabricated by combining a biocompatible inert polymeric matrix of poly(dimethylsiloxane) (PDMS) and a bioactive cargo of saturated fatty acids. We demonstrate the effectiveness of our approach to deliver antimicrobial activity for the model bacteria Escherichia coli. The system responds to two control variables, temperature and pH, delivering two levels of antimicrobial response under distinct combinations of stimuli: one response toward the planktonic media and another response directly at the surface for sessile bacteria. Spatially resolved Raman spectroscopy alongside thermal and structural material analysis reveals that the system not only exhibits ON/OFF states but can also control relocation and targeting of the active cargo toward either the surface or the liquid media, leading to different ON/OFF states for the planktonic and sessile bacteria. The approach proposed herein is technologically simple and scalable, facing low regulatory barriers within the food and healthcare sectors by using approved components and relying on fundamental chemical processes. Our results also provide a proof-of-concept platform for the design and easy fabrication of delivery systems capable of operating as Boolean logic gates, delivering different responses under different environmental conditions.
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Affiliation(s)
- Gareth Morris
- Open
Innovation Hub for Antimicrobial Surfaces, Surface Science Research
Centre, University of Liverpool, Liverpool L69 3BX, U.K.
- Department
of Physics and Stephenson Institute for Renewable Energy, University of Liverpool, Liverpool L69 7ZE, U.K.
| | - Sean Goodman
- Open
Innovation Hub for Antimicrobial Surfaces, Surface Science Research
Centre, University of Liverpool, Liverpool L69 3BX, U.K.
| | - Ioritz Sorzabal Bellido
- Open
Innovation Hub for Antimicrobial Surfaces, Surface Science Research
Centre, University of Liverpool, Liverpool L69 3BX, U.K.
| | - Chiara Milanese
- Department
of Chemistry, University of Pavia, Via Taramelli 12, Pavia 27100, Italy
| | - Alessandro Girella
- Department
of Chemistry, University of Pavia, Via Taramelli 12, Pavia 27100, Italy
| | | | - Angelo Taglietti
- Department
of Chemistry, University of Pavia, Via Taramelli 12, Pavia 27100, Italy
| | - Mattia Gaboardi
- Materials
Physics Center, CSIC-UPV/EHU, Donostia - San Sebastian 20018, Spain
| | - Frank Jäckel
- Department
of Physics and Stephenson Institute for Renewable Energy, University of Liverpool, Liverpool L69 7ZE, U.K.
| | - Yuri A. Diaz Fernandez
- Open
Innovation Hub for Antimicrobial Surfaces, Surface Science Research
Centre, University of Liverpool, Liverpool L69 3BX, U.K.
- Department
of Chemistry, University of Pavia, Via Taramelli 12, Pavia 27100, Italy
| | - Rasmita Raval
- Open
Innovation Hub for Antimicrobial Surfaces, Surface Science Research
Centre, University of Liverpool, Liverpool L69 3BX, U.K.
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19
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Jaśkiewicz M, Neubauer D, Sikora K, Bauer M, Bartoszewska S, Błażewicz I, Marek D, Barańska-Rybak W, Kamysz W. The Study of Antistaphylococcal Potential of Omiganan and Retro-Omiganan Under Flow Conditions. Probiotics Antimicrob Proteins 2024:10.1007/s12602-023-10197-w. [PMID: 38224448 DOI: 10.1007/s12602-023-10197-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/16/2024]
Abstract
Staphylococcus aureus is considered one of the leading pathogens responsible for infections in humans and animals. The heterogeneous nature of diseases caused by these bacteria is due to the occurrence of multiple strains, differentiated by several mechanisms of antibiotic resistance and virulence factors. One of these is the ability to form biofilm. Biofilm-associated bacteria exhibit a different phenotype that protects them from external factors such as the activity of immune system or antimicrobial substances. Moreover, it has been shown that the majority of persistent and recurrent infections are associated with the presence of the biofilm. Omiganan, an analog of indolicidin - antimicrobial peptide (AMP) derived from bovine neutrophil granules, was found to exhibit high antistaphylococcal and antibiofilm potential. Furthermore, its analog with a reversed sequence (retro-omiganan) was found to display enhanced activity against a variety of pathogens. Based on experience of our group, we found out that counterion exchange can improve the antistaphylococcal activity of AMPs. The aim of this study was to investigate the activity of both compounds against S. aureus biofilm under flow conditions. The advantage of this approach was that it offered the opportunity to form and characterize the biofilm under more controlled conditions. To do this, unique flow cells made of polydimethylsiloxane (PDMS) were developed. The activity against pre-formed biofilm as well as AMPs-treated bacteria was measured. Also, the incorporation of omiganan and retro-omiganan into the channels was conducted to learn whether or not it would inhibit the development of biofilm. The results of the microbiological tests ultimately confirmed the high potential of the omiganan and its retro-analog as well as the importance of counterion exchange in terms of antimicrobial examination. We found out that retro-omiganan trifluoroacetate had the highest biofilm inhibitory properties, however, acetates of both compounds exhibited the highest activity against planktonic and biofilm cultures. Moreover, the developed methodology of investigation under flow conditions allows the implementation of the studies under flow conditions to other compounds.
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Affiliation(s)
- Maciej Jaśkiewicz
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland.
- International Research Agenda 3P-Medicine Laboratory, Medical University of Gdańsk, Building No. 5, Dębinki 7, 80-211, Gdańsk, Poland.
| | - Damian Neubauer
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland.
| | - Karol Sikora
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland.
| | - Marta Bauer
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland
| | - Sylwia Bartoszewska
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland
| | - Izabela Błażewicz
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Mariana Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | - Dariusz Marek
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland
| | - Wioletta Barańska-Rybak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Mariana Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | - Wojciech Kamysz
- Department of Inorganic Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Al. Gen. J. Hallera 107, 80-416, Gdańsk, Poland
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20
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Zhang Y, Song G, Hu C, Liu Z, Liu H, Wang Y, Wang L, Feng X. Perfluoropolyether-incorporated polyurethane with enhanced antibacterial and anti-adhesive activities for combating catheter-induced infection. RSC Adv 2024; 14:568-576. [PMID: 38173603 PMCID: PMC10759042 DOI: 10.1039/d3ra07831k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
To avoid the undesired bacterial attachment on polyurethane-based biomedical devices, we designed a class of novel perfluoropolyether-incorporated polyurethanes (PFPU) containing different contents of perfluoropolyether (PFPE) segments. After blending with Ag nanoparticles (AgNPs), a series of bifunctional PFPU/AgNPs composites with bactericidal and anti-adhesion abilities were obtained and correspondingly made into PFPU/AgNPs films (PFPU/Ag-F) using a simple solvent-casting method. Due to its highest hydrophobicity and suitable mechanical properties, PFPU8/Ag-F containing 8 mol% of PFPE content was chosen as the optimized one for the next antibacterial assessment. The PFPU8/Ag-F can effectively deactivate over 99.9% of Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) cells at 106 CFU mL-1 within 30 min. Furthermore, the PFPU8/AgNPs composite was used as painting material to form a protective coating for the commercial polyurethane (PU) catheter. The as-prepared PFPU8/Ag coating exhibits high resistance to bacterial adhesion in a continuous-flow artificial urine model in an 8 day exposure. Therefore, it can be expected that the proposed PFPE-containing films and coatings can effectively prevent bacterial colonization and biofilm formation on catheters or other implants, thereby reducing the risk of postoperative catheter-induced infection.
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Affiliation(s)
- Yang Zhang
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Guangbin Song
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Can Hu
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Zixu Liu
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Huansen Liu
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Yilei Wang
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Liang Wang
- School of Chemistry and Chemical Engineering, Tianjin University of Technology Tianjin China
| | - Xuequan Feng
- Neurosurgery Department, Tianjin First Centre Hospital Tianjin China
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21
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Sanjanwala D, Londhe V, Trivedi R, Bonde S, Sawarkar S, Kale V, Patravale V. Polysaccharide-based hydrogels for medical devices, implants and tissue engineering: A review. Int J Biol Macromol 2024; 256:128488. [PMID: 38043653 DOI: 10.1016/j.ijbiomac.2023.128488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/10/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
Hydrogels are highly biocompatible biomaterials composed of crosslinked three-dimensional networks of hydrophilic polymers. Owing to their natural origin, polysaccharide-based hydrogels (PBHs) possess low toxicity, high biocompatibility and demonstrate in vivo biodegradability, making them great candidates for use in various biomedical devices, implants, and tissue engineering. In addition, many polysaccharides also show additional biological activities such as antimicrobial, anticoagulant, antioxidant, immunomodulatory, hemostatic, and anti-inflammatory, which can provide additional therapeutic benefits. The porous nature of PBHs allows for the immobilization of antibodies, aptamers, enzymes and other molecules on their surface, or within their matrix, potentiating their use in biosensor devices. Specific polysaccharides can be used to produce transparent hydrogels, which have been used widely to fabricate ocular implants. The ability of PBHs to encapsulate drugs and other actives has been utilized for making neural implants and coatings for cardiovascular devices (stents, pacemakers and venous catheters) and urinary catheters. Their high water-absorption capacity has been exploited to make superabsorbent diapers and sanitary napkins. The barrier property and mechanical strength of PBHs has been used to develop gels and films as anti-adhesive formulations for the prevention of post-operative adhesion. Finally, by virtue of their ability to mimic various body tissues, they have been explored as scaffolds and bio-inks for tissue engineering of a wide variety of organs. These applications have been described in detail, in this review.
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Affiliation(s)
- Dhruv Sanjanwala
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga (E), Mumbai 400019, Maharashtra, India; Department of Pharmaceutical Sciences, College of Pharmacy, 428 Church Street, University of Michigan, Ann Arbor, MI 48109, United States.
| | - Vaishali Londhe
- SVKM's NMIMS, Shobhaben Pratapbhai College of Pharmacy and Technology Management, V.L. Mehta Road, Vile Parle (W), Mumbai 400056, Maharashtra, India
| | - Rashmi Trivedi
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur 441002, Maharashtra, India
| | - Smita Bonde
- SVKM's NMIMS, School of Pharmacy and Technology Management, Shirpur Campus, Maharashtra, India
| | - Sujata Sawarkar
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai 400056, Maharashtra, India
| | - Vinita Kale
- Department of Pharmaceutics, Gurunanak College of Pharmacy, Kamptee Road, Nagpur 440026, Maharashtra, India
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga (E), Mumbai 400019, Maharashtra, India.
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22
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Klubthawee N, Wongchai M, Aunpad R. The bactericidal and antibiofilm effects of a lysine-substituted hybrid peptide, CM-10K14K, on biofilm-forming Staphylococcus epidermidis. Sci Rep 2023; 13:22262. [PMID: 38097636 PMCID: PMC10721899 DOI: 10.1038/s41598-023-49302-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
Staphylococci, notably biofilm-forming Staphylococcus epidermidis, have been recognized as global nosocomial pathogens in medical device-related infections. Their potential to attach to and form biofilm on indwelling catheters are significant factors impeding conventional treatment. Due to their extensive antimicrobial and antibiofilm actions, antimicrobial peptides (AMPs) have attracted interest as promising alternative compounds for curing difficult-to-treat, biofilm-forming bacterial infections. Cecropin A-melittin or CM, a well-known hybrid peptide, exhibits broad-spectrum antimicrobial activity, however it also possesses high toxicity. In the current study, a series of hybrid CM derivatives was designed using an amino acid substitution strategy to explore potential antibacterial and antibiofilm peptides with low toxicity. Among the derivatives, CM-10K14K showed the least hemolysis along with potent antibacterial activity against biofilm-forming S. epidermidis (MICs = 3.91 μg/mL) and rapid killing after 15 min exposure (MBCs = 7.81 μg/mL). It can prevent the formation of S. epidermidis biofilm and also exhibited a dose-dependent eradication activity on mature or established S. epidermidis biofilm. In addition, it decreased the development of biofilm by surviving bacteria, and formation of biofilm on the surface of CM-10K14K-impregnated catheters. Released CM-10K14K decreased planktonic bacterial growth and inhibited biofilm formation by S. epidermidis in a dose-dependent manner for 6 and 24 h post-exposure. Impregnation of CM-10K14K prevented bacterial attachment on catheters and thus decreased formation of extensive biofilms. SEM images supported the antibiofilm activity of CM-10K14K. Flow cytometry analysis and TEM images demonstrated a membrane-active mechanism of CM-10K14K, inducing depolarization and permeabilization, and subsequent membrane rupture leading to cell death. The presence of an interaction with bacterial DNA was verified by gel retardation assay. These antibacterial and antibiofilm activities of CM-10K14K suggest its potential application to urinary catheters for prevention of biofilm-forming colonization or for treatment of medical devices infected with S. epidermidis.
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Affiliation(s)
- Natthaporn Klubthawee
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Khlong Luang, 12120, Pathum Thani, Thailand
| | - Mathira Wongchai
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Khlong Luang, 12120, Pathum Thani, Thailand
| | - Ratchaneewan Aunpad
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Khlong Luang, 12120, Pathum Thani, Thailand.
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23
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Agarwalla A, Ahmed W, Al-Marzouqi AH, Rizvi TA, Khan M, Zaneldin E. Characteristics and Key Features of Antimicrobial Materials and Associated Mechanisms for Diverse Applications. Molecules 2023; 28:8041. [PMID: 38138531 PMCID: PMC10745420 DOI: 10.3390/molecules28248041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Since the Fourth Industrial Revolution, three-dimensional (3D) printing has become a game changer in manufacturing, particularly in bioengineering, integrating complex medical devices and tools with high precision, short operation times, and low cost. Antimicrobial materials are a promising alternative for combating the emergence of unforeseen illnesses and device-related infections. Natural antimicrobial materials, surface-treated biomaterials, and biomaterials incorporated with antimicrobial materials are extensively used to develop 3D-printed products. This review discusses the antimicrobial mechanisms of different materials by providing examples of the most commonly used antimicrobial materials in bioengineering and brief descriptions of their properties and biomedical applications. This review will help researchers to choose suitable antimicrobial agents for developing high-efficiency biomaterials for potential applications in medical devices, packaging materials, biomedical applications, and many more.
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Affiliation(s)
- Aaruci Agarwalla
- Department of Chemical and Petroleum Engineering, College of Engineering, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (A.A.)
| | - Waleed Ahmed
- Engineering Requirements Unit, College of Engineering, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Ali H. Al-Marzouqi
- Department of Chemical and Petroleum Engineering, College of Engineering, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (A.A.)
| | - Tahir A. Rizvi
- Department of Microbiology & Immunology, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Mushtaq Khan
- Department of Microbiology & Immunology, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Essam Zaneldin
- Department of Civil and Environmental Engineering, College of Engineering, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates;
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24
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Wei L, Li Y, Qiu X, Zhang X, Song X, Zhao Y, Yu Q, Shao J, Ge S, Huang J. An underwater stable and durable gelatin composite hydrogel coating for biomedical applications. J Mater Chem B 2023; 11:11372-11383. [PMID: 38009934 DOI: 10.1039/d3tb01817b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Developing underwater stable and durable hydrogel coatings with drag-reducing, drug release, and antibacterial properties is essential for lots of biomedical applications. However, most hydrogel coatings cannot meet the requirement of underwater stability and versatility, which severely limits their widespread use. In this work, an underwater stable, durable and substrate-independent gelatin composite hydrogel (GMP) coating is developed through covalent crosslinks, where a silane coupling agent with an unsaturated double bond is grafted onto a substrate of co-deposited polydopamine and polyethylenimine. GMP coating can be easily coated onto various medical device surfaces, such as artificial joints, catheters, tracheal tubes and titanium alloys, showing excellent structural stability and mechanical tunability under extreme conditions of ultrasonic treatment for 1 h (400 W of ultrasonic power) or underwater shearing for 14 days (400 rpm). Besides, friction experiment reveals that GMP coating exhibits good lubrication properties (coefficient of friction < 0.003). The drug-loading and bacterial inhibition ring tests show that the GMP coating has a tunable drug release ability with the final releasing ratios of 70-95% by changing the content of poly (ethylene glycol) diacrylate. This work offers a scalable approach of fabricating bio-functional and stable hydrogel coatings, which can be potentially used in biomedical applications.
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Affiliation(s)
- Luxing Wei
- Center for Advanced Jet Engineering Technologies (CaJET), Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan, Shandong, 25006, China
| | - Yuan Li
- Sinopec Research Institute of Petroleum Engineering, Fracturing & Acidizing and Natural Gas Production Research Institute, Dongying, Shandong, 257000, China
| | - Xiaoyong Qiu
- Key Laboratory of Colloid and Interface Chemistry of the Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan 250100, China.
| | - Xiaolai Zhang
- Key Laboratory of Colloid and Interface Chemistry of the Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan 250100, China.
| | - Xiaoyu Song
- Center for Advanced Jet Engineering Technologies (CaJET), Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan, Shandong, 25006, China
| | - Yunpeng Zhao
- Department of Orthopaedic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Qing Yu
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, 250012, China
| | - Jinlong Shao
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, 250012, China
| | - Shaohua Ge
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, 250012, China
| | - Jun Huang
- Center for Advanced Jet Engineering Technologies (CaJET), Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan, Shandong, 25006, China
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25
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Baburova PI, Kladko DV, Lokteva A, Pozhitkova A, Rumyantceva V, Rumyantceva V, Pankov IV, Taskaev S, Vinogradov VV. Magnetic Soft Robot for Minimally Invasive Urethral Catheter Biofilm Eradication. ACS NANO 2023; 17:20925-20938. [PMID: 37871301 DOI: 10.1021/acsnano.2c10127] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Catheter-related biofilm infection remains the main problem for millions of people annually, affecting morbidity, mortality, and quality of life. Despite the recent advances in the prevention of biofilm formation, alternative methods for biofilm prevention or eradication still should be found to avoid traumatic and expensive removal or catheter replacement. Soft magnetic robots have drawn significant interest in favor of remote control, fast response, and wide space for design. In this work, we demonstrated magnetic soft robots as a minimally invasive, safe, and effective approach to eliminate biofilm from urethral catheters (20 Fr or 5.1 mm in diameter). Seven designs of the robot were fabricated (size 4.5 × 15 mm), characterized, and tested in the presence of a rotating magnetic field. As a proof-of-concept, we demonstrated the superior efficiency of biofilm removal on the model of a urethral catheter using a magnetic robot, reaching full eradication for the octagram-shaped robot (velocity 2.88 ± 0.6 mm/s) at a 15 Hz frequency and a 10 mT amplitude. These findings are helpful for the treatment of biofilm-associated catheter contamination, which allows an increase in the catheter wearing time without frequent replacement and treatment of catheter-associated infections.
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Affiliation(s)
- Polina I Baburova
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
| | - Daniil V Kladko
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
| | - Alina Lokteva
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
| | - Anna Pozhitkova
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
| | - Viktoriya Rumyantceva
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
| | - Valeriya Rumyantceva
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
| | - Ilya V Pankov
- Institute of Physical and Organic Chemistry, Southern Federal University, 344090 Rostov-on-Don, Russia
| | - Sergey Taskaev
- National Research South Ural State University, Chelyabinsk 454080, Russia
- Chelyabinsk State University, Chelyabinsk 454001, Russia
| | - Vladimir V Vinogradov
- International Institute "Solution Chemistry of Advanced Materials and Technologies", ITMO University, 191002 Saint Petersburg, Russia
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26
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Zaugg A, Sherren E, Yi R, Larsen T, Dyck B, Stump S, Pauga F, Linder A, Takara M, Gardner E, Shin S, Pulsipher J, Savage PB. Incorporating Ceragenins into Coatings Protects Peripherally Inserted Central Catheter Lines against Pathogen Colonization for Multiple Weeks. Int J Mol Sci 2023; 24:14923. [PMID: 37834369 PMCID: PMC10573620 DOI: 10.3390/ijms241914923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Healthcare-acquired infections and multi-drug resistance in pathogens pose a major crisis for the healthcare industry. Novel antibiotics which are effective against resistant strains and unlikely to elicit strong resistance are sought after in these settings. We have previously developed synthetic mimics of ubiquitous antimicrobial peptides and have worked to apply a lead compound, CSA-131, to the crisis. We aimed to generate a system of CSA-131-containing coatings for medical devices that can be adjusted to match elution and compound load for various environments and establish their efficacy in preventing the growth of common pathogens in and around these devices. Peripherally inserted central catheter (PICC) lines were selected for our substrate in this work, and a polyurethane-based system was used to establish coatings for evaluation. Microbial challenges by methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans were performed and SEM was used to evaluate coating structure and colonization. The results indicate that selected coatings show activity against selected planktonic pathogens that extend between 16 and 33 days, with similar periods of biofilm prevention.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Paul B. Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602, USA (R.Y.); (M.T.)
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27
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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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28
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Khan SA, Shakoor A. Recent Strategies and Future Recommendations for the Fabrication of Antimicrobial, Antibiofilm, and Antibiofouling Biomaterials. Int J Nanomedicine 2023; 18:3377-3405. [PMID: 37366489 PMCID: PMC10290865 DOI: 10.2147/ijn.s406078] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/06/2023] [Indexed: 06/28/2023] Open
Abstract
Biomaterials and biomedical devices induced life-threatening bacterial infections and other biological adverse effects such as thrombosis and fibrosis have posed a significant threat to global healthcare. Bacterial infections and adverse biological effects are often caused by the formation of microbial biofilms and the adherence of various biomacromolecules, such as platelets, proteins, fibroblasts, and immune cells, to the surfaces of biomaterials and biomedical devices. Due to the programmed interconnected networking of bacteria in microbial biofilms, they are challenging to treat and can withstand several doses of antibiotics. Additionally, antibiotics can kill bacteria but do not prevent the adsorption of biomacromolecules from physiological fluids or implanting sites, which generates a conditioning layer that promotes bacteria's reattachment, development, and eventual biofilm formation. In these viewpoints, we highlighted the magnitude of biomaterials and biomedical device-induced infections, the role of biofilm formation, and biomacromolecule adhesion in human pathogenesis. We then discussed the solutions practiced in healthcare systems for curing biomaterials and biomedical device-induced infections and their limitations. Moreover, this review comprehensively elaborated on the recent advances in designing and fabricating biomaterials and biomedical devices with these three properties: antibacterial (bacterial killing), antibiofilm (biofilm inhibition/prevention), and antibiofouling (biofouling inhibition/prevention) against microbial species and against the adhesion of other biomacromolecules. Besides we also recommended potential directions for further investigations.
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Affiliation(s)
- Shakeel Ahmad Khan
- Department of Applied Biology and Chemical Technology, the Hong Kong Polytechnic University, Hung Hom, Kowloon, 999077, Hong Kong
| | - Adnan Shakoor
- Department of Control and Instrumentation Engineering, King Fahd University of Petroleum & Minerals, Dhahran, Saudi Arabia
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29
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Ghosh S, Mukherjee R, Patra D, Haldar J. Engineering Photo-Crosslinked Antimicrobial Coating to Tackle Catheter-Associated Infections In Vivo. ACS Biomater Sci Eng 2023. [PMID: 37335583 DOI: 10.1021/acsbiomaterials.3c00342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Microbial colonization on urinary and intravascular catheter surfaces results in steeply rising cases of catheter-associated infections as well as blood stream infections. Currently marketed efforts include impregnation and loading of antimicrobials and antiseptics that leach out into the local environment and inactivate microbes. However, they suffer from uncontrolled release, induction of resistance, and undesired toxicity. Here, in this manuscript, we have developed a photocurable, covalent coating on catheters using quaternary benzophenone-based amide (QSM-1). The coating was found to be active against drug-resistant bacteria and fungi. The coating inactivated stationary and persister cells of superbug MRSA and inhibited the formation of biofilms with retained activity against broad-spectrum bacteria when challenged in realistic urinary conditions. The coating was seen to be biocompatible in vitro and in vivo. Remarkably, the coated catheters showed reduced fouling and >99.9% reduction in bacterial burden when implanted in vivo in a mice model of subcutaneous implantation. We conceive the possibility of application of QSM-1-coated catheters in the healthcare settings to tackle the notorious catheter-associated nosocomial infections.
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Affiliation(s)
- Sreyan Ghosh
- Antimicrobial Research Laboratory, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru 560064, Karnataka, India
| | - Riya Mukherjee
- Antimicrobial Research Laboratory, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru 560064, Karnataka, India
| | - Dipanjana Patra
- Antimicrobial Research Laboratory, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru 560064, Karnataka, India
| | - Jayanta Haldar
- Antimicrobial Research Laboratory, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru 560064, Karnataka, India
- School of Advanced Materials, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bengaluru 560064, Karnataka, India
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30
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Moore JV, Burns J, McClelland N, Quinn J, McCoy CP. Understanding the properties of intermittent catheters to inform future development. Proc Inst Mech Eng H 2023:9544119231178468. [PMID: 37300485 DOI: 10.1177/09544119231178468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite the extensive use of intermittent catheters (ICs) in healthcare, various issues persist for long-term IC users, such as pain, discomfort, infection, and tissue damage, including strictures, scarring and micro-abrasions. A lubricous IC surface is considered necessary to reduce patient pain and trauma, and therefore is a primary focus of IC development to improve patient comfort. While an important consideration, other factors should be routinely investigated to inform future IC development. An array of in vitro tests should be employed to assess IC's lubricity, biocompatibility and the risk of urinary tract infection development associated with their use. Herein, we highlight the importance of current in vitro characterisation techniques, the demand for optimisation and an unmet need to develop a universal 'toolkit' to assess IC properties.
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Affiliation(s)
- Jessica V Moore
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jane Burns
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Nicola McClelland
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - James Quinn
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Colin P McCoy
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
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31
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Felix L, Whitely C, Tharmalingam N, Mishra B, Vera-Gonzalez N, Mylonakis E, Shukla A, Fuchs BB. Auranofin coated catheters inhibit bacterial and fungal biofilms in a murine subcutaneous model. Front Cell Infect Microbiol 2023; 13:1135942. [PMID: 37313344 PMCID: PMC10258325 DOI: 10.3389/fcimb.2023.1135942] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/24/2023] [Indexed: 06/15/2023] Open
Abstract
Microbe entry through catheter ports can lead to biofilm accumulation and complications from catheter-related bloodstream infection and ultimately require antimicrobial treatment and catheter replacement. Although strides have been made with microbial prevention by applying standardized antiseptic techniques during catheter implantation, both bacterial and fungal microbes can present health risks to already sick individuals. To reduce microbial adhesion, murine and human catheters were coated with polyurethane and auranofin using a dip coating method and compared to non-coated materials. Upon passage of fluid through the coated material in vitro, flow dynamics were not impacted. The unique antimicrobial properties of the coating material auranofin has shown inhibitory activity against bacteria such as Staphylococcus aureus and fungi such as Candida albicans. Auranofin coating on catheters at 10mg/mL reduced C. albicans accumulation in vitro from 2.0 x 108 to 7.8 x 105 CFU for mouse catheters and from 1.6 x 107 to 2.8 x 106 for human catheters, showing an impact to mature biofilms. Assessment of a dual microbe biofilm on auranofin-coated catheters resulted in a 2-log reduction in S. aureus and a 3-log reduction in C. albicans compared to uncoated catheters. In vivo assessment in a murine subcutaneous model demonstrated that catheters coated with 10 mg/mL auranofin reduced independent S. aureus and C. albicans accumulation by 4-log and 1-log, respectively, compared to non-coated catheters. In conclusion, the auranofin-coated catheters demonstrate proficiency at inhibiting multiple pathogens by decreasing S. aureus and C. albicans biofilm accumulation.
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Affiliation(s)
- LewisOscar Felix
- Division of Infectious Diseases, Rhode Island Hospital, The Miriam Hospital, Alpert Medical School and Brown University, Providence, RI, United States
| | - Cutler Whitely
- Center for Biomedical Engineering, School of Engineering, Institute for Molecular and Nanoscale Innovation, Brown University, Providence, RI, United States
| | - Nagendran Tharmalingam
- Division of Infectious Diseases, Rhode Island Hospital, The Miriam Hospital, Alpert Medical School and Brown University, Providence, RI, United States
| | - Biswajit Mishra
- Division of Infectious Diseases, Rhode Island Hospital, The Miriam Hospital, Alpert Medical School and Brown University, Providence, RI, United States
| | - Noel Vera-Gonzalez
- Center for Biomedical Engineering, School of Engineering, Institute for Molecular and Nanoscale Innovation, Brown University, Providence, RI, United States
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital, The Miriam Hospital, Alpert Medical School and Brown University, Providence, RI, United States
| | - Anita Shukla
- Center for Biomedical Engineering, School of Engineering, Institute for Molecular and Nanoscale Innovation, Brown University, Providence, RI, United States
| | - Beth Burgwyn Fuchs
- Division of Infectious Diseases, Rhode Island Hospital, The Miriam Hospital, Alpert Medical School and Brown University, Providence, RI, United States
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Behzadinasab S, Williams MD, Falkinham JO, Ducker WA. Facile Implementation of Antimicrobial Coatings through Adhesive Films (Wraps) Demonstrated with Cuprous Oxide Coatings. Antibiotics (Basel) 2023; 12:antibiotics12050920. [PMID: 37237824 DOI: 10.3390/antibiotics12050920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Antimicrobial coatings have a finite lifetime because of wear, depletion of the active ingredient, or surface contamination that produces a barrier between the pathogen and the active ingredient. The limited lifetime means that facile replacement is important. Here, we describe a generic method for rapidly applying and reapplying antimicrobial coatings to common-touch surfaces. The method is to deposit an antimicrobial coating on a generic adhesive film (wrap), and then to attach that modified wrap to the common-touch surface. In this scenario, the adhesion of the wrap and antimicrobial efficacy are separated and can be optimized independently. We demonstrate the fabrication of two antimicrobial wraps, both using cuprous oxide (Cu2O) as the active ingredient. The first uses polyurethane (PU) as the polymeric binder and the second uses polydopamine (PDA). Our antimicrobial PU/Cu2O and PDA/Cu2O wraps, respectively, kill >99.98% and >99.82% of the human pathogen, P. aeruginosa, in only 10 min, and each of them kill >99.99% of the bacterium in 20 min. These antimicrobial wraps can be removed and replaced on the same object in <1 min with no tools. Wraps are already frequently used by consumers to coat drawers or cars for aesthetic or protective purposes.
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Affiliation(s)
- Saeed Behzadinasab
- Department of Chemical Engineering, Virginia Tech, Blacksburg, VR 24061, USA
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, VR 24061, USA
- Macromolecules Innovation Institute, Virginia Tech, Blacksburg, VR 24061, USA
| | - Myra D Williams
- Department of Biological Sciences, Virginia Tech, Blacksburg, VR 24061, USA
| | - Joseph O Falkinham
- Department of Biological Sciences, Virginia Tech, Blacksburg, VR 24061, USA
| | - William A Ducker
- Department of Chemical Engineering, Virginia Tech, Blacksburg, VR 24061, USA
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, VR 24061, USA
- Macromolecules Innovation Institute, Virginia Tech, Blacksburg, VR 24061, USA
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van den Berg D, Asker D, Awad TS, Lavielle N, Hatton BD. Mechanical deformation of elastomer medical devices can enable microbial surface colonization. Sci Rep 2023; 13:7691. [PMID: 37169828 PMCID: PMC10175502 DOI: 10.1038/s41598-023-34217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/26/2023] [Indexed: 05/13/2023] Open
Abstract
Elastomers such as silicone are common in medical devices (catheters, prosthetic implants, endoscopes), but they remain prone to microbial colonization and biofilm infections. For the first time, our work shows that rates of microbial surface attachment to polydimethylsiloxane (PDMS) silicone can be significantly affected by mechanical deformation. For a section of bent commercial catheter tubing, bacteria (P. aeruginosa) show a strong preference for the 'convex' side compared to the 'concave' side, by a factor of 4.2. Further testing of cast PDMS materials in bending only showed a significant difference for samples that were manually wiped (damaged) beforehand (1.75 × 104 and 6.02 × 103 cells/mm2 on the convex and concave sides, respectively). We demonstrate that surface microcracks in elastomers are opened under tensile stress (convex bending) to become 'activated' as sites for microbial colonization. This work demonstrates that the high elastic limit of elastomers enables these microcracks to reversibly open and close, as 'dynamic defects'. Commercial catheters have relatively high surface roughness inherent to manufacturing, but we show that even manual wiping of newly-cast PDMS is sufficient to generate surface microcracks. We consider the implication for medical devices that feature sustained, surgical, or cyclic deformation, in which localized tensile conditions may expose these surface defects to opportunistic microbes. As a result, our work showcases serious potential problems in the widespread usage and development of elastomers in medical devices.
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Affiliation(s)
| | - Dalal Asker
- Department of Materials Science and Engineering, University of Toronto, Toronto, Canada
- Food Science & Technology Department, Alexandria University, Alexandria, Egypt
| | - Tarek S Awad
- Department of Materials Science and Engineering, University of Toronto, Toronto, Canada
| | - Nicolas Lavielle
- Physique et Mécanique des Milieux Hétérogènes, CNRS, ESPCI, PSL Research University, Sorbonne Université, Sorbonne Paris Cité, 75005, Paris, France
| | - Benjamin D Hatton
- Department of Materials Science and Engineering, University of Toronto, Toronto, Canada.
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada.
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Cai Y, Gu R, Dong Y, Zhao Q, Zhang K, Cheng C, Yang H, Li J, Yuan X. Fabrication of antibacterial polydopamine-carboxymethyl cellulose-Ag nanoparticle hydrogel coating for urinary catheters. J Biomater Appl 2023:8853282231173576. [PMID: 37142296 DOI: 10.1177/08853282231173576] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Urinary tract infections caused by catheter insertion are prevalent in hospital clinics, which can induce serious complications such as bacteriuria and sepsis, and even lead to patient death. The disposable catheters currently used in clinical practice suffer from poor biocompatibility and high infection rate. In this paper, we developed a polydopamine (PDA)-carboxymethylcellulose (CMC)-Ag nanoparticles (AgNPs) coating with both good antibacterial and anti-adhesion properties to bacteria on the surfaces of a disposable medical latex catheter by a simple dipping method. The antibacterial efficiency of the coated catheters against Gram-negative E. coli and Gram-positive S. aureus bacteria was evaluated with both inhibition zone tests and fluorescence microscopy. Compared with the untreated catheter, the PDA-CMC-AgNPs coated catheters showed both good antibacterial and anti-adhesion properties to bacteria, which inhibited the adhesion of live bacteria and dead bacteria by 99.0% and 86.6%, respectively. This novel PDA-CMC-AgNPs composite hydrogel coating has great potential in applications in catheters and other biomedical devices to reduce infections.
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Affiliation(s)
- Yongwei Cai
- School of Chemistry and Chemical Engineering, Chongqing University of Technology, Chongqing, China
| | - Ronghua Gu
- Chongqing University Cancer Hospital, Chongqing, China
| | | | - Qi Zhao
- University of Dundee, Dundee, UK
| | - Ke Zhang
- University of Dundee, Dundee, UK
| | | | - Hong Yang
- School of Chemistry and Chemical Engineering, Chongqing University of Technology, Chongqing, China
| | - Jianxiang Li
- School of Chemistry and Chemical Engineering, Chongqing University of Technology, Chongqing, China
| | - Xinggen Yuan
- School of Chemistry and Chemical Engineering, Chongqing University of Technology, Chongqing, China
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Miao J, Wu X, Fang Y, Zeng M, Huang Z, Ouyang M, Wang R. Multifunctional hydrogel coatings with high antimicrobial loading efficiency and pH-responsive properties for urinary catheter applications. J Mater Chem B 2023; 11:3373-3386. [PMID: 37000775 DOI: 10.1039/d3tb00148b] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Catheter-associated urinary tract infections are one of the most common hospital-acquired infections. Encrustation formation results from infection of urease-producing bacteria and further complicates the situation. A typical sign of the initial onset of encrustation formation is the alkalization of the urine (pH up to 9-10). However, effective antibacterial strategies with high antimicrobial loading efficiency and pH-responsiveness of antimicrobial release are still lacking. In this study, we developed a poly(sulfobetaine methacrylate)-tannic acid (polySBMA-TA) hydrogel coating, which served as a universal, efficient, and responsive carrier for antimicrobials on urinary catheters. Common antimicrobials, including poly(vinylpyrrolidone)-iodine, copper ions, and nitrofurazone were loaded into the polySBMA-TA coating in high efficiency (several fold higher than that of the polySBMA coating), via the formation of multiple non-covalent interactions between the antimicrobials and hydrogel coating. The hydrogel coatings maintained good antibacterial properties under neutral conditions. More importantly, the pH-responsive release of antibacterial agents under alkaline conditions further enhanced the antibacterial activity of the coatings, which was advantageous for killing the urease-producing bacteria and preventing encrustation. In vitro and in vivo tests confirmed that the hydrogel coating has good biocompatibility, and could effectively inhibit bacterial colonization and encrustation formation. This study offers new opportunities for the utilization of a simple and universal antimicrobial-loaded hydrogel coating with smart pH-responsive properties to combat bacterial colonization and encrustation formation in urinary catheters.
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Affiliation(s)
- Jiru Miao
- College of Chemical Engineering, Zhejiang University of Technology, Hangzhou, 310014, P. R. China.
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315300, P. R. China.
| | - Xiang Wu
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315300, P. R. China.
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Li Huili Hospital, Ningbo University School of Medicine, Ningbo, 315000, China
| | - Yue Fang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315300, P. R. China.
| | - Mingzhu Zeng
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315300, P. R. China.
| | - Zhimao Huang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315300, P. R. China.
| | - Mi Ouyang
- College of Chemical Engineering, Zhejiang University of Technology, Hangzhou, 310014, P. R. China.
| | - Rong Wang
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Zhejiang Engineering Research Center for Biomedical Materials, Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315300, P. R. China.
- University of Chinese Academy of Sciences, Beijing, 101408, P. R. China
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Behzadinasab S, Williams MD, Aktuglu M, Falkinham JO, Ducker WA. Porous Antimicrobial Coatings for Killing Microbes within Minutes. ACS APPLIED MATERIALS & INTERFACES 2023; 15:15120-15128. [PMID: 36920368 DOI: 10.1021/acsami.2c22240] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Antimicrobial coatings can be used to reduce the transmission of infectious agents that are spread by contact. An effective coating should kill microbes in the time between users, which is sometimes minutes or less. Fast killing requires fast transport, and our proposed method of fast transport is a porous coating where the contaminated liquid imbibes (infiltrates) into the pores to achieve rapid contact with active material inside the pores. We test the hypothesis that a porous antimicrobial coating will enable faster inactivation of microorganisms than a planar coating of the same material. We use hydrophilic pores with dimensions of 5-100 μm such that liquid droplets imbibe in seconds, and from there transport distances and times are short, defined by the pore size rather than the droplet size. Our coating has two levels of structure: (A) a porous scaffold and (B) an antimicrobial coating within the pore structure containing the active ingredient. Two scaffolds are studied: stainless steel and poly(methyl methacrylate) (PMMA). The active ingredient is electrolessly deposited copper. To enhance adhesion and growth of copper, a layer of polydopamine (PDA) is deposited on the scaffold prior to deposition of the copper. This porous copper coating kills 99.84% of Pseudomonas aeruginosa within 3 min, which is equivalent to a half-life of 27 s. In contrast, the same layer of PDA/copper on a nonporous coating kills 79.65% in the same time frame, consistent with the hypothesis that the killing rate is increased by the addition of porosity. Using the porous PMMA scaffold, the porous antimicrobial coating kills >99.99% P. aeruginosa in 5 min, which is equivalent to a half-life of 21 s. The higher rate of kill on the porous antimicrobial solid is appropriate for hindering the spread of infectious agents on common-use objects.
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Affiliation(s)
- Saeed Behzadinasab
- Department of Chemical Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia 24061, United States
- Macromolecules Innovation Institute, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Myra D Williams
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Mete Aktuglu
- Department of Chemical Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Joseph O Falkinham
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - William A Ducker
- Department of Chemical Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
- Center for Soft Matter and Biological Physics, Virginia Tech, Blacksburg, Virginia 24061, United States
- Macromolecules Innovation Institute, Virginia Tech, Blacksburg, Virginia 24061, United States
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Gao P, Jin P, Dumas R, Huang J, Asha AB, Narain R, Vankelecom I, Van der Bruggen B, Yang X. High-performance zwitterionic membranes via an adhesive prebiotic chemistry-inspired coating strategy: A demonstration in dye/salt fractionation. J Memb Sci 2023. [DOI: 10.1016/j.memsci.2023.121572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Efficacy of organo-selenium-incorporated urinary catheter tubing for in vitro growth inhibition of E. coli, K. pneumoniae, P. aeruginosa, and H. influenzae. Int Urol Nephrol 2023; 55:503-510. [PMID: 36462116 DOI: 10.1007/s11255-022-03422-y] [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: 07/12/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE Catheter-associated urinary tract infections are of significant medical burden in cost, morbidity, and mortality. Experimental selenium-coated medical devices have demonstrated non-toxic in vitro and in vivo antimicrobial activity. While antimicrobial-coated catheters have shown efficacy in preventing CAUTIs, selenium has not been tested in this context. The purpose of this in vitro study is to evaluate selenium-incorporated urinary catheters for inhibition of uropathogenic bacterial growth and biofilm formation. METHODS Urinary catheters incorporated with 1% organo-selenium and standard (uncoated) catheters were incubated in vitro with E. coli, K. pneumoniae, P. aeruginosa, H. influenzae, and combinations of these bacteria. Growth was evaluated by colony-forming unit count and visualized with confocal laser and scanning electron microscopy. Organo-selenium catheter material integrity was also tested by soaking the tubing in phosphate-buffered saline for 12 weeks at 37 °C. RESULTS Organo-selenium-incorporated catheters demonstrated total reduction (100%) of in vitro bacterial growth and biofilm formation for E. coli, K. pneumoniae, H. influenzae, and a combination of these species when compared to control. P. aeruginosa growth was inhibited by approximately 4 logs (99.99%). Complete inhibition of E. coli growth was maintained after long-term phosphate-buffered saline soaking. CONCLUSION The results demonstrate that organo-selenium was stably incorporated into catheter tubing and inhibited bacterial attachment, growth, and biofilm formation for multiple uropathogenic organisms. Furthermore, long-term soaking of organo-selenium tubing in phosphate-buffered saline did not show any decline in bacterial growth inhibition or biofilm formation. These findings suggest that organo-selenium-incorporated catheters may be advantageous in preventing catheter-associated urinary tract infections and warrant further in vivo and clinical evaluation.
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Alves D, Grainha T, Pereira MO, Lopes SP. Antimicrobial materials for endotracheal tubes: A review on the last two decades of technological progress. Acta Biomater 2023; 158:32-55. [PMID: 36632877 DOI: 10.1016/j.actbio.2023.01.001] [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: 10/17/2022] [Revised: 12/21/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
Ventilator-associated pneumonia (VAP) is an unresolved problem in nosocomial settings, remaining consistently associated with a lack of treatment, high mortality, and prolonged hospital stay. The endotracheal tube (ETT) is the major culprit for VAP development owing to its early surface microbial colonization and biofilm formation by multiple pathogens, both critical events for VAP pathogenesis and relapses. To combat this matter, gradual research on antimicrobial ETT surface coating/modification approaches has been made. This review provides an overview of the relevance and implications of the ETT bioburden for VAP pathogenesis and how technological research on antimicrobial materials for ETTs has evolved. Firstly, certain main VAP attributes (definition/categorization; outcomes; economic impact) were outlined, highlighting the issues in defining/diagnosing VAP that often difficult VAP early- and late-onset differentiation, and that generate misinterpretations in VAP surveillance and discrepant outcomes. The central role of the ETT microbial colonization and subsequent biofilm formation as fundamental contributors to VAP pathogenesis was then underscored, in parallel with the uncovering of the polymicrobial ecosystem of VAP-related infections. Secondly, the latest technological developments (reported since 2002) on materials able to endow the ETT surface with active antimicrobial and/or passive antifouling properties were annotated, being further subject to critical scrutiny concerning their potentialities and/or constraints in reducing ETT bioburden and the risk of VAP while retaining/improving the safety of use. Taking those gaps/challenges into consideration, we discussed potential avenues that may assist upcoming advances in the field to tackle VAP rampant rates and improve patient care. STATEMENT OF SIGNIFICANCE: The use of the endotracheal tube (ETT) in patients requiring mechanical ventilation is associated with the development of ventilator-associated pneumonia (VAP). Its rapid surface colonization and biofilm formation are critical events for VAP pathogenesis and relapses. This review provides a comprehensive overview on the relevance/implications of the ETT biofilm in VAP, and on how research on antimicrobial ETT surface coating/modification technology has evolved over the last two decades. Despite significant technological advances, the limited number of gathered reports (46), highlights difficulty in overcoming certain hurdles associated with VAP (e.g., persistent colonization/biofilm formation; mechanical ventilation duration; hospital length of stay; VAP occurrence), which makes this an evolving, complex, and challenging matter. Challenges and opportunities in the field are discussed.
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Affiliation(s)
- Diana Alves
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - Tânia Grainha
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - Maria Olívia Pereira
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - Susana Patrícia Lopes
- CEB - Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
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40
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Deposition of Chitosan on Plasma-Treated Polymers-A Review. Polymers (Basel) 2023; 15:polym15051109. [PMID: 36904353 PMCID: PMC10007447 DOI: 10.3390/polym15051109] [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: 01/08/2023] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Materials for biomedical applications often need to be coated to enhance their performance, such as their biocompatibility, antibacterial, antioxidant, and anti-inflammatory properties, or to assist the regeneration process and influence cell adhesion. Among naturally available substances, chitosan meets the above criteria. Most synthetic polymer materials do not enable the immobilization of the chitosan film. Therefore, their surface should be altered to ensure the interaction between the surface functional groups and the amino or hydroxyl groups in the chitosan chain. Plasma treatment can provide an effective solution to this problem. This work aims to review plasma methods for surface modification of polymers for improved chitosan immobilization. The obtained surface finish is explained in view of the different mechanisms involved in treating polymers with reactive plasma species. The reviewed literature showed that researchers usually use two different approaches: direct immobilization of chitosan on the plasma-treated surface or indirect immobilization by additional chemistry and coupling agents, which are also reviewed. Although plasma treatment leads to remarkably improved surface wettability, this was not the case for chitosan-coated samples, where a wide range of wettability was reported ranging from almost superhydrophilic to hydrophobic, which may have a negative effect on the formation of chitosan-based hydrogels.
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Capper-Parkin KL, Nichol T, Smith TJ, Lacey MM, Forbes S. Antimicrobial and cytotoxic synergism of biocides and quorum-sensing inhibitors against uropathogenic Escherichiacoli. J Hosp Infect 2023; 134:138-146. [PMID: 36801429 DOI: 10.1016/j.jhin.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Uropathogenic Escherichia coli (UPEC) are a primary cause of catheter-associated urinary tract infections (CAUTIs), often forming mature recalcitrant biofilms on the catheter surface. Anti-infective catheter coatings containing single biocides have been developed but display limited antimicrobial activity due to the selection of biocide-resistant bacterial populations. Furthermore, biocides often display cytotoxicity at concentrations required to eradicate biofilms, limiting their antiseptic potential. Quorum-sensing inhibitors (QSIs) provide a novel anti-infective approach to disrupt biofilm formation on the catheter surface and help prevent CAUTIs. AIM To evaluate the combinatorial impact of biocides and QSIs at bacteriostatic, bactericidal and biofilm eradication concentrations in parallel to assessing cytotoxicity in a bladder smooth muscle (BSM) cell line. METHODS Checkerboard assays were performed to determine fractional inhibitory, bactericidal, and biofilm eradication concentrations of test combinations in UPEC and combined cytotoxic effects in BSM cells. FINDINGS Synergistic antimicrobial activity was observed between polyhexamethylene biguanide, benzalkonium chloride or silver nitrate in combination with either cinnamaldehyde or furanone-C30 against UPEC biofilms. However, furanone-C30 was cytotoxic at concentrations below those required even for bacteriostatic activity. A dose-dependent cytotoxicity profile was observed for cinnamaldehyde when in combination with BAC, PHMB or silver nitrate. Both PHMB and silver nitrate displayed combined bacteriostatic and bactericidal activity below the half-maximum inhibitory concentration (IC50). Triclosan in combination with both QSIs displayed antagonistic activity in both UPEC and BSM cells. CONCLUSION PHMB and silver in combination with cinnamaldehyde display synergistic antimicrobial activity in UPEC at non-cytotoxic concentrations, suggesting potential as anti-infective catheter-coating agents.
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Affiliation(s)
- K L Capper-Parkin
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - T Nichol
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - T J Smith
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - M M Lacey
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - S Forbes
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK.
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Urethral Injuries: Diagnostic and Management Strategies for Critical Care and Trauma Clinicians. J Clin Med 2023; 12:jcm12041495. [PMID: 36836030 PMCID: PMC9959137 DOI: 10.3390/jcm12041495] [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: 11/21/2022] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Urologic trauma is a well-known cause of urethral injury with a range of management recommendations. Retrograde urethrogram remains the preferred initial diagnostic modality to evaluate a suspected urethral injury. The management thereafter varies based on mechanism of injury. Iatrogenic urethral injury is often caused by traumatic catheterization and is best managed by an attempted catheterization performed by an experienced clinician or suprapubic catheter to maximize urinary drainage. Penetrating trauma, most commonly associated with gunshot wounds, can cause either an anterior and/or posterior urethral injury and is best treated with early operative repair. Blunt trauma, most commonly associated with straddle injuries and pelvic fractures, can be treated with either early primary endoscopic realignment or delayed urethroplasty after suprapubic cystostomy. With any of the above injury patterns and treatment options, a well thought out and regimented follow-up with a urologist is of utmost importance for accurate assessment of outcomes and appropriate management of complications.
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43
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Dai S, Gao Y, Duan L. Recent advances in hydrogel coatings for urinary catheters. J Appl Polym Sci 2023. [DOI: 10.1002/app.53701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Simin Dai
- Polymeric and Soft Materials Laboratory, School of Chemistry and Life Science and Advanced Institute of Materials Science Changchun University of Technology Changchun People's Republic of China
| | - Yang Gao
- Polymeric and Soft Materials Laboratory, School of Chemical Engineering and Advanced Institute of Materials Science Changchun University of Technology Changchun People's Republic of China
| | - Lijie Duan
- Polymeric and Soft Materials Laboratory, School of Chemistry and Life Science and Advanced Institute of Materials Science Changchun University of Technology Changchun People's Republic of China
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Zhang S, Teng X, Liang X, Gadd GM, McCoy CP, Dong Y, Wang Y, Zhao Q. Fibrinogen Deposition on Silicone Oil-Infused Silver-Releasing Urinary Catheters Compromises Antibiofilm and Anti-Encrustation Properties. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2023; 39:1562-1572. [PMID: 36661856 PMCID: PMC9893812 DOI: 10.1021/acs.langmuir.2c03020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Slippery silicone-oil-infused (SOI) surfaces have recently emerged as a promising alternative to conventional anti-infection coatings for urinary catheters to combat biofilm and encrustation formation. Benefiting from the ultralow low hysteresis and slippery behavior, the liquid-like SOI coatings have been found to effectively reduce bacterial adhesion under both static and flow conditions. However, in real clinical settings, the use of catheters may also trigger local inflammation, leading to release of host-secreted proteins, such as fibrinogen (Fgn) that deposits on the catheter surfaces, creating a niche that can be exploited by uropathogens to cause infections. In this work, we report on the fabrication of a silicone oil-infused silver-releasing catheter which exhibited superior durability and robust antibacterial activity in aqueous conditions, reducing biofilm formation of two key uropathogens Escherichia coli and Proteus mirabilis by ∼99%, when compared with commercial all-silicone catheters after 7 days while remaining noncytotoxic toward L929 mouse fibroblasts. After exposure to Fgn, the oil-infused surfaces induced conformational changes in the protein which accelerated adsorption onto the surfaces. The deposited Fgn blocked the interaction of silver with the bacteria and served as a scaffold, which promoted bacterial colonization, resulting in a compromised antibiofilm activity. Fgn binding also facilitated the migration of Proteus mirabilis over the catheter surfaces and accelerated the deposition and spread of crystalline biofilm. Our findings suggest that the use of silicone oil-infused silver-releasing urinary catheters may not be a feasible strategy to combat infections and associated complications arising from severe inflammation.
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Affiliation(s)
- Shuai Zhang
- School
of Pharmacy, Queen’s University Belfast, BT9 7BL, Belfast, United Kingdom
| | - Xiao Teng
- School
of Pharmacy, Queen’s University Belfast, BT9 7BL, Belfast, United Kingdom
| | - Xinjin Liang
- School
of Life Sciences, University of Dundee, DD1 5EH, Dundee, United Kingdom
- School
of Mechanical and Aerospace Engineering, Queen’s University Belfast, BT9 AG, Belfast, United Kingdom
| | - Geoffrey Michael Gadd
- School
of Life Sciences, University of Dundee, DD1 5EH, Dundee, United Kingdom
- State
Key Laboratory of Heavy Oil Processing, Beijing Key Laboratory of
Oil and Gas Pollution Control, China University
of Petroleum, Beijing102249, China
| | - Colin Peter McCoy
- School
of Pharmacy, Queen’s University Belfast, BT9 7BL, Belfast, United Kingdom
| | - Yuhang Dong
- School
of Science and Engineering, University of
Dundee, DD1 4HN, Dundee, United Kingdom
| | - Yimeng Wang
- School
of Science and Engineering, University of
Dundee, DD1 4HN, Dundee, United Kingdom
| | - Qi Zhao
- School
of Science and Engineering, University of
Dundee, DD1 4HN, Dundee, United Kingdom
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45
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Crintea A, Carpa R, Mitre AO, Petho RI, Chelaru VF, Nădășan SM, Neamti L, Dutu AG. Nanotechnology Involved in Treating Urinary Tract Infections: An Overview. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:555. [PMID: 36770516 PMCID: PMC9919202 DOI: 10.3390/nano13030555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Considered as the most frequent contaminations that do not require hospitalization, urinary tract infections (UTIs) are largely known to cause significant personal burdens on patients. Although UTIs overall are highly preventable health issues, the recourse to antibiotics as drug treatments for these infections is a worryingly spread approach that should be addressed and gradually overcome in a contemporary, modernized healthcare system. With a virtually alarming global rise of antibiotic resistance overall, nanotechnologies may prove to be the much-needed 'lifebuoy' that will eventually suppress this prejudicial phenomenon. This review aims to present the most promising, currently known nano-solutions, with glimpses on clinical and epidemiological aspects of the UTIs, prospective diagnostic instruments, and non-antibiotic treatments, all of these engulfed in a comprehensive overview.
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Affiliation(s)
- Andreea Crintea
- Department of Medical Biochemistry, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Rahela Carpa
- Department of Molecular Biology and Biotechnology, Faculty of Biology and Geology, Babes-Bolyai University, 400084 Cluj-Napoca, Romania
| | - Andrei-Otto Mitre
- Department of Pathophysiology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Robert Istvan Petho
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Vlad-Florin Chelaru
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Sebastian-Mihail Nădășan
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Lidia Neamti
- Department of Medical Biochemistry, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Alina Gabriela Dutu
- Department of Medical Biochemistry, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
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46
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Dubern JF, Hook AL, Carabelli AM, Chang CY, Lewis-Lloyd CA, Luckett JC, Burroughs L, Dundas AA, Humes DJ, Irvine DJ, Alexander MR, Williams P. Discovery of a polymer resistant to bacterial biofilm, swarming, and encrustation. SCIENCE ADVANCES 2023; 9:eadd7474. [PMID: 36696507 PMCID: PMC9876547 DOI: 10.1126/sciadv.add7474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Innovative approaches to prevent catheter-associated urinary tract infections (CAUTIs) are urgently required. Here, we describe the discovery of an acrylate copolymer capable of resisting single- and multispecies bacterial biofilm formation, swarming, encrustation, and host protein deposition, which are major challenges associated with preventing CAUTIs. After screening ~400 acrylate polymers, poly(tert-butyl cyclohexyl acrylate) was selected for its biofilm- and encrustation-resistant properties. When combined with the swarming inhibitory poly(2-hydroxy-3-phenoxypropyl acrylate), the copolymer retained the bioinstructive properties of the respective homopolymers when challenged with Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. Urinary tract catheterization causes the release of host proteins that are exploited by pathogens to colonize catheters. After preconditioning the copolymer with urine collected from patients before and after catheterization, reduced host fibrinogen deposition was observed, and resistance to diverse uropathogens was maintained. These data highlight the potential of the copolymer as a urinary catheter coating for preventing CAUTIs.
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Affiliation(s)
- Jean-Frédéric Dubern
- National Biofilms Innovation Centre, University of Nottingham Biodiscovery Institute, School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Andrew L. Hook
- Advanced Materials and Healthcare Technologies, School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Alessandro M. Carabelli
- National Biofilms Innovation Centre, University of Nottingham Biodiscovery Institute, School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
- Advanced Materials and Healthcare Technologies, School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Chien-Yi Chang
- National Biofilms Innovation Centre, University of Nottingham Biodiscovery Institute, School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Christopher A. Lewis-Lloyd
- Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, University of Nottingham and Nottingham University Hospitals NHS Trust, School of Medicine, Queen’s Medical Centre, Nottingham NG7 2UH, UK
| | - Jeni C. Luckett
- National Biofilms Innovation Centre, University of Nottingham Biodiscovery Institute, School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Laurence Burroughs
- Advanced Materials and Healthcare Technologies, School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Adam A. Dundas
- Centre for Additive Manufacturing, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - David J. Humes
- Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, University of Nottingham and Nottingham University Hospitals NHS Trust, School of Medicine, Queen’s Medical Centre, Nottingham NG7 2UH, UK
| | - Derek J. Irvine
- Centre for Additive Manufacturing, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Morgan R. Alexander
- Advanced Materials and Healthcare Technologies, School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - Paul Williams
- National Biofilms Innovation Centre, University of Nottingham Biodiscovery Institute, School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
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47
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Zhang J, Fu Y, Zhou R, Yin M, Zhu W, Yan S, Wang H. The Construction of Alkaline Phosphatase-Responsive Biomaterial and Its Application for In Vivo Urinary Tract Infection Therapy. Adv Healthc Mater 2022; 12:e2202421. [PMID: 36546611 DOI: 10.1002/adhm.202202421] [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: 09/21/2022] [Revised: 11/23/2022] [Indexed: 12/24/2022]
Abstract
Urinary tract infections caused by urinary catheter implantations are becoming more serious. Therefore, the construction of a responsive antibacterial biomaterial that can not only provide biocompatible conditions, but also effectively prevent the growth and metabolism of bacteria, is urgently needed. In this work, a benzophenone-derived phosphatase light-triggered antibacterial agent is designed and synthesized, which is tethered to the biological materials using a one-step method for in vivo antibacterial therapy. This surface could kill gram-positive bacteria (Staphylococcus aureus) and gram-negative bacteria (Escherichia coli). More importantly, because this material exhibited a zwitterion structure, it does not damage blood cells and tissue cells. When the bacteria interact with this surface, the initial fouling of the bacteria is reduced by zwitterion hydration. When the bacteria actively accumulate and metabolize to produce a certain amount of alkaline phosphatase, the surface immediately started the sterilization performance, and the bactericidal effect is achieved by destroying the bacterial cell membrane. In summary, an antibacterial biomaterial that shows biocompatibility with mammalian cells is successfully constructed, providing new ideas for the development of intelligent urinary catheters.
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Affiliation(s)
- Jing Zhang
- Jilin Medical University, Jilin, 132013, P. R. China
| | - Ying Fu
- Jilin Medical University, Jilin, 132013, P. R. China
| | - Rongtao Zhou
- National Engineering Laboratory of Medical Implantable Devices, Key Laboratory for Medical Implantable Devices of Shandong Province, WEGO Holding Company Limited, Weihai, 264210, P. R. China
| | - Moli Yin
- Jilin Medical University, Jilin, 132013, P. R. China
| | - Wenhe Zhu
- Jilin Medical University, Jilin, 132013, P. R. China
| | - Shunjie Yan
- National Engineering Laboratory of Medical Implantable Devices, Key Laboratory for Medical Implantable Devices of Shandong Province, WEGO Holding Company Limited, Weihai, 264210, P. R. China
| | - Huiyan Wang
- Jilin Medical University, Jilin, 132013, P. R. China
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48
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Al Nakib R, Toncheva A, Fontaine V, Vanheuverzwijn J, Raquez JM, Meyer F. Design of Thermoplastic Polyurethanes with Conferred Antibacterial, Mechanical, and Cytotoxic Properties for Catheter Application. ACS APPLIED BIO MATERIALS 2022; 5:5532-5544. [PMID: 36367751 DOI: 10.1021/acsabm.2c00531] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Thermoplastic polyurethanes (TPUs) are proposed as suitable solution for the fabrication of biocompatible catheters with appropriate mechanical parameters and confirmed antibacterial and cytocompatible properties. For this purpose, a series of quaternary ammonium salts (QASs) and quaternary phosphonium salts (QPSs) based monomers were prepared followed by the determination of their minimal inhibitory concentrations (MICs) against Gram-positive Staphylococcus aureus (S. aureus) and Gram-negative Pseudomonas aeruginosa (P. aeruginosa). A combination of the most active ammonium (QAS-C14) and phosphonium (QPS-TOP) salts led to a MIC down to 2.4 μg/mL against S. aureus and 9 μg/mL against P. aeruginosa, corroborating the existence of a synergistic effect. These quaternary onium salt (QOS) units were successfully incorporated along the polymer chain, as part of a two-step synthesis approach. The resulting TPU-QOS materials were subsequently characterized through thermal, mechanical, and surface analyses. TPU-Mix (combining the most active QAS-C14 and QPS-TOP units) showed the highest antibacterial efficiency, confirming the synergistic effect between both QOS groups. Finally, an MTT assay on the SiHa cell line revealed the low cytotoxicity level of these polymeric films, making these materials suitable for biomedical application. To go one step further in the preindustrialization approach, proof of concept regarding the catheter prototype fabrication based on TPU-QAS/QPS was validated by extrusion.
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Affiliation(s)
- Rana Al Nakib
- Laboratory of Polymeric and Composite Materials, University of Mons, Faculty of Science, Campus Plaine de Nimy Place du Parc, 20, 7000 Mons, Belgium.,Microbiology, Bioorganic and Macromolecular Chemistry Unit, Université libre de Bruxelles (ULB), Faculty of Pharmacy, Campus Plaine, Boulevard du Triomphe, 1050 Bruxelles, Belgium
| | - Antoniya Toncheva
- Laboratory of Polymeric and Composite Materials, University of Mons, Faculty of Science, Campus Plaine de Nimy Place du Parc, 20, 7000 Mons, Belgium.,Laboratory of Bioactive Polymers, Institute of Polymers, Bulgarian Academy of Sciences, Acad. G. Bonchev St., 103A, 1113 Sofia, Bulgaria
| | - Veronique Fontaine
- Microbiology, Bioorganic and Macromolecular Chemistry Unit, Université libre de Bruxelles (ULB), Faculty of Pharmacy, Campus Plaine, Boulevard du Triomphe, 1050 Bruxelles, Belgium
| | - Jérôme Vanheuverzwijn
- Microbiology, Bioorganic and Macromolecular Chemistry Unit, Université libre de Bruxelles (ULB), Faculty of Pharmacy, Campus Plaine, Boulevard du Triomphe, 1050 Bruxelles, Belgium
| | - Jean-Marie Raquez
- Laboratory of Polymeric and Composite Materials, University of Mons, Faculty of Science, Campus Plaine de Nimy Place du Parc, 20, 7000 Mons, Belgium
| | - Franck Meyer
- Microbiology, Bioorganic and Macromolecular Chemistry Unit, Université libre de Bruxelles (ULB), Faculty of Pharmacy, Campus Plaine, Boulevard du Triomphe, 1050 Bruxelles, Belgium
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49
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Self-Disinfecting Urethral Catheter to Overcome Urinary Infections: From Antimicrobial Photodynamic Action to Antibacterial Biochemical Entities. Microorganisms 2022; 10:microorganisms10122484. [PMID: 36557737 PMCID: PMC9785902 DOI: 10.3390/microorganisms10122484] [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: 10/21/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Medical-device-related infections are considered a worldwide public health problem. In particular, urinary catheters are responsible for 75% of cases of hospital urinary infections (a mortality rate of 2.3%) and present a high cost for public and private health systems. Some actions have been performed and described aiming to avoid it, including clinical guidelines for catheterization procedure, antibiotic prophylaxis, and use of antimicrobial coated-urinary catheters. In this review paper, we present and discuss the functionalization of urinary catheters surfaces with antimicrobial entities (e.g., photosensitizers, antibiotics, polymers, silver salts, oxides, bacteriophage, and enzymes) highlighting the immobilization of photosensitizing molecules for antimicrobial photodynamic applications. Moreover, the characterization techniques and (photo)antimicrobial effects of the coated-urinary catheters are described and discussed. We highlight the most significant examples in the last decade (2011-2021) concerning the antimicrobial coated-urinary catheter and their potential use, limitations, and future perspectives.
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50
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Hwang YE, Im S, Cho JH, Lee W, Cho BK, Sung BH, Kim SC. Semi-Biosynthetic Production of Surface-Binding Adhesive Antimicrobial Peptides Using Intein-Mediated Protein Ligation. Int J Mol Sci 2022; 23:ijms232315202. [PMID: 36499519 PMCID: PMC9738365 DOI: 10.3390/ijms232315202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 12/11/2022] Open
Abstract
Microbial infections remain a global health concern, calling for the urgent need to implement effective prevention measures. Antimicrobial peptides (AMPs) have been extensively studied as potential antimicrobial coating agents. However, an efficient and economical method for AMP production is lacking. Here, we synthesized the direct coating adhesive AMP, NKC-DOPA5, composed of NKC, a potent AMP, and repeats of the adhesive amino acid 3,4-dihydroxyphenylalanine (DOPA) via an intein-mediated protein ligation strategy. NKC was expressed as a soluble fusion protein His-NKC-GyrA (HNG) in Escherichia coli, comprising an N-terminal 6× His-tag and a C-terminal Mxe GyrA intein. The HNG protein was efficiently produced in a 500-L fermenter, with a titer of 1.63 g/L. The NKC-thioester was released from the purified HNG fusion protein by thiol attack and subsequently ligated with chemically synthesized Cys-DOPA5. The ligated peptide His-NKC-Cys-DOPA5 was obtained at a yield of 88.7%. The purified His-NKC-Cys-DOPA5 possessed surface-binding and antimicrobial properties identical to those of the peptide obtained via solid-phase peptide synthesis. His-NKC-Cys-DOPA5 can be applied as a practical and functional antimicrobial coating to various materials, such as medical devices and home appliances.
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Affiliation(s)
- Young Eun Hwang
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Seonghun Im
- Synthetic Biology and Bioengineering Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 34141, Republic of Korea
- Center for Industrialization of Agricultural and Livestock Microorganisms (CIALM), Jeongeup 56212, Republic of Korea
| | - Ju Hyun Cho
- Division of Applied Life Science (BK21Four), Research Institute of Life Sciences, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Wonsik Lee
- School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Byung-Kwan Cho
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Bong Hyun Sung
- Synthetic Biology and Bioengineering Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 34141, Republic of Korea
- Correspondence: (B.H.S.); (S.C.K.)
| | - Sun Chang Kim
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
- Correspondence: (B.H.S.); (S.C.K.)
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