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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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2
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Shahriar A, Rob Siddiquee MF, Ahmed H, Mahmud AR, Ahmed T, Mahmud MR, Acharjee M. Catheter-associated urinary tract infections: Etiological analysis, biofilm formation, antibiotic resistance, and a novel therapeutic era of phage. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.86-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Urinary tract infection (UTI) caused by uropathogens has put global public health at its utmost risk, especially in developing countries where people are unaware of personal hygiene and proper medication. In general, the infection frequently occurs in the urethra, bladder, and kidney, as reported by the physician. Moreover, many UTI patients whose acquired disorder from the hospital or health-care center has been addressed previously have been referred to as catheter-associated UTI (CAUTI). Meanwhile, the bacterial biofilm triggering UTI is another critical issue, mostly by catheter insertion. In most cases, the biofilm inhibits the action of antibiotics against the UTI-causing bacteria. Therefore, new therapeutic tools should be implemented to eliminate the widespread multidrug resistance (MDR) UTI-causing bacteria. Based on the facts, the present review emphasized the current status of CAUTI, its causative agent, clinical manifestation, and treatment complications. This review also delineated a model of phage therapy as a new therapeutic means against bacterial biofilm-originated UTI. The model illustrated the entire mechanism of destroying the extracellular plyometric substances of UTI-causing bacteria with several enzymatic actions produced by phage particles. This review will provide a complete outline of CAUTI for the general reader and create a positive vibe for the researchers to sort out alternative remedies against the CAUTI-causing MDR microbial agents.
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Affiliation(s)
- Asif Shahriar
- Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh
| | | | - Hossain Ahmed
- Department of Biotechnology and Genetic Engineering, University of Development Alternative, Dhaka 1208, Bangladesh
| | - Aar Rafi Mahmud
- Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh
| | - Tasnia Ahmed
- Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh
| | - Md. Rayhan Mahmud
- Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh
| | - Mrityunjoy Acharjee
- Department of Microbiology, Stamford University Bangladesh, Dhaka, Bangladesh
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3
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Lim H, Chung JH, Park Y, Baek N, Seo Y, Park H, Cho YK, Jung D, Han DH. Inner surface modification of ureteral stent polyurethane tubes based by plasma-enhanced chemical vapor deposition to reduce encrustation and biofilm formation. BIOFOULING 2022; 38:482-492. [PMID: 35707890 DOI: 10.1080/08927014.2022.2087513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 04/26/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
Encrustation and/or biofilm formation in ureteral stents are major causes of obstruction and reduce the lifetime of a ureteral stent. In this study, the inner surfaces of polyurethane (PU) tubes (inner and outer diameters of 1.2 and 2.0 mm, respectively) were reformed with Ar, O2, and C2H2 gases using specialized plasma-enhanced chemical vapor deposition techniques for the first time. Then, the modified PU tubes were immersed in urine for 15 days, and the characteristics of the inner surfaces were analyzed. Depending on the modification procedure, the corresponding inner surface exhibited different chemical properties and different rates of encrustation and biofilm formation. For a hydrophilic surface treated with Ar and O2, encrustation and biofilm formation increased, while for the C2H2 coating, the development of encrustation and biofilm reduced by more than five times compared with the untreated bare PU tube. This study demonstrated that inner plasma surface modification of ureteral stents greatly enhances resistance to encrustation and biofilm formation.
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Affiliation(s)
- Hyuna Lim
- Department of Physics, Institute of Basic Science, Brain Korea 21 Physics Research Division, Sungkyunkwan University, Suwon, South Korea
| | - Jae Hoon Chung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yoonsoo Park
- Department of Physics, Institute of Basic Science, Brain Korea 21 Physics Research Division, Sungkyunkwan University, Suwon, South Korea
| | - Namwuk Baek
- Department of Physics, Institute of Basic Science, Brain Korea 21 Physics Research Division, Sungkyunkwan University, Suwon, South Korea
| | - Youngsik Seo
- Department of Molecular Biology and Institute of Nanosensor and Biotechnology, Dankook University, Cheonan, South Korea
| | - Heonyong Park
- Department of Molecular Biology and Institute of Nanosensor and Biotechnology, Dankook University, Cheonan, South Korea
| | - Yong Ki Cho
- Heat Treatment R&D Group, Korea Institute of Industrial Technology, Incheon, South Korea
| | - Donggeun Jung
- Department of Physics, Institute of Basic Science, Brain Korea 21 Physics Research Division, Sungkyunkwan University, Suwon, South Korea
| | - Deok Hyun Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
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4
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Biofilm Matrix Formation in Human: Clinical Significance, Diagnostic Techniques, and Therapeutic Drugs. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.107919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context: Some recent reports have indicated that almost 80% of clinical infections in humans have biofilm origin and impose additional healthcare costs. This study was an updated review of extracellular polymeric substance matrix (Biofilm) formation in humans and elaborated on its clinical significance, diagnosis, and therapeutic approaches. Evidence Acquisition: This narrative study reviewed the most recent information on the significance of microbial biofilm formation in clinical settings, common biofilm-producing bacterial species, its diagnosis, antibiotic drug resistance, and new approaches to the treatment of infections associated with biofilm formation. Results: Evidence indicated a permanent increase in the frequency of microbial biofilm in the central venous catheter, mechanical heart valve, and urinary catheter, as well as persistent infections. However, antimicrobial resistance induced by biofilms formation and the antimicrobial treatment of biofilms were problematic. Moreover, several assays and lab devices were described to evaluate biofilm formation. Furthermore, new attitudes towards anti-biofilm treatments were introduced in this paper. Conclusions: The number of different mechanisms were in accordance with the recent knowledge on how biofilms play a critical role in the disease pathogenesis. Biofilm strikes the treatment and surveillance of patients bearing infectious diseases under different conditions. The use of new methods in anti-biofilm treatments is effective for the recovery of infected patients.
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5
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Shahid A, Aslam B, Muzammil S, Aslam N, Shahid M, Almatroudi A, Allemailem KS, Saqalein M, Nisar MA, Rasool MH, Khurshid M. The prospects of antimicrobial coated medical implants. J Appl Biomater Funct Mater 2021; 19:22808000211040304. [PMID: 34409896 DOI: 10.1177/22808000211040304] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The implants are increasingly being a part of modern medicine in various surgical procedures for functional or cosmetic purposes. The progressive use of implants is associated with increased infectious complications and prevention of such infections always remains precedence in the clinical settings. The preventive approaches include the systemic administration of antimicrobial agents before and after the surgical procedures as well as the local application of antibiotics. The relevant literature and existing clinical practices have highlighted the role of antimicrobial coating approaches in the prevention of implants associated infections, although the applications of these strategies are not yet standardized, and the clinical efficacy is not much clear. The adequate data from the randomized control trials is challenging because of the unavailability of a large sample size although it is compulsory in this context to assess the clinical efficacy of preemptive practices. This review compares the efficacy of preventive approaches and the prospects of antimicrobial-coated implants in preventing implant-related infections.
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Affiliation(s)
- Aqsa Shahid
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Bilal Aslam
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Saima Muzammil
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Nosheen Aslam
- Department of Biochemistry, Government College University, Faisalabad, Pakistan
| | - Muhammad Shahid
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Ahmad Almatroudi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Khaled S Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Muhammad Saqalein
- Department of Microbiology, Government College University, Faisalabad, Pakistan
| | - Muhammad Atif Nisar
- Department of Microbiology, Government College University, Faisalabad, Pakistan.,College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
| | | | - Mohsin Khurshid
- Department of Microbiology, Government College University, Faisalabad, Pakistan
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6
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Biofilm Development on Urinary Catheters Promotes the Appearance of Viable but Nonculturable Bacteria. mBio 2021; 12:mBio.03584-20. [PMID: 33758085 PMCID: PMC8092313 DOI: 10.1128/mbio.03584-20] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Several antimicrobial urinary catheter materials have been developed, but, although laboratory studies may show a benefit, none have significantly improved clinical outcomes. The use of poorly designed laboratory testing and lack of consideration of the impact of VBNC populations may be responsible. Catheter-associated urinary tract infections have serious consequences, for both patients and health care resources. Much work has been carried out to develop an antimicrobial catheter. Although such developments have shown promise under laboratory conditions, none have demonstrated a clear advantage in clinical trials. Using a range of microbiological and advanced microscopy techniques, a detailed laboratory study comparing biofilm development on silicone, hydrogel latex, and silver alloy-coated hydrogel latex catheters was carried out. Biofilm development by Escherichia coli, Pseudomonas aeruginosa, and Proteus mirabilis on three commercially available catheters was tracked over time. Samples were examined with episcopic differential interference contrast (EDIC) microscopy, culture analysis, and staining techniques to quantify viable but nonculturable (VBNC) bacteria. Both qualitative and quantitative assessments found biofilms to develop rapidly on all three materials. EDIC microscopy revealed the rough surface topography of the materials. Differences between culture counts and quantification of total and dead cells demonstrated the presence of VBNC populations, where bacteria retain viability but are not metabolically active. The use of nonculture-based techniques showed the development of widespread VBNC populations. These VBNC populations were more evident on silver alloy-coated hydrogel latex catheters, indicating a bacteriostatic effect at best. The laboratory tests reported here, which detect VBNC bacteria, allow more rigorous assessment of antimicrobial catheters, explaining why there is often minimal benefit to patients.
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7
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An antibacterial coated polymer prevents biofilm formation and implant-associated infection. Sci Rep 2021; 11:3602. [PMID: 33574464 PMCID: PMC7878515 DOI: 10.1038/s41598-021-82992-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/18/2021] [Indexed: 11/09/2022] Open
Abstract
To prevent infections associated with medical implants, various antimicrobial silver-coated implant materials have been developed. However, these materials do not always provide consistent antibacterial effects in vivo despite having dramatic antibacterial effects in vitro, probably because the antibacterial effects involve silver-ion-mediated reactive oxygen species generation. Additionally, the silver application process often requires extremely high temperatures, which damage non-metal implant materials. We recently developed a bacteria-resistant coating consisting of hydroxyapatite film on which ionic silver is immobilized via inositol hexaphosphate chelation, using a series of immersion and drying steps performed at low heat. Here we applied this coating to a polymer, polyetheretherketone (PEEK), and analyzed the properties and antibacterial activity of the coated polymer in vitro and in vivo. The ionic silver coating demonstrated significant bactericidal activity and prevented bacterial biofilm formation in vitro. Bio-imaging of a soft tissue infection mouse model in which a silver-coated PEEK plate was implanted revealed a dramatic absence of bacterial signals 10 days after inoculation. These animals also showed a strong reduction in histological features of infection, compared to the control animals. This innovative coating can be applied to complex structures for clinical use, and could prevent infections associated with a variety of plastic implants.
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Okuzu Y, Fujibayashi S, Yamaguchi S, Masamoto K, Otsuki B, Goto K, Kawai T, Shimizu T, Morizane K, Kawata T, Shimizu Y, Hayashi M, Matsuda S. In vitro study of antibacterial and osteogenic activity of titanium metal releasing strontium and silver ions. J Biomater Appl 2020; 35:670-680. [PMID: 32954894 DOI: 10.1177/0885328220959584] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Peri-prosthetic infection and loosening of implants are major problems in orthopaedic and dental surgery. To address these issues, surface treatment methods for titanium implants have been improved by modifying the alkali and heat treatment. We have previously fabricated calcium-treated Ti metal that releases Sr ions (CaSr-Ti), which resulted in a higher in vitro osteogenic response and early in vivo bone bonding.Further, we developed a Ti metal that released both Sr and Ag ions (CaSrAg-Ti). In this study, we evaluated the antibacterial ability and osteogenic cellular response of CaSrAg-Ti and CaSr-Ti in vitro using rat bone marrow stromal cells (BMSCs) cultured on implant samples and extract mediums (EMs) made by immersing the implant samples in the medium. CaSrAg-Ti did not show cytotoxicity and was associated with a slightly higher osteogenic response when compared to CaSr-Ti, without inhibiting the effect of Sr. The osteogenic response was also observed in the cells cultured with the CaSrAg-Ti EM; however, the response was not as high as that of the cells on the CaSrAg-Ti implant sample. Significantly higher antibacterial activity was observed along with an antibacterial efficacy of more than 95% against methicillin-susceptible Staphylococcus aureus and Escherichia coli. The main advantages of our surface treatment are its simplicity and low cost. Therefore, our treatment is promising for clinical applications in orthopaedic or dental Ti-based implants with antibacterial and early bone-bonding abilities.
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Affiliation(s)
- Yaichiro Okuzu
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Shunsuke Fujibayashi
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Seiji Yamaguchi
- Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, Aichi, Japan
| | - Kazutaka Masamoto
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Bungo Otsuki
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Koji Goto
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Toshiyuki Kawai
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Takayoshi Shimizu
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Kazuaki Morizane
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Tomotoshi Kawata
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Yu Shimizu
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Makoto Hayashi
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
| | - Shuichi Matsuda
- Graduate School of Medicine, Department of Orthopaedic Surgery, Kyoto University, Japan
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9
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Masamoto K, Fujibayashi S, Yamaguchi S, Otsuki B, Okuzu Y, Kawata T, Goto K, Shimizu T, Shimizu Y, Kawai T, Hayashi M, Morizane K, Imamura M, Ikeda N, Takaoka Y, Matsuda S. Bioactivity and antibacterial activity of strontium and silver ion releasing titanium. J Biomed Mater Res B Appl Biomater 2020; 109:238-245. [PMID: 32767436 DOI: 10.1002/jbm.b.34695] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 07/11/2020] [Accepted: 07/16/2020] [Indexed: 11/11/2022]
Abstract
To overcome problems associated with loosening of orthopedic implants and surgical site infections, we developed a novel, titanium (Ti)-based material that releases both strontium and silver ions (CaSrAg-Ti) based on alkali-and-heat treatment. The results of commercially pure Ti (cp-Ti), Ti that releases Sr ions only (CaSr-Ti), and the novel CaSrAg-Ti material were compared. Mechanical tests were performed to evaluate the in vivo bonding properties of CaSrAg-Ti and the bone-implant contact (BIC) ratio in histological specimens was determined at 4 and 8 weeks after implantation in a rat femur. Also, the in vitro antibacterial activities of this material against methicillin-susceptible Staphylococcus aureus (MSSA) were evaluated after a 24 h incubation period by assaying colony-forming units. In addition, antibacterial activities were evaluated in vivo at 7 days after implantation in a rat subcutaneous pocket model. There was direct contact between the bone and CaSrAg-Ti in histological specimens and no apparent signs of argyrosis in any rat. The bone-bonding strength and the BIC ratio were increased by 2.7- and 2.3-fold for CaSrAg-Ti vs. cp-Ti at 4 weeks and 2.2- and 2.0-fold at 8 weeks, respectively. As compared with cp-Ti, the number of viable MSSA remaining on CaSrAg-Ti was reduced by 100 ± 0% in vitro and 94.2 ± 6.9% in vivo. Ti that releases Sr and Ag ions is a promising material that exhibits both bone-bonding properties and anti-MSSA activities.
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Affiliation(s)
- Kazutaka Masamoto
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Seiji Yamaguchi
- Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, Kasugai, Aichi, Japan
| | - Bungo Otsuki
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yaichiro Okuzu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomotoshi Kawata
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayoshi Shimizu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yu Shimizu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshiyuki Kawai
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Makoto Hayashi
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuaki Morizane
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masashi Imamura
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Norimasa Ikeda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yusuke Takaoka
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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10
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Francolini I, Hall-Stoodley L, Stoodley P. Biofilms, Biomaterials, and Device-Related Infections. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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11
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Zhang S, Liang X, Gadd GM, Zhao Q. Superhydrophobic Coatings for Urinary Catheters To Delay Bacterial Biofilm Formation and Catheter-Associated Urinary Tract Infection. ACS APPLIED BIO MATERIALS 2019; 3:282-291. [DOI: 10.1021/acsabm.9b00814] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Shuai Zhang
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, U.K
| | - Xinjin Liang
- School of Life Sciences, University of Dundee, Dundee DD1 5EH, Scotland, U.K
| | | | - Qi Zhao
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, Scotland, U.K
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12
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Cortese YJ, Wagner VE, Tierney M, Devine D, Fogarty A. Review of Catheter-Associated Urinary Tract Infections and In Vitro Urinary Tract Models. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:2986742. [PMID: 30405898 PMCID: PMC6204192 DOI: 10.1155/2018/2986742] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 12/22/2022]
Abstract
Catheter-associated urinary tract infections (CAUTIs) are one of the most common nosocomial infections and can lead to numerous medical complications from the mild catheter encrustation and bladder stones to the severe septicaemia, endotoxic shock, and pyelonephritis. Catheters are one of the most commonly used medical devices in the world and can be characterised as either indwelling (ID) or intermittent catheters (IC). The primary challenges in the use of IDs are biofilm formation and encrustation. ICs are increasingly seen as a solution to the complications caused by IDs as ICs pose no risk of biofilm formation due to their short time in the body and a lower risk of bladder stone formation. Research on IDs has focused on the use of antimicrobial and antibiofilm compounds, while research on ICs has focused on preventing bacteria entering the urinary tract or coming into contact with the catheter. There is an urgent need for in vitro urinary tract models to facilitate faster research and development for CAUTI prevention. There are currently three urinary tract models that test IDs; however, there is only a single very limited model for testing ICs. There is currently no standardised urinary tract model to test the efficacies of ICs.
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Affiliation(s)
- Yvonne J. Cortese
- Materials Research Institute, Athlone Institute of Technology, Athlone, Ireland
- Bioscience Research Institute, Athlone Institute of Technology, Athlone, Ireland
| | | | | | - Declan Devine
- Materials Research Institute, Athlone Institute of Technology, Athlone, Ireland
| | - Andrew Fogarty
- Bioscience Research Institute, Athlone Institute of Technology, Athlone, Ireland
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13
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Gatto F, Bardi G. Metallic Nanoparticles: General Research Approaches to Immunological Characterization. NANOMATERIALS 2018; 8:nano8100753. [PMID: 30248990 PMCID: PMC6215296 DOI: 10.3390/nano8100753] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 12/12/2022]
Abstract
Our immunity is guaranteed by a complex system that includes specialized cells and active molecules working in a spatially and temporally coordinated manner. Interaction of nanomaterials with the immune system and their potential immunotoxicity are key aspects for an exhaustive biological characterization. Several assays can be used to unravel the immunological features of nanoparticles, each one giving information on specific pathways leading to immune activation or immune suppression. Size, shape, and surface chemistry determine the surrounding corona, mainly formed by soluble proteins, hence, the biological identity of nanoparticles released in cell culture conditions or in a living organism. Here, we review the main laboratory characterization steps and immunological approaches that can be used to understand and predict the responses of the immune system to frequently utilized metallic or metal-containing nanoparticles, in view of their potential uses in diagnostics and selected therapeutic treatments.
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Affiliation(s)
- Francesca Gatto
- Istituto Italiano di Tecnologia, Nanobiointeractions & Nanodiagnostics, Via Morego 30, 16163 Genova, Italy.
| | - Giuseppe Bardi
- Istituto Italiano di Tecnologia, Nanobiointeractions & Nanodiagnostics, Via Morego 30, 16163 Genova, Italy.
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14
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Nandi SK, Shivaram A, Bose S, Bandyopadhyay A. Silver nanoparticle deposited implants to treat osteomyelitis. J Biomed Mater Res B Appl Biomater 2018; 106:1073-1083. [PMID: 28508595 PMCID: PMC5685947 DOI: 10.1002/jbm.b.33910] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/18/2017] [Accepted: 04/22/2017] [Indexed: 01/11/2023]
Abstract
In this study, electrolytically deposited strongly adherent silver nanoparticles on stainless-steel (SS) implants were used for in situ osteomyelitis treatment. Samples were heat treated to enhance adhesion of silver on 316 L SS. Ex vivo studies were performed to measure silver-release profiles from the 316 L SS screws inserted in equine cadaver bones. No change in the release profiles of silver ions were observed in vitro between the implanted screws and the control. In vivo studies were performed using osteomyelitic rabbit model with 3 mm diameter silver-deposited 316 L SS pins at two different doses of silver: high and low. Infection control ability of the pins for treating osteomyelitis in a rabbit model was measured using bacteriologic, radiographic, histological, and scanning electron microscopic studies. Silver-coated pins, especially high dose, offered a promising result to treat infection in animal osteomyelitis model without any toxicity to major organs. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1073-1083, 2018.
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Affiliation(s)
- Samit Kumar Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, 700037, India
| | - Anish Shivaram
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, Washington, 99164-2920, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, Washington, 99164-2920, USA
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, Washington, 99164-2920, USA
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15
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Anjum S, Singh S, Benedicte L, Roger P, Panigrahi M, Gupta B. Biomodification Strategies for the Development of Antimicrobial Urinary Catheters: Overview and Advances. GLOBAL CHALLENGES (HOBOKEN, NJ) 2018; 2:1700068. [PMID: 31565299 PMCID: PMC6607219 DOI: 10.1002/gch2.201700068] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/05/2017] [Indexed: 05/27/2023]
Abstract
Microbial burden associated with medical devices poses serious health challenges and is accountable for an increased number of deaths leading to enormous medical costs. Catheter-associated urinary tract infections are the most common hospital-acquired infections with enhanced patient morbidity. Quite often, catheter-associated bacteriuria produces apparent adverse outcomes such as urosepsis and even death. Taking this into account, the methods to modify urinary catheters to control microbial infections with relevance to clinical drug resistance are systematically evaluated in this review. Technologies to restrict biofilm formation at initial stages by using functional nanomaterials are elucidated. The conventional methodology of using single therapeutic intervention for developing an antimicrobial catheter lacks clinically meaningful benefit. Therefore, catheter modification using naturally derived antimicrobials such as essential oils, curcumin, enzymes, and antimicrobial peptides in combination with synthetic antibiotics/nanoantibiotics is likely to exert sufficient inhibitory effect on uropathogens and is extensively discussed. Futuristic efforts in this area are projected here that demand clinical studies to address areas of uncertainty to avoid development of bacterial resistance to the new generation therapy with minimum discomfort to the patients.
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Affiliation(s)
- Sadiya Anjum
- Bioengineering LaboratoryDepartment of Textile TechnologyIndian Institute of TechnologyNew Delhi110016India
| | - Surabhi Singh
- Bioengineering LaboratoryDepartment of Textile TechnologyIndian Institute of TechnologyNew Delhi110016India
| | - Lepoittevin Benedicte
- ICMMO ‐ LG2M ‐ Bât 420Université Paris‐Sud XI, 15rue Georges Clémenceau91405Orsay CedexFrance
| | - Philippe Roger
- ICMMO ‐ LG2M ‐ Bât 420Université Paris‐Sud XI, 15rue Georges Clémenceau91405Orsay CedexFrance
| | - Manoj Panigrahi
- Department of Urology and PathologySikkim Manipal Institute of Medical SciencesGangtokSikkim737101India
| | - Bhuvanesh Gupta
- Bioengineering LaboratoryDepartment of Textile TechnologyIndian Institute of TechnologyNew Delhi110016India
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16
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Milo S, Hathaway H, Nzakizwanayo J, Alves DR, Esteban PP, Jones BV, Jenkins ATA. Prevention of encrustation and blockage of urinary catheters by Proteus mirabilis via pH-triggered release of bacteriophage. J Mater Chem B 2017; 5:5403-5411. [PMID: 32264080 DOI: 10.1039/c7tb01302g] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The crystalline biofilms of Proteus mirabilis can seriously complicate the care of patients undergoing long-term indwelling urinary catheterisation. Expression of bacterial urease causes a significant increase in urinary pH, leading to the supersaturation and precipitation of struvite and apatite crystals. These crystals become lodged within the biofilm, resulting in the blockage of urine flow through the catheter. Here, we describe an infection-responsive surface coating for urinary catheters, which releases a therapeutic dose of bacteriophage in response to elevated urinary pH, in order to delay catheter blockage. The coating employs a dual-layered system comprising of a lower hydrogel 'reservoir' layer impregnated with bacteriophage, capped by a 'trigger' layer of the pH-responsive polymer poly(methyl methacrylate-co-methacrylic acid) (EUDRAGIT®S 100). Evaluation of prototype coatings using a clinically reflective in vitro bladder model system showed that catheter blockage time was doubled (13 h to 26 h (P < 0.05)) under conditions of established infection (108 CFU ml-1) in response to a 'burst-release' of bacteriophage (108 PFU ml-1). Coatings were stable both in the absence of infection, and in the presence of urease-negative bacteria. Quantitative and visual analysis of crystalline biofilm reduction show that bacteriophage constitute a promising strategy for the prevention of catheter blockage, a clinical problem for which there is currently no effective control method.
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Affiliation(s)
- Scarlet Milo
- Department of Chemistry, University of Bath, BA2 7AY, UK.
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17
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Francolini I, Vuotto C, Piozzi A, Donelli G. Antifouling and antimicrobial biomaterials: an overview. APMIS 2017; 125:392-417. [PMID: 28407425 DOI: 10.1111/apm.12675] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/14/2017] [Indexed: 12/12/2022]
Abstract
The use of implantable medical devices is a common and indispensable part of medical care for both diagnostic and therapeutic purposes. However, as side effect, the implant of medical devices quite often leads to the occurrence of difficult-to-treat infections, as a consequence of the colonization of their abiotic surfaces by biofilm-growing microorganisms increasingly resistant to antimicrobial therapies. A promising strategy to combat device-related infections is based on anti-infective biomaterials that either repel microbes, so they cannot attach to the device surfaces, or kill them in the surrounding areas. In general, such biomaterials are characterized by antifouling coatings, exhibiting low adhesion or even repellent properties towards microorganisms, or antimicrobial coatings, able to kill microbes approaching the surface. In this light, the present overview will address the development in the last two decades of antifouling and antimicrobial biomaterials designed to potentially limit the initial stages of microbial adhesion, as well as the microbial growth and biofilm formation on medical device surfaces.
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Affiliation(s)
| | - Claudia Vuotto
- Microbial Biofilm Laboratory, IRCCS Fondazione Santa Lucia, Rome
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18
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Ghasemi T, Arash V, Rabiee SM, Rajabnia R, Pourzare A, Rakhshan V. Antimicrobial effect, frictional resistance, and surface roughness of stainless steel orthodontic brackets coated with nanofilms of silver and titanium oxide: a preliminary study. Microsc Res Tech 2017; 80:599-607. [PMID: 28181353 DOI: 10.1002/jemt.22835] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/20/2016] [Accepted: 12/23/2016] [Indexed: 11/11/2022]
Abstract
Nano-silver and nano-titanium oxide films can be coated over brackets in order to reduce bacterial aggregation and friction. However, their antimicrobial efficacy, surface roughness, and frictional resistance are not assessed before. Fifty-five stainless-steel brackets were divided into 5 groups of 11 brackets each: uncoated brackets, brackets coated with 60 µm silver, 100 µm silver, 60 µm titanium, and 100 µm titanium. Coating was performed using physical vapor deposition method. For friction test, three brackets from each group were randomly selected and tested. For scanning electron microscopy and atomic-force microscopy assessments, one and one brackets were selected from each group. For antibacterial assessment, six brackets were selected from each group. Of them, three were immediately subjected to direct contact with S. mutans. Colonies were counted 3, 6, 24, and 48 h of contact. The other three were stored in water for 3 months. Then were subjected to a similar direct contact test. Results pertaining to both subgroups were combined. Groups were compared statistically. Mean (SD) friction values of the groups 'control, silver-60, silver-100, titanium-60, and titanium-100' were 0.55 ± 0.14, 0.77 ± 0.08, 0.82 ± 0.11, 1.52 ± 0.24, and 1.57 ± 0.41 N, respectively (p = .0004, Kruskal-Wallis). Titanium frictions were significantly greater than control (p < .05), but silver groups were not (p > .05, Dunn). In the uncoated group, colony count increased exponentially within 48 h. The coated groups showed significant reductions in colony count (p < .05, two-way-repeated-measures ANOVA). In conclusions, all four explained coatings reduce surface roughness and bacterial growth. Nano-titanium films are not suitable for friction reduction. Nano-silver results were not conclusive and need future larger studies.
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Affiliation(s)
- Tania Ghasemi
- Department of Orthodontics, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Valiollah Arash
- Department of Orthodontics, Dental material research center, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | | | - Ramazan Rajabnia
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Amirhosein Pourzare
- Department of Material Engineering, Babol University of Technology, Babol, Iran
| | - Vahid Rakhshan
- Department of Dental Anatomy, Dental School, Azad University, Tehran, Iran
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19
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Lee KH, Park SJ, Choi S, Uh Y, Park JY, Han KH. The Influence of Urinary Catheter Materials on Forming Biofilms of Microorganisms. ACTA ACUST UNITED AC 2017. [DOI: 10.4167/jbv.2017.47.1.32] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kyoung-Ho Lee
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Su Jung Park
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - SunJu Choi
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Joo Young Park
- Department of Microbiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyoung-Hee Han
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea
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20
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Cooper IR, Pollini M, Paladini F. The potential of photo-deposited silver coatings on Foley catheters to prevent urinary tract infections. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 69:414-20. [DOI: 10.1016/j.msec.2016.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/24/2016] [Accepted: 07/04/2016] [Indexed: 11/30/2022]
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21
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Ghanwate NA, Tiwari AA, Thakare PV. Importance of biofilm in medical sciences: With special reference to uropathogens. ACTA ACUST UNITED AC 2016. [DOI: 10.5897/ajmr2016.8178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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22
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Mandakhalikar KD, Chua RR, Tambyah PA. New Technologies for Prevention of Catheter Associated Urinary Tract Infection. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2016. [DOI: 10.1007/s40506-016-0069-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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23
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Ketchum AR, Kappler MP, Wu J, Xi C, Meyerhoff ME. The preparation and characterization of nitric oxide releasing silicone rubber materials impregnated with S-nitroso- tert-dodecyl mercaptan. J Mater Chem B 2016; 4:422-430. [PMID: 27087965 PMCID: PMC4826759 DOI: 10.1039/c5tb01664a] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recently, considerable research efforts have focused on increasing the biocompatibility a nd bactericidal activity of biomedical polymeric devices (e.g., catheters, etc.) through incorporation of nitric oxide (NO) releasing molecules. NO is an important endogenous molecule that is well known for enhancing blood flow via its vasodilatory activity, but it also exhibits potent antithrombotic and antimicrobial properties. In this work, we demonstrate that silicone rubber tubing can be impregnated with a tertiary S-nitrosothiol (RSNO), S-nitroso-tert-dodecylmercaptan, via a simple solvent swelling method. We further characterize the NO release and RSNO leaching from the tubing over time via use of chemiluminescence and UV/Vis spectroscopy, respectively. The tubing is shown to maintain an NO flux above the physiological levels released by endothelial cells, 0.5-4.0 × 10-10 molcm-2min-1, for more than 3 weeks while stored at 37 °C and exhibit minimal leaching. Finally, the RSNO impregnated tu bing exhibits significant antimicrobial activity over a 21 d period (vs. controls) during incubation in a CDC bioreactor after inoculation of media with S. aureus bacteria. The use of such lipophilic RSNO impregnated silicone rubber tubing could dramatically reduce the risk of catheter-related infections, which are a common problem associated with placement of intravascular or urinary catheters.
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Affiliation(s)
- Alex R Ketchum
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109
| | - Michael P Kappler
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109
| | - Jianfeng Wu
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109
| | - Chuanwu Xi
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, MI 48109
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24
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Pérez-Tanoira R, Horwat D, Kinnari TJ, Pérez-Jorge C, Gómez-Barrena E, Migot S, Esteban J. Bacterial adhesion on biomedical surfaces covered by yttria stabilized zirconia. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:6. [PMID: 26610929 DOI: 10.1007/s10856-015-5625-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/09/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to compare the bacterial adhesion of Staphylococcus spp. on Ti-6Al-4V with respect to Ti-6Al-V modified alloys with a set of Cubic yttria stabilized zirconia (YSZ) and Ag-YSZ nanocomposite films. Silver is well known to have a natural biocidal character and its presence in the surface predicted to enhance the antimicrobial properties of biomedical surfaces. Microbial adhesion tests were performed using collection strains and twelve clinical strains of Staphylococcus aureus and Staphylococcus epidermidis. The adherence study was performed using a previously published protocol by Kinnari et al. Both collection strains and clinical isolates have shown lower bacterial adhesion to materials modified with respect to the alloy Ti-6Al-4V and the modification with silver reduced the bacterial adhesion for most of all the strains studied. Moreover the percentage of dead bacteria have been evaluated, demonstrating increased proportion of dead bacteria for the modified surfaces. Nanocrystalline silver dissolves releasing both Ag(+) and Ag(0) whereas other silver sources release only Ag(+). We can conclude that YSZ with nanocrystalline silver coating may lead to diminished postoperative infections and to increased corrosion and scratch resistance of YSZ incorporating alloys Ti-6Al-4V.
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Affiliation(s)
- Ramón Pérez-Tanoira
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, Ave Reyes Católicos 2, 28040, Madrid, Spain.
- Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - David Horwat
- Institut Jean Lamour, UMR7198, Université de Lorraine, 54011, Nancy, France
| | - Teemu J Kinnari
- Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Concepción Pérez-Jorge
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, Ave Reyes Católicos 2, 28040, Madrid, Spain
| | | | - Sylvie Migot
- Centre de Compétences en Microscopies Electroniques et Microsondes (CC-MEM), Institut Jean Lamour, Parc de Saurupt, CS 50840, 54011, Nancy, France
| | - Jaime Esteban
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, Ave Reyes Católicos 2, 28040, Madrid, Spain
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25
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Wilks SA, Fader MJ, Keevil CW. Novel Insights into the Proteus mirabilis Crystalline Biofilm Using Real-Time Imaging. PLoS One 2015; 10:e0141711. [PMID: 26516766 PMCID: PMC4627822 DOI: 10.1371/journal.pone.0141711] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 10/12/2015] [Indexed: 11/18/2022] Open
Abstract
The long-term use of indwelling catheters results in a high risk from urinary tract infections (UTI) and blockage. Blockages often occur from crystalline deposits, formed as the pH rises due to the action of urease-producing bacteria; the most commonly found species being Proteus mirabilis. These crystalline biofilms have been found to develop on all catheter materials with P. mirabilis attaching to all surfaces and forming encrustations. Previous studies have mainly relied on electron microscopy to describe this process but there remains a lack of understanding into the stages of biofilm formation. Using an advanced light microscopy technique, episcopic differential interference contrast (EDIC) microscopy combined with epifluorescence (EF), we describe a non-destructive, non-contact, real-time imaging method used to track all stages of biofilm development from initial single cell attachment to complex crystalline biofilm formation. Using a simple six-well plate system, attachment of P. mirabilis (in artificial urine) to sections of silicone and hydrogel latex catheters was tracked over time (up to 24 days). Using EDIC and EF we show how initial attachment occurred in less than 1 h following exposure to P. mirabilis. This was rapidly followed by an accumulation of an additional material (indicated to be carbohydrate based using lectin staining) and the presence of highly elongated, motile cells. After 24 h exposure, a layer developed above this conditioning film and within 4 days the entire surface (of both catheter materials) was covered with diffuse crystalline deposits with defined crystals embedded. Using three-dimensional image reconstruction software, cells of P. mirabilis were seen covering the crystal surfaces. EDIC microscopy could resolve these four components of the complex crystalline biofilm and the close relationship between P. mirabilis and the crystals. This real-time imaging technique permits study of this complex biofilm development with no risk of artefacts due to sample manipulation. A full understanding of the stages and components involved in crystalline encrustation formation will aid in the development of new protocols to manage and ultimately prevent catheter blockage.
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Affiliation(s)
- Sandra A. Wilks
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
- * E-mail:
| | - Mandy J. Fader
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
| | - C. William Keevil
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, Hampshire, United Kingdom
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26
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Yang L, Whiteside S, Cadieux PA, Denstedt JD. Ureteral stent technology: Drug-eluting stents and stent coatings. Asian J Urol 2015; 2:194-201. [PMID: 29264145 PMCID: PMC5730737 DOI: 10.1016/j.ajur.2015.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 08/24/2015] [Indexed: 02/05/2023] Open
Abstract
Ureteral stents are commonly used following urological procedures to maintain ureteral patency. However, alongside the benefits of the device, indwelling stents frequently cause significant patient discomfort (pain, urgency, frequency) and can become encrusted and infected. The importance of these sequelae is that they are not only bothersome to the patient but can lead to significant morbidity, urinary retention, ureteral damage, recurrent infections, pyelonephritis and sepsis. When these problems occur, stent removal or replacement alongside antibiotic, analgesic and/or other symptom-modifying therapies are essential to successfully treat the patient. In an attempt to prevent such morbidity, numerous approaches have been investigated over the past several decades to modify the stent itself, thereby affecting changes locally within the urinary tract without significant systemic therapy. These strategies include changes to device design, polymeric composition, drug-elution and surface coatings. Of these, drug-elution and surface coatings are the most studied and display the most promise for advancing ureteral stent use and efficacy. This article reviews these two strategies in detail to determine their clinical potential and guide future research in the area.
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Affiliation(s)
- Luo Yang
- Department of Surgery, Division of Urology, No.4 West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Department of Urology of West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Surgery, Division of Urology, Western University, London, Ontario, Canada
| | - Samantha Whiteside
- Department of Microbiology and Immunology, Western University, London, Ontario, Canada
| | - Peter A Cadieux
- Department of Microbiology and Immunology, Western University, London, Ontario, Canada.,School of Health Sciences, Fanshawe College, London, Ontario, Canada
| | - John D Denstedt
- Department of Surgery, Division of Urology, Western University, London, Ontario, Canada
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27
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Aflori M, Miron C, Dobromir M, Drobota M. Bactericidal effect on Foley catheters obtained by plasma and silver nitrate treatments. HIGH PERFORM POLYM 2015. [DOI: 10.1177/0954008315584171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
New medical, materials, and surgical procedures keep improving current health-care practices. Many of these innovations involve polymeric devices that must meet certain clinical and cost requirements. Novel antimicrobial technologies and nanotechnologies are being implemented in more applications such as implant interphases, coatings, and others to avoid postoperatory infections. Here we present a novel approach to create antimicrobial surfaces on Foley catheters widely used in hospitals in order to avoid a variety of harms including infection, pain, and trauma. The combination of plasma and silver nitrate wet treatments demonstrates to be a fast, easy, and convenient method for obtaining colonization-resistant catheter surfaces.
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Affiliation(s)
- Magdalena Aflori
- “Petru Poni” Institute of Macromolecular Chemistry, Iasi, Romania
| | - Camelia Miron
- Leibniz Institute for Plasma Science and Technology, Greifswald, Germany
| | | | - Mioara Drobota
- “Petru Poni” Institute of Macromolecular Chemistry, Iasi, Romania
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28
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Colletta A, Wu J, Wo Y, Kappler M, Chen H, Xi C, Meyerhoff ME. S-Nitroso- N-acetylpenicillamine (SNAP) Impregnated Silicone Foley Catheters: A Potential Biomaterial/Device To Prevent Catheter-Associated Urinary Tract Infections. ACS Biomater Sci Eng 2015; 1:416-424. [PMID: 26462294 PMCID: PMC4593359 DOI: 10.1021/acsbiomaterials.5b00032] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/27/2015] [Indexed: 01/26/2023]
Abstract
![]()
Urinary Foley catheters are utilized
for management of hospitalized
patients and are associated with high rates of urinary tract infections
(UTIs). Nitric oxide (NO) potently inhibits microbial biofilm formation,
which is the primary cause of catheter associated UTIs (CAUTIs). Herein,
commercial silicone Foley catheters are impregnated via a solvent
swelling method with S-nitroso-N-acetyl-D-penicillamine (SNAP), a synthetic NO donor that exhibits
long-term NO release and stability when incorporated into low water-uptake
polymers. The proposed catheters generate NO surface-fluxes >0.7
×
10–10 mol min–1 cm–2 for over one month under physiological conditions, with minimal
SNAP leaching. These biomedical devices are demonstrated to significantly
decrease formation of biofilm on the surface of the catheter tubings
over 3, 7, and 14 day periods by microbial species (Staphylococcus
epidermidis and Proteus mirabilis) commonly
causing CAUTIs. Toxicity assessment demonstrates that the SNAP-impregnated
catheters are fully biocompatible, as extracts of the catheter tubings
score 0 on a 3-point grading scale using an accepted mouse fibroblast
cell-line toxicity model. Consequently, SNAP-impregnated silicone
Foley catheters can likely provide an efficient strategy to greatly
reduce the occurrence of nosocomial CAUTIs.
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Affiliation(s)
- Alessandro Colletta
- Department of Chemistry and Department of Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Jianfeng Wu
- Department of Chemistry and Department of Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Yaqi Wo
- Department of Chemistry and Department of Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
| | | | - Hao Chen
- Biocrede Inc. , Plymouth, Michigan 48170, United States
| | - Chuanwu Xi
- Department of Chemistry and Department of Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Mark E Meyerhoff
- Department of Chemistry and Department of Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
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29
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Mahata D, Mandal SM, Basak A, Nando GB. Self-assembled capsules of poly-N-glycidyl histidine ether–tannic acid for inhibition of biofilm formation in urinary catheters. RSC Adv 2015. [DOI: 10.1039/c5ra06815k] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A coating made of N-glycidyl-histidine ether–tannic acid complex, a biocompatible polymer, onto a catheter surface inhibits the biofilm formation and helps to control the catheter associated infections caused by biofilm forming MDR pathogens.
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Affiliation(s)
- Denial Mahata
- Department of Chemistry
- Rubber Technology Centre
- Central Research Facility
- Indian Institute of Technology Kharagpur
- Kharagpur 721302
| | - Santi M. Mandal
- Department of Chemistry
- Rubber Technology Centre
- Central Research Facility
- Indian Institute of Technology Kharagpur
- Kharagpur 721302
| | - Amit Basak
- Department of Chemistry
- Rubber Technology Centre
- Central Research Facility
- Indian Institute of Technology Kharagpur
- Kharagpur 721302
| | - Golok B. Nando
- Department of Chemistry
- Rubber Technology Centre
- Central Research Facility
- Indian Institute of Technology Kharagpur
- Kharagpur 721302
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30
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Preventing microbial colonisation of catheters: Antimicrobial and antibiofilm activities of cellobiose dehydrogenase. Int J Antimicrob Agents 2014; 44:402-8. [DOI: 10.1016/j.ijantimicag.2014.06.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/13/2014] [Accepted: 06/15/2014] [Indexed: 11/17/2022]
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31
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Abstract
Bacterial biofilms play an important role in urinary tract infections (UTIs), being responsible for persistence infections causing relapses and acute prostatitis. Bacterial forming biofilm are difficult to eradicate due to the antimicrobial resistant phenotype that this structure confers being combined therapy recommended for the treatment of biofilm-associated infections. However, the presence of persistent cells showing reduced metabolism that leads to higher levels of antimicrobial resistance makes the search for new therapeutic tools necessary. Here, a review of these new therapeutic approaches is provided including catheters coated with hydrogels or antibiotics, nanoparticles, iontophoresis, biofilm enzyme inhibitors, liposomes, bacterial interference, bacteriophages, quorum sensing inhibitors, low-energy surface acoustic waves, and antiadhesion agents. In conclusion, new antimicrobial drugs that inhibit bacterial virulence and biofilm formation are needed.
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32
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Making Wise Choices When Incorporating Technology for Infection Control Prevention. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2014. [DOI: 10.1007/s40506-013-0004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, Browne J, Prieto J, Wilcox M, UK Department of Health. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 2014; 86 Suppl 1:S1-70. [PMID: 24330862 PMCID: PMC7114876 DOI: 10.1016/s0195-6701(13)60012-2] [Citation(s) in RCA: 670] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.
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Affiliation(s)
- H P Loveday
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London).
| | - J A Wilson
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London)
| | - R J Pratt
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London)
| | - M Golsorkhi
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London)
| | - A Tingle
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London)
| | - A Bak
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London)
| | - J Browne
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London (London)
| | - J Prieto
- Faculty of Health Sciences, University of Southampton (Southampton)
| | - M Wilcox
- Microbiology and Infection Control, Leeds Teaching Hospitals and University of Leeds (Leeds)
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Tran PL, Hamood AN, Reid TW. Antimicrobial Coatings to Prevent Biofilm Formation on Medical Devices. SPRINGER SERIES ON BIOFILMS 2014. [DOI: 10.1007/978-3-642-53833-9_9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Akiyama T, Miyamoto H, Yonekura Y, Tsukamoto M, Ando Y, Noda I, Sonohata M, Mawatari M. Silver oxide-containing hydroxyapatite coating has in vivo antibacterial activity in the rat tibia. J Orthop Res 2013; 31:1195-200. [PMID: 23589130 DOI: 10.1002/jor.22357] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 03/07/2013] [Indexed: 02/04/2023]
Abstract
Bacterial infection is a serious postoperative complication of joint replacement. To prevent infections related to implantation, we have developed a novel antibacterial coating with Ag-containing hydroxyapatite (Ag-HA). In the present study, we examined the antibacterial activity of Ag-HA implant coatings in the medullary cavity of rat tibiae. Forty 10-week-old rats received implantation of Ag-HA- or HA-coated titanium rods, then were inoculated with ∼1.0 × 10(2) colony-forming units of methicillin-resistant Staphylococcus aureus. Bacterial counts were calculated for rats euthanized at 24, 48, and 72 h postoperatively. Serum levels of Ag (in the Ag-HA group only) were calculated for rats euthanized at 24, 48, 72 h and 4 weeks. Radiographic evaluations of bone infection were also performed at 4 weeks. Tibiae from both groups showing infection were evaluated histologically. Significant differences in bacterial counts were seen at 24, 48, and 72 h. Mean concentrations of Ag in serum peaked about 48 h after implantation, then gradually decreased. Mean radiographic scores for infection were significantly lower with Ag-HA implants than with HA implants. Histological examination showed better results for abscesses, bone resorption, and destruction of cortical bone around Ag-HA-coated implants. These results indicate that Ag-HA coatings may help prevent surgical-site infections associated with joint replacement.
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Affiliation(s)
- Takayuki Akiyama
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
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Govindji N, Wills P, Upton M, Tirelli N, Yeates S, Webb M. The antibiofilm effects of Byotrol™ G32. J Appl Microbiol 2013; 114:1285-93. [DOI: 10.1111/jam.12162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 01/17/2013] [Accepted: 01/20/2013] [Indexed: 11/30/2022]
Affiliation(s)
- N. Govindji
- School of Medicine; University of Manchester; Manchester UK
| | - P. Wills
- Organic Materials Innovation Centre; School of Chemistry University of Manchester; Manchester UK
| | - M. Upton
- School of Medicine; University of Manchester; Manchester UK
| | - N. Tirelli
- School of Materials and School of Medicine; University of Manchester; Manchester UK
| | - S. Yeates
- Organic Materials Innovation Centre; School of Chemistry University of Manchester; Manchester UK
| | - M. Webb
- School of Medicine; University of Manchester; Manchester UK
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Gandra S, Ellison RT. Modern trends in infection control practices in intensive care units. J Intensive Care Med 2013; 29:311-26. [PMID: 23753240 DOI: 10.1177/0885066613485215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection.
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Affiliation(s)
- Sumanth Gandra
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Richard T Ellison
- Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, MA, USA
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Murphy C, Fader M, Prieto J. Interventions to minimise the initial use of indwelling urinary catheters in acute care: a systematic review. Int J Nurs Stud 2013; 51:4-13. [PMID: 23332716 DOI: 10.1016/j.ijnurstu.2012.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 12/13/2012] [Accepted: 12/13/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND Indwelling urinary catheters (IUC) are the primary cause of urinary tract infection in acute care. Current research aimed at reducing the use of IUCs in acute care has focused on the prompt removal of catheters already placed. This paper evaluates attempts to minimise the initial placement of IUCs. OBJECTIVES To evaluate systematically the evidence of the effectiveness of interventions to minimise the initial placement of IUCs in adults in acute care. DESIGN Studies incorporating an intervention to reduce the initial placement of IUCs in an acute care environment in patients aged 18 and over that reported on the incidence of IUC placement were included in the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist has been used as a tool to guide the structure of the review. DATA SOURCES MEDLINE, CINAHL, EMBASE, National Health Service Centre for Review and Dissemination and Cochrane Library. REVIEW METHODS A systematic review to identify and synthesise research reporting on the impact on interventions to minimise the use of IUCs in acute care published up to July 2011. RESULTS 2689 studies were scanned for eligibility. Only eight studies were found that reported any change (increase or decrease) in the level of initial placement of IUCs as a result of an intervention in acute care. Of the eight, six had an uncontrolled before-after design. Seven demonstrated a reduction in the initial use of IUCs post-intervention. There was insufficient evidence to support or rule out the effectiveness of interventions due to the small number of studies, limitations in study design and variation in clinical environments. Notably, each study listed the indications considered to be acceptable uses of an IUC and there was substantial variation between the lists of indications. CONCLUSIONS More work is needed to establish when the initial placement of an IUC is appropriate in order to better understand when IUCs are overused and inform the development of methodologically robust research on the potential of interventions to minimise the initial placement of IUCs.
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Affiliation(s)
- Catherine Murphy
- Faculty of Health Sciences, University of Southampton, United Kingdom.
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Novel approaches to the diagnosis, prevention, and treatment of medical device-associated infections. Infect Dis Clin North Am 2012; 26:173-86. [PMID: 22284383 DOI: 10.1016/j.idc.2011.09.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The pathogenesis of device-associated infections is related to biofilm bacteria that exhibit distinct characteristics with respect to growth rate, structural features, and protection from host immune mechanisms and antimicrobial agents when compared with planktonic counterparts. Biofilm-associated infections are prevented, diagnosed, and treated differently from infections not associated with biofilms. This article reviews innovative concepts for the prevention of biofilm formation, and novel treatment approaches. Specific approaches for the diagnosis and prevention of catheter-associated urinary tract and bloodstream infections, as well as infections associated with orthopedic implants and cardiovascular implantable electronic devices, are also discussed.
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Pérez-Tanoira R, Pérez-Jorge C, Endrino JL, Gómez-Barrena E, Horwat D, Pierson JF, Esteban J. Bacterial adhesion on biomedical surfaces covered by micrometric silver Islands. J Biomed Mater Res A 2012; 100:1521-8. [DOI: 10.1002/jbm.a.34090] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 11/14/2011] [Accepted: 01/04/2012] [Indexed: 11/05/2022]
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Ryu HS, Bae IH, Lee KG, Hwang HS, Lee KH, Koh JT, Cho JH. Antibacterial effect of silver-platinum coating for orthodontic appliances. Angle Orthod 2012; 82:151-157. [PMID: 21810004 PMCID: PMC8881025 DOI: 10.2319/021411-111.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE To develop a hard coating for stainless surfaces based on silver (Ag)-platinum (Pt) alloys. MATERIALS AND METHODS Ag-Pt alloys, which have high degree of biocompatibility, excellent resistance to sterilization conditions, and antibacterial properties to different bacteria, are associated with long-term antibacterial efficiency. Approximately 1.03-µm to 2.34-µm-thick coatings, as determined by scanning electron microscopy, were deposited on stainless surfaces by the simultaneous vaporization of both metals (Ag and Pt) in an inert argon atmosphere. The coating was done by physical vapor deposition. Microorganisms and eukaryotic culture cells were grown on these surfaces. RESULTS The coatings released sufficient Ag ions when immersed in phosphate-buffered saline and showed significant antimicrobial potency against Streptococcus mutans and Aggregatibacter actinomycetemcomitans strains. At the same time, human gingival fibroblast cells were not adversely affected. CONCLUSION Ag-Pt coatings on load-bearing orthodontic bracket surfaces can provide suitable antimicrobial activity during active orthodontic treatment.
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Affiliation(s)
- Hwang-Sog Ryu
- Department of Orthodontics, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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Kasten KR, Makley AT, Kagan RJ. Update on the critical care management of severe burns. J Intensive Care Med 2011; 26:223-36. [PMID: 21764766 DOI: 10.1177/0885066610390869] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Care of the severely injured patient with burn requires correct diagnosis, appropriately tailored resuscitation, and definitive surgical management to reduce morbidity and mortality. Currently, mortality rates related to severe burn injuries continue to steadily decline due to the standardization of a multidisciplinary approach instituted at tertiary health care centers. Prompt and accurate diagnoses of burn wounds utilizing Lund-Browder diagrams allow for appropriate operative and nonoperative management. Coupled with diagnostic improvements, advances in resuscitation strategies involving rates, volumes, and fluid types have yielded demonstrable benefits related to all aspects of burn care. More recently, identification of comorbid conditions such as inhalation injury and malnutrition have produced appropriate protocols that aid the healing process in severely injured patients with burn. As more patients survive larger burn injuries, the early diagnosis and successful treatment of secondary and tertiary complications are becoming commonplace. While advances in this area are exciting, much work to elucidate immune pathways, diagnostic tests, and effective treatment regimens still remain. This review will provide an update on the critical care management of severe burns, touching on accurate diagnosis, resuscitation, and acute management of this difficult patient population.
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Affiliation(s)
- Kevin R Kasten
- Department of Surgery, University of Cincinnati, Cincinnati, OH 45229, USA
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Ewald A, Hösel D, Patel S, Grover LM, Barralet JE, Gbureck U. Silver-doped calcium phosphate cements with antimicrobial activity. Acta Biomater 2011; 7:4064-70. [PMID: 21763795 DOI: 10.1016/j.actbio.2011.06.049] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Revised: 06/07/2011] [Accepted: 06/27/2011] [Indexed: 11/27/2022]
Abstract
There is a current need for the localised delivery of antibiotics in order to treat implant-based bacterial infections. Existing treatments use non-resorbable materials such as poly(methyl methacrylate) beads loaded with antibiotics; unfortunately, as they are not resorbable, these beads require secondary surgery for removal. Calcium phosphate cements have considerable potential for the localised delivery of drugs since they can be resorbed to some extent within the body, eliminating the need for a secondary surgical procedure. Therefore, in this study, the efficacy of both hydroxyapatite and brushite cements in the delivery of silver ions has been investigated. The activity of the Ag(+) released from the cements was assessed against the growth of both Staphylococcus aureus and Staphylococcus epidermidis; the brushite cement exhibited excellent antibacterial properties and also showed an increase in compressive strength of over 30%. In this study we have found that with a few changes in Ag(+) concentration it should be possible to produce a fully resorbable bone replacement material that is combined with an antibacterial scaffold with controlled release over a period of time, which is likely to inhibit bacterial infections associated with implantation procedures.
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CROSBY-NWAOBI R, FAITHFULL S. High risk of urinary tract infections in post-operative gynaecology patients: a retrospective case analysis. Eur J Cancer Care (Engl) 2011; 20:825-31. [DOI: 10.1111/j.1365-2354.2011.01283.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Liu XS, Zola JC, McGinnis DE, Squadrito JF, Zeltser IS. Do silver alloy-coated catheters increase risk of urethral strictures after robotic-assisted laparoscopic radical prostatectomy? Urology 2011; 78:365-7. [PMID: 21696808 DOI: 10.1016/j.urology.2011.04.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 04/12/2011] [Accepted: 04/12/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate whether the use of silver-coated catheters increased the risk of developing urethral stricture disease after robotic-assisted laparoscopic radical prostatectomy (RALP). Recently, silver alloy-coated Foley catheters have been shown to decrease the risk of catheter-associated urinary tract infections. Other than the increased cost, no disadvantages to the use of these catheters have been reported. MATERIAL AND METHODS We switched to routine use of the Bardex I.C. silver alloy-coated Foley catheters for all urologic procedures on November 1, 2008. After institutional review board approval, we retrospectively reviewed the records of all consecutive patients who had undergone RALP 12 months before and after the catheter change. The primary outcome was the rate of urethral strictures after RALP. RESULTS A total of 188 RALPs were performed during the 12 months before the catheter change. No patients who underwent RALP in the months before the catheter change had developed a new postoperative urethral stricture. In the 12 months after the change to the silver-coated catheters, 217 RALPs were performed. Six patients after RALP using silver-coated catheters developed new strictures, at a rate of 2.8% (P = .03). CONCLUSIONS Silver alloy-coated urinary catheters might increase the risk of developing urethral strictures after RALP compared with standard noncoated catheters. Additional evaluation by a large randomized prospective trial is warranted to elucidate the true risk of stricture formation.
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Affiliation(s)
- Xiaolong S Liu
- Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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Yonekura Y, Miyamoto H, Shimazaki T, Ando Y, Noda I, Mawatari M, Hotokebuchi T. Osteoconductivity of thermal-sprayed silver-containing hydroxyapatite coating in the rat tibia. ACTA ACUST UNITED AC 2011; 93:644-9. [DOI: 10.1302/0301-620x.93b5.25518] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A silver-containing hydroxyapatite (Ag-HA) coating has been developed using thermal spraying technology. We evaluated the osteoconductivity of this coating on titanium (Ti) implants in rat tibiae in relation to bacterial infection in joint replacement. At 12 weeks, the mean affinity indices of bone formation of a Ti, an HA, a 3%Ag-HA and a 50%Ag-HA coating were 97.3%, 84.9%, 81.0% and 40.5%, respectively. The mean affinity indices of bone contact of these four coatings were 18.8%, 83.7%, 77.2% and 40.5%, respectively. The indices of bone formation and bone contact around the implant of the 3%Ag-HA coating were similar to those of the HA coating, and no significant differences were found between them (bone formation, p = 0.99; bone contact, p = 0.957). However, inhibition of bone formation was observed with the 50%Ag-HA coating. These results indicate that the 3%Ag-HA coating has low toxicity and good osteoconductivity, and that the effect of silver toxicity on osteoconductivity depends on the dose.
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Affiliation(s)
| | - H. Miyamoto
- Department of Pathology and Microbiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | | | - Y. Ando
- Research Department, Japan Medical Materials Corporation, 3-3-31 Miyahara, Yodogawa-ku, Osaka, Japan
| | - I. Noda
- Research Department, Japan Medical Materials Corporation, 3-3-31 Miyahara, Yodogawa-ku, Osaka, Japan
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Stenzelius K, Persson S, Olsson UB, Stjärneblad M. Noble metal alloy-coated latex versus silicone Foley catheter in short-term catheterization: a randomized controlled study. ACTA ACUST UNITED AC 2011; 45:258-64. [PMID: 21452931 DOI: 10.3109/00365599.2011.560007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The primary aim of this study was to compare the incidence of catheter-associated bacteriuria with a noble metal alloy-coated latex catheter or a non-coated silicone catheter in patients undergoing elective orthopaedic surgery with short-term catheterization. Secondary objectives included identifying risk factors for bacteriuria and catheter-associated urinary tract symptoms. MATERIAL AND METHODS The study compared 217 patients randomized to and receiving a silicone catheter with 222 patients treated with a coated latex catheter. Before removal of the catheter a sample for urinary culture was obtained. Bacteriuria was defined as the growth of ≥100 000 cfu/ml. A logistic regression model was used to identify risk groups for bacteriuria. Patients were interviewed about urinary tract symptoms during and after catheterization. RESULTS The incidence of bacteriuria was 1.5% with the coated latex catheter and 5.5% with the silicone catheter (p = 0.027) after a mean period of 2 days' catheterization time. Female gender (odds ratio 6.02) and obesity (odds ratio 5.08) were significant risk factors for bacteriuria. A quarter of the patients reported at least one symptom from the urinary tract during and after catheterization. Most patients defined the symptoms as "yes, a little" and a few consulted a healthcare professional because of the symptoms. CONCLUSION This study confirmed previous results that the noble metal alloy coating significantly reduces the risk of catheter-associated bacteriuria in short-term catheterization (1-3 days). Female gender and obesity were significant risk factors for developing bacteriuria, while the use of an open drainage system and insertion of the catheter on the ward were not.
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Affiliation(s)
- Karin Stenzelius
- Urology Department , University Hospital of Skane, Malmö , Sweden.
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Schrand AM, Rahman MF, Hussain SM, Schlager JJ, Smith DA, Syed AF. Metal-based nanoparticles and their toxicity assessment. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2010; 2:544-68. [PMID: 20681021 DOI: 10.1002/wnan.103] [Citation(s) in RCA: 351] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Nanoparticles (NPs) can potentially cause adverse effects on organ, tissue, cellular, subcellular, and protein levels due to their unusual physicochemical properties (e.g., small size, high surface area to volume ratio, chemical composition, crystallinity, electronic properties, surface structure reactivity and functional groups, inorganic or organic coatings, solubility, shape, and aggregation behavior). Metal NPs, in particular, have received increasing interest due to their widespread medical, consumer, industrial, and military applications. However, as particle size decreases, some metal-based NPs are showing increased toxicity, even if the same material is relatively inert in its bulk form (e.g., Ag, Au, and Cu). NPs also interact with proteins and enzymes within mammalian cells and they can interfere with the antioxidant defense mechanism leading to reactive oxygen species generation, the initiation of an inflammatory response and perturbation and destruction of the mitochondria causing apoptosis or necrosis. As a result, there are many challenges to overcome before we can determine if the benefits outweigh the risks associated with NPs.
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Williams LB, Haydel SE. Evaluation of the medicinal use of clay minerals as antibacterial agents. INTERNATIONAL GEOLOGY REVIEW 2010; 52:745-770. [PMID: 20640226 PMCID: PMC2904249 DOI: 10.1080/00206811003679737] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Natural clays have been used to heal skin infections since the earliest recorded history. Recently our attention was drawn to a clinical use of French green clay (rich in Fe-smectite) for healing Buruli ulcer, a necrotizing fasciitis ('flesh-eating' infection) caused by Mycobacterium ulcerans. These clays and others like them are interesting as they may reveal an antibacterial mechanism that could provide an inexpensive treatment for this and other skin infections, especially in global areas with limited hospitals and medical resources.Microbiological testing of two French green clays, and other clays used traditionally for healing, identified three samples that were effective at killing a broad-spectrum of human pathogens. A clear distinction must be made between 'healing clays' and those we have identified as antibacterial clays. The highly adsorptive properties of many clays may contribute to healing a variety of ailments, although they are not antibacterial. The antibacterial process displayed by the three identified clays is unknown. Therefore, we have investigated the mineralogical and chemical compositions of the antibacterial clays for comparison with non-antibacterial clays in an attempt to elucidate differences that may lead to identification of the antibacterial mechanism(s).The two French green clays used to treat Buruli ulcer, while similar in mineralogy, crystal size, and major element chemistry, have opposite effects on the bacterial populations tested. One clay deposit promoted bacterial growth whereas another killed the bacteria. The reasons for the difference in antibacterial properties thus far show that the bactericidal mechanism is not physical (e.g., an attraction between clay and bacteria), but by a chemical transfer or reaction. The chemical variables are still under investigation.Cation exchange experiments showed that the antibacterial component of the clay can be removed, implicating exchangeable cations in the antibacterial process. Furthermore, aqueous leachates of the antibacterial clays effectively kill the bacteria. Progressively heating the clay leads first to dehydration (200 degrees C), then dehydroxylation (550 degrees C or more), and finally to destruction of the clay mineral structure by (~900 degrees C). By identifying the elements lost after each heating step, and testing the bactericidal effect of the heated product, we eliminated many toxins from consideration (e.g., microbes, organic compounds, volatile elements) and identified several redox-sensitive refractory metals that are common among antibacterial clays. We conclude that the pH and oxidation state buffered by the clay mineral surfaces is key to controlling the solution chemistry and redox related reactions occurring at the bacterial cell wall.
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Affiliation(s)
- Lynda B. Williams
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287-1404, Tel. (480) 965-0829, Fax. (480) 965-8102,
| | - Shelley E. Haydel
- The Biodesign Institute Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287-5401
- School of Life Sciences, Arizona State University, Tempe, AZ 85287-5401, Tel. (480) 727-7234, Fax. (480) 727-0599,
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