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Bhattacharjee B, Ghosh S, Patra D, Haldar J. Advancements in release-active antimicrobial biomaterials: A journey from release to relief. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2021; 14:e1745. [PMID: 34374498 DOI: 10.1002/wnan.1745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/13/2021] [Accepted: 07/08/2021] [Indexed: 12/13/2022]
Abstract
Escalating medical expenses due to infectious diseases are causing huge socioeconomic pressure on mankind globally. The emergence of antibiotic resistance has further aggravated this problem. Drug-resistant pathogens are also capable of forming thick biofilms on biotic and abiotic surfaces to thrive in a harsh environment. To address these clinical problems, various strategies including antibacterial agent delivering matrices and bactericidal coatings strategies have been developed. In this review, we have discussed various types of polymeric vehicles such as hydrogels, sponges/cryogels, microgels, nanogels, and meshes, which are commonly used to deliver antibiotics, metal nanoparticles, and biocides. Compositions of these polymeric matrices have been elaborately depicted by elucidating their chemical interactions and potential activity have been discussed. On the other hand, various implant/device-surface coating strategies which exploit the release-active mechanism of bacterial killing are discussed in elaboration. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.
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Affiliation(s)
- Brinta Bhattacharjee
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
| | - Sreyan Ghosh
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
| | - Dipanjana Patra
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
| | - Jayanta Haldar
- Antimicrobial Research Laboratory, New Chemistry, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India.,School of Advanced Materials, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru, Karnataka, India
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2
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Wasfi R, Hamed SM, Amer MA, Fahmy LI. Proteus mirabilis Biofilm: Development and Therapeutic Strategies. Front Cell Infect Microbiol 2020; 10:414. [PMID: 32923408 PMCID: PMC7456845 DOI: 10.3389/fcimb.2020.00414] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/06/2020] [Indexed: 01/21/2023] Open
Abstract
Proteus mirabilis is a Gram negative bacterium that is a frequent cause of catheter-associated urinary tract infections (CAUTIs). Its ability to cause such infections is mostly related to the formation of biofilms on catheter surfaces. In order to form biofilms, P. mirabilis expresses a number of virulence factors. Such factors may include adhesion proteins, quorum sensing molecules, lipopolysaccharides, efflux pumps, and urease enzyme. A unique feature of P. mirabilis biofilms that build up on catheter surfaces is their crystalline nature owing to their ureolytic biomineralization. This leads to catheter encrustation and blockage and, in most cases, is accompanied by urine retention and ascending UTIs. Bacteria embedded in crystalline biofilms become highly resistant to conventional antimicrobials as well as the immune system. Being refractory to antimicrobial treatment, alternative approaches for eradicating P. mirabilis biofilms have been sought by many studies. The current review focuses on the mechanism by which P. mirabilis biofilms are formed, and a state of the art update on preventing biofilm formation and reduction of mature biofilms. These treatment approaches include natural, and synthetic compounds targeting virulence factors and quorum sensing, beside other strategies that include carrier-mediated diffusion of antimicrobials into biofilm matrix. Bacteriophage therapy has also shown successful results in vitro for combating P. mirabilis biofilms either merely through their lytic effect or by acting as facilitators for antimicrobials diffusion.
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Affiliation(s)
- Reham Wasfi
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Samira M Hamed
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Mai A Amer
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Lamiaa Ismail Fahmy
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
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Majeed A, Sagar F, Latif A, Hassan H, Iftikhar A, Darouiche RO, Mohajer MA. Does antimicrobial coating and impregnation of urinary catheters prevent catheter-associated urinary tract infection? A review of clinical and preclinical studies. Expert Rev Med Devices 2019; 16:809-820. [PMID: 31478395 DOI: 10.1080/17434440.2019.1661774] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections in hospitals, accounting for 36% of all health care-associated infections. Areas covered: We aimed to address the potential impact of antimicrobial coating of catheter materials for the prevention of CAUTI and to analyze the progress made in this field. We conducted literature searches in the PubMed, Embase, and Cochrane Library databases, and found 578 articles. Data from 60 articles in either the preclinical or clinical stage were analyzed in this expert review. Expert opinion: The literature review revealed many promising methods for preventing CAUTI. Recent studies have suggested the combination of silver-based products and antibiotics, owing to their synergistic effect, to help address the problem of antibiotic resistance. Other coating materials that have been tested include nitric oxide, chlorhexidine, antimicrobial peptides, enzymes, and bacteriophages. Because of heterogeneity among studies, it is difficult to reliably comment on the clinical efficacy of different coating materials. Future research should focus on double-blind randomized clinical trials for evaluating the role of these potential coating agents.
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Affiliation(s)
- Aneela Majeed
- Division of Infectious Diseases, Department of Medicine, Stanford University , Stanford , CA , USA
| | - Fnu Sagar
- Department of Medicine, University of Arizona , Tucson , AZ , USA
| | - Azka Latif
- Department of Medicine, Creighton University , Omaha , NE , USA
| | - Hamza Hassan
- Department of Medicine, Rochester General Hospital , Rochester , NY , USA
| | - Ahmad Iftikhar
- Department of Medicine, University of Arizona , Tucson , AZ , USA
| | - Rabih O Darouiche
- Section of Infectious Diseases, Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine , Houston , TX , USA.,Section of Infectious Diseases, Baylor College of Medicine , Houston , TX , USA
| | - Mayar Al Mohajer
- Section of Infectious Diseases, Baylor College of Medicine , Houston , TX , USA
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4
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Imani Rad H, Peeri H, Amani M, Mohammadnia A, Ogunniyi AD, Khazandi M, Venter H, Arzanlou M. Allicin prevents the formation of Proteus-induced urinary crystals and the blockage of catheter in a bladder model in vitro. Microb Pathog 2019; 132:293-301. [PMID: 31082531 DOI: 10.1016/j.micpath.2019.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
Stone formation and catheter blockage are major complications of Proteus UTIs. In this study, we investigated the ability of allicin to inhibit P. mirabilis-induced struvite crystallization and catheter blockage using a synthetic bladder model. Struvite crystallization inhibition study was carried out using P. mirabilis lysate as urease enzyme source in synthetic urine (SU). Struvite productions were monitored by phase contrast light microscopy and measurements of pH, Mg2+ and Ca2+ precipitation and turbidity. A catheter blockage study was performed in a synthetic bladder model mimicking natural UTI in the presence of allicin at sub-MIC concentrations (MIC = 64 μg/ml). The results of crystallization study showed that allicin inhibited pH rise and consequently turbidity and precipitation of ions in a dose-dependent manner. The results of catheter blockage study showed that allicin at sub-MIC concentrations (2, 4, 8 μg/ml) significantly increased the time for catheter blockage to occur to 61, 74 and 92 h respectively compared to allicin-free control (48 h). In a similar way, the results showed that allicin delayed the increase of SU pH level in bladder model in a dose-dependent manner compared to allicin-free control. The results also showed that following the increase of allicin concentration, Mg2+ and Ca2+ deposition in catheters were much lower compared to allicin-free control, further confirmed by direct observation of the catheters' eyehole and cross sections. We conclude that allicin prevents the formation of Proteus-induced urinary crystals and the blockage of catheters by delaying pH increase and lowering Mg2+ and Ca2+ deposition in a dose-dependent manner.
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Affiliation(s)
- Hamed Imani Rad
- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hadi Peeri
- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mojtaba Amani
- Department of Clinical Chemistry, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran; Department of Biochemistry, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Mohammadnia
- Department of Information Technologies, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Abiodun David Ogunniyi
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, Australia
| | - Manouchehr Khazandi
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, Australia
| | - Henrietta Venter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, 5000, Australia
| | - Mohsen Arzanlou
- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
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5
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Durgadevi R, Veera Ravi A, Alexpandi R, Krishnan Swetha T, Abirami G, Vishnu S, Karutha Pandian S. Virulence targeted inhibitory effect of linalool against the exclusive uropathogen Proteus mirabilis. BIOFOULING 2019; 35:508-525. [PMID: 31144520 DOI: 10.1080/08927014.2019.1619704] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/30/2019] [Accepted: 05/09/2019] [Indexed: 06/09/2023]
Abstract
Proteus mirabilis is one of the leading causes of catheter-associated UTIs (CAUTI) in individuals with prolonged urinary catheterization. Since, biofilm assisted antibiotic resistance is reported to complicate the treatment strategies of P. mirabilis infections, the present study was aimed to attenuate biofilm and virulence factor production in P. mirabilis. Linalool is a naturally occurring monoterpene alcohol found in a wide range of flowers and spice plants and has many biological applications. In this study, linalool exhibited concentration dependent anti-biofilm activity against crystalline biofilm of P. mirabilis through reduced production of the virulence enzyme urease that raises the urinary pH and drives the formation of crystals (struvite) in the biofilm. The results of q-PCR analysis unveiled the down regulation of biofilm/virulence associated genes upon linalool treatment, which was in correspondence with the in vitro bioassays. Thus, this study reports the feasibility of linalool acting as a promising anti-biofilm agent against P. mirabilis mediated CAUTI.
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Affiliation(s)
| | | | - Rajaiah Alexpandi
- Department of Biotechnology, Alagappa University , Tamil Nadu , India
| | | | - Gurusamy Abirami
- Department of Biotechnology, Alagappa University , Tamil Nadu , India
| | - Selvam Vishnu
- Department of Biotechnology, Alagappa University , Tamil Nadu , India
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Pelling H, Nzakizwanayo J, Milo S, Denham EL, MacFarlane WM, Bock LJ, Sutton JM, Jones BV. Bacterial biofilm formation on indwelling urethral catheters. Lett Appl Microbiol 2019; 68:277-293. [PMID: 30811615 DOI: 10.1111/lam.13144] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/22/2019] [Accepted: 02/23/2019] [Indexed: 12/21/2022]
Abstract
Urethral catheters are the most commonly deployed medical devices and used to manage a wide range of conditions in both hospital and community care settings. The use of long-term catheterization, where the catheter remains in place for a period >28 days remains common, and the care of these patients is often undermined by the acquisition of infections and formation of biofilms on catheter surfaces. Particular problems arise from colonization with urease-producing species such as Proteus mirabilis, which form unusual crystalline biofilms that encrust catheter surfaces and block urine flow. Encrustation and blockage often lead to a range of serious clinical complications and emergency hospital referrals in long-term catheterized patients. Here we review current understanding of bacterial biofilm formation on urethral catheters, with a focus on crystalline biofilm formation by P. mirabilis, as well as approaches that may be used to control biofilm formation on these devices. SIGNIFICANCE AND IMPACT OF THE STUDY: Urinary catheters are the most commonly used medical devices in many healthcare systems, but their use predisposes to infection and provide ideal conditions for bacterial biofilm formation. Patients managed by long-term urethral catheterization are particularly vulnerable to biofilm-related infections, with crystalline biofilm formation by urease producing species frequently leading to catheter blockage and other serious clinical complications. This review considers current knowledge regarding biofilm formation on urethral catheters, and possible strategies for their control.
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Affiliation(s)
- H Pelling
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - J Nzakizwanayo
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
| | - S Milo
- Department of Chemistry, University of Bath, Claverton Down, Bath, UK
| | - E L Denham
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
| | - W M MacFarlane
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - L J Bock
- National Infections Service, Public Health England, Porton Down, Salisbury, UK
| | - J M Sutton
- National Infections Service, Public Health England, Porton Down, Salisbury, UK
| | - B V Jones
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
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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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8
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Milo S, Nzakizwanayo J, Hathaway HJ, Jones BV, Jenkins ATA. Emerging medical and engineering strategies for the prevention of long-term indwelling catheter blockage. Proc Inst Mech Eng H 2018; 233:68-83. [PMID: 29807465 DOI: 10.1177/0954411918776691] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Urinary catheters have been used on an intermittent or indwelling basis for centuries, in order to relieve urinary retention and incontinence. Nevertheless, the use of urinary catheters in the clinical setting is fraught with complication, the most common of which is the development of nosocomial urinary tract infections, known as catheter-associated urinary tract infections. Infections of this nature are not only significant owing to their high incidence rate and subsequent economic burden but also to the severe medical consecutions that result. A range of techniques have been employed in recent years, utilising various technologies in attempts to counteract the perilous medical cascade following catheter blockage. This review will focus on the current advancement (within the last 10 years) in prevention of encrustation and blockage of long-term indwelling catheters both from engineering and medical perspectives, with particular emphasis on the importance of stimuli-responsive systems.
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Affiliation(s)
- Scarlet Milo
- 1 Department of Chemistry, University of Bath, Bath, UK
| | - Jonathan Nzakizwanayo
- 2 School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | | | - Brian V Jones
- 4 Department of Biology and Biochemistry, University of Bath, UK
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Novikov M, Thong KL, Zazali NIM, Hamid SBA. Treatment of Cotton by β-Cyclodextrin/Triclosan Inclusion Complex and Factors Affecting Antimicrobial Properties. FIBERS AND POLYMERS 2018; 19:548-560. [DOI: 10.1007/s12221-018-7028-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/23/2018] [Accepted: 01/27/2018] [Indexed: 09/02/2023]
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Singha P, Locklin J, Handa H. A review of the recent advances in antimicrobial coatings for urinary catheters. Acta Biomater 2017; 50:20-40. [PMID: 27916738 PMCID: PMC5316300 DOI: 10.1016/j.actbio.2016.11.070] [Citation(s) in RCA: 242] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 12/21/2022]
Abstract
More than 75% of hospital-acquired or nosocomial urinary tract infections are initiated by urinary catheters, which are used during the treatment of 15-25% of hospitalized patients. Among other purposes, urinary catheters are primarily used for draining urine after surgeries and for urinary incontinence. During catheter-associated urinary tract infections, bacteria travel up to the bladder and cause infection. A major cause of catheter-associated urinary tract infection is attributed to the use of non-ideal materials in the fabrication of urinary catheters. Such materials allow for the colonization of microorganisms, leading to bacteriuria and infection, depending on the severity of symptoms. The ideal urinary catheter is made out of materials that are biocompatible, antimicrobial, and antifouling. Although an abundance of research has been conducted over the last forty-five years on the subject, the ideal biomaterial, especially for long-term catheterization of more than a month, has yet to be developed. The aim of this review is to highlight the recent advances (over the past 10years) in developing antimicrobial materials for urinary catheters and to outline future requirements and prospects that guide catheter materials selection and design. STATEMENT OF SIGNIFICANCE This review article intends to provide an expansive insight into the various antimicrobial agents currently being researched for urinary catheter coatings. According to CDC, approximately 75% of urinary tract infections are caused by urinary catheters and 15-25% of hospitalized patients undergo catheterization. In addition to these alarming statistics, the increasing cost and health related complications associated with catheter associated UTIs make the research for antimicrobial urinary catheter coatings even more pertinent. This review provides a comprehensive summary of the history, the latest progress in development of the coatings and a brief conjecture on what the future entails for each of the antimicrobial agents discussed.
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Affiliation(s)
- Priyadarshini Singha
- School of Materials, Chemical and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - Jason Locklin
- School of Materials, Chemical and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA; Department of Chemistry, University of Georgia, Athens, GA, USA.
| | - Hitesh Handa
- School of Materials, Chemical and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA.
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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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Reshamwala SMS, Mamidipally C, Pissurlenkar RRS, Coutinho EC, Noronha SB. Evaluation of risedronate as an antibiofilm agent. J Med Microbiol 2016; 65:9-18. [DOI: 10.1099/jmm.0.000193] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Shamlan M. S. Reshamwala
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | | | - Raghuvir R. S. Pissurlenkar
- Molecular Simulations Group, Department of Pharmaceutical Chemistry, Goa College of Pharmacy, , Panaji, India
| | - Evans C. Coutinho
- Department of Pharmaceutical Chemistry, Bombay College of Pharmacy, , Mumbai, India
| | - Santosh B. Noronha
- Department of Chemical Engineering, Indian Institute of Technology Bombay, Mumbai, India
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13
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Urinary catheter capable of repeated on-demand removal of infectious biofilms via active deformation. Biomaterials 2015; 77:77-86. [PMID: 26584348 DOI: 10.1016/j.biomaterials.2015.10.070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/17/2015] [Accepted: 10/26/2015] [Indexed: 12/25/2022]
Abstract
Biofilm removal from biomaterials is of fundamental importance, and is especially relevant when considering the problematic and deleterious impact of biofilm infections on the inner surfaces of urinary catheters. Catheter-associated urinary tract infections are the most common cause of hospital-acquired infections and there are over 30 million Foley urinary catheters used annually in the USA. In this paper, we present the design and optimization of urinary catheter prototypes capable of on-demand removal of biofilms from the inner luminal surface of catheters. The urinary catheters utilize 4 intra-wall inflation lumens that are pressure-actuated to generate region-selective strains in the elastomeric urine lumen, and thereby remove overlying biofilms. A combination of finite-element modeling and prototype fabrication was used to optimize the catheter design to generate greater than 30% strain in the majority of the luminal surface when subjected to pressure. The catheter prototypes are able to remove greater than 80% of a mixed community biofilm of Proteus mirabilis and Escherichia coli on-demand, and furthermore are able to remove the biofilm repeatedly. Additionally, experiments with the prototypes demonstrate that biofilm debonding can be achieved upon application of both tensile and compressive strains in the inner surface of the catheter. The fouling-release catheter offers the potential for a non-biologic, non-antibiotic method to remove biofilms and thereby for impacting the thus far intractable problem of catheter-associated infections.
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14
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Feneley RCL, Hopley IB, Wells PNT. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol 2015; 39:459-70. [PMID: 26383168 PMCID: PMC4673556 DOI: 10.3109/03091902.2015.1085600] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 08/11/2015] [Accepted: 08/18/2015] [Indexed: 01/11/2023]
Abstract
For more than 3500 years, urinary catheters have been used to drain the bladder when it fails to empty. For people with impaired bladder function and for whom the method is feasible, clean intermittent self-catheterization is the optimal procedure. For those who require an indwelling catheter, whether short- or long-term, the self-retaining Foley catheter is invariably used, as it has been since its introduction nearly 80 years ago, despite the fact that this catheter can cause bacterial colonization, recurrent and chronic infections, bladder stones and septicaemia, damage to the kidneys, the bladder and the urethra, and contribute to the development of antibiotic resistance. In terms of medical, social and economic resources, the burden of urinary retention and incontinence, aggravated by the use of the Foley catheter, is huge. In the UK, the harm resulting from the use of the Foley catheter costs the National Health Service between £1.0-2.5 billion and accounts for ∼2100 deaths per year. Therefore, there is an urgent need for the development of an alternative indwelling catheter system. The research agenda is for the new catheter to be easy and safe to insert, either urethrally or suprapubically, to be retained reliably in the bladder and to be withdrawn easily and safely when necessary, to mimic natural physiology by filling at low pressure and emptying completely without damage to the bladder, and to have control mechanisms appropriate for all users.
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Affiliation(s)
- Roger C. L. Feneley
- North Bristol NHS Foundation Trust, Southmead Hospital, Southmead Road,
Bristol BS10 5NB,
UK
| | - Ian B. Hopley
- Alternative Urological Catheter Systems Ltd, Bramford House, 23 Westfield Park,
Bristol BS6 6LT,
UK
| | - Peter N. T. Wells
- Cardiff University, School of Engineering, Queen’s Buildings,
The Parade, Cardiff CF24 3AA,
UK
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15
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Marcone Marchitti C, Boarin M, Villa G. Encrustations of the urinary catheter and prevention strategies: an observational study. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mattia Boarin
- Department of Urology; San Raffaele Hospital; Milan Italy
| | - Giulia Villa
- School of Nursing; Vita-Salute San Raffaele University; Milan Italy
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16
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Marcone Marchitti C, Boarin M, Villa G. Encrustations of the urinary catheter and prevention strategies: a literature review. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mattia Boarin
- Department of Urology; San Raffaele Hospital; Milan Italy
| | - Giulia Villa
- School of Nursing; Vita-Salute San Raffaele University; Milan Italy
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17
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Jordan RPC, Malic S, Waters MG, Stickler DJ, Williams DW. Development of an antimicrobial urinary catheter to inhibit urinary catheter encrustation. ACTA ACUST UNITED AC 2015. [DOI: 10.7243/2052-6180-3-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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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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Vani K, Thomas S, Prabhawathi V, Boobalan T, Sawant SN, Doble M. In vitro biocompatiblity of modified polycarbonate as a biomaterial. Colloids Surf B Biointerfaces 2013; 108:191-8. [DOI: 10.1016/j.colsurfb.2013.01.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 01/23/2013] [Accepted: 01/30/2013] [Indexed: 10/27/2022]
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Capita R, Alonso-Calleja C. Antibiotic-resistant bacteria: a challenge for the food industry. Crit Rev Food Sci Nutr 2013; 53:11-48. [PMID: 23035919 DOI: 10.1080/10408398.2010.519837] [Citation(s) in RCA: 237] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Antibiotic-resistant bacteria were first described in the 1940s, but whereas new antibiotics were being discovered at a steady rate, the consequences of this phenomenon were slow to be appreciated. At present, the paucity of new antimicrobials coming into the market has led to the problem of antibiotic resistance fast escalating into a global health crisis. Although the selective pressure exerted by the use of antibiotics (particularly overuse or misuse) has been deemed the major factor in the emergence of bacterial resistance to these antimicrobials, concerns about the role of the food industry have been growing in recent years and have been raised at both national and international levels. The selective pressure exerted by the use of antibiotics (primary production) and biocides (e.g., disinfectants, food and feed preservatives, or decontaminants) is the main driving force behind the selection and spread of antimicrobial resistance throughout the food chain. Genetically modified (GM) crops with antibiotic resistance marker genes, microorganisms added intentionally to the food chain (probiotic or technological) with potentially transferable antimicrobial resistance genes, and food processing technologies used at sub-lethal doses (e.g., alternative non-thermal treatments) are also issues for concern. This paper presents the main trends in antibiotic resistance and antibiotic development in recent decades, as well as their economic and health consequences, current knowledge concerning the generation, dissemination, and mechanisms of antibacterial resistance, progress to date on the possible routes for emergence of resistance throughout the food chain and the role of foods as a vehicle for antibiotic-resistant bacteria. The main approaches to prevention and control of the development, selection, and spread of antibacterial resistance in the food industry are also addressed.
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Affiliation(s)
- Rosa Capita
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of León, Spain.
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Jones SM, Ravani P, Hemmelgarn BR, Muruve D, MacRae JM. Morphometric and Biological Characterization of Biofilm in Tunneled Hemodialysis Catheters. Am J Kidney Dis 2011; 57:449-55. [DOI: 10.1053/j.ajkd.2010.10.053] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 10/22/2010] [Indexed: 11/11/2022]
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WELSCH TANNERT, GILLOCK ERICT. Triclosan-resistant bacteria isolated from feedlot and residential soils. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2011; 46:436-40. [PMID: 21391038 PMCID: PMC4041650 DOI: 10.1080/10934529.2011.549407] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Triclosan is an antimicrobial agent that is currently incorporated into hundreds of consumer and medical products. It can be either a bacteriostatic or bactericidal agent, depending on its formulation. It has activity against Gram-positive and Gram-negative bacteria, as well as some viruses and protists. The purpose of this study was to determine whether triclosan-resistant bacteria could be isolated from the soil. Soils from cattle feedlots and residential lawns were collected and assayed for the presence of these organisms by plating samples on growth media containing triclosan. Organisms were subsequently identified by partial 16S rRNA sequencing analysis. All the organisms isolated in this study were Gram-negative rods, with members of genus Pseudomonas being particularly well represented. This result may not be surprising because Gram-negative organisms are generally more resistant to triclosan, and since Pseudomonas bacteria are known to have numerous efflux mechanisms for dealing with harmful substances.
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Affiliation(s)
| | - ERIC T. GILLOCK
- Address correspondence to Eric T. Gillock, Department of Biological Sciences, Fort Hays State University, 600 Park Street, Hays, KS 67601, Tel: 785-628-5324, Fax: 785-628-4153,
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Naves P, del Prado G, Huelves L, Rodríguez-Cerrato V, Ruiz V, Ponte M, Soriano F. Effects of human serum albumin, ibuprofen and N-acetyl-l-cysteine against biofilm formation by pathogenic Escherichia coli strains. J Hosp Infect 2010; 76:165-70. [DOI: 10.1016/j.jhin.2010.05.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 05/14/2010] [Indexed: 10/19/2022]
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Singh D, Vasudeva P, Goel A. "Egg shell" in bladder: A calculus around neglected Foley balloon catheter. Indian J Urol 2010; 26:299-300. [PMID: 20877616 PMCID: PMC2938562 DOI: 10.4103/0970-1591.65410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Suprapubic catheterization of the bladder is used as a short- or long-term alternative to urethral catheterization. As with any indwelling urinary catheter, proper care is vitally important to minimize complications.
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Affiliation(s)
- Dharamveer Singh
- Department of Urology, C.S.M. Medical University (Upgraded King George's Medical College), Lucknow-226 003, Uttar Pradesh, India
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In vitro multicompartmental bladder model for assessing blockage of urinary catheters: effect of hydrogel coating on dynamics of Proteus mirabilis growth. Urology 2010; 76:515.e15-20. [PMID: 20696356 DOI: 10.1016/j.urology.2010.04.039] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 04/01/2010] [Accepted: 04/21/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate the effect of a hydrogel coating on the dynamics of bacterial growth in laboratory models of the catheterized bladder. Infection of the urinary tract by Proteus mirabilis can result in catheter blockage by crystalline biofilm, a common complication in patients undergoing long-term bladder catheterization. METHODS Two series of catheters were tested in the infected bladder models: test series 1, silicone catheters impregnated with triclosan (0.5%, 1%, 4%), or silicone catheters with 0% triclosan impregnated with pure solvents and hydrogel coated (based on polyvinylpyrrolidone); and test series 2, silicone catheters, hydrogel-coated with hydrogel plus iodine (polyvinylpyrrolidone plus iodine) or hydrogel plus polyhexamethylene biguanide. Test series 1 was used to detect the influence of triclosan, solvents, impregnation time, and the presence of hydrogel coating on the interval to catheter blockage by P. mirabilis biofilm. The experiments with test series 2 focused on the dynamic interaction of the hydrogel coating and biofilm formation. The division of the catheterized bladder model into 3 sampling zones brought more information about the spatial segregation of the bacterial population. RESULTS The bacteriostatic efficiency of the water-soluble polyhexamethylene biguanide and polyvinylpyrrolidone iodine complex was limited to the first hours after catheterization. Only catheters containing triclosan resisted encrustation for significantly longer (up to >7 days). In contrast, the uncoated and hydrogel-coated catheters were occluded by day 2. CONCLUSIONS The hydrogel layer can increase aggregation of the planktonic cells and newly nucleated crystals, leading to even faster catheter blockage than in the case of uncoated silicone. However, the addition of active agents were able to suppress this negative effect.
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Guggenheim B, Gmür R, Galicia JC, Stathopoulou PG, Benakanakere MR, Meier A, Thurnheer T, Kinane DF. In vitro modeling of host-parasite interactions: the 'subgingival' biofilm challenge of primary human epithelial cells. BMC Microbiol 2009; 9:280. [PMID: 20043840 PMCID: PMC2818713 DOI: 10.1186/1471-2180-9-280] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 12/31/2009] [Indexed: 11/13/2022] Open
Abstract
Background Microbial biofilms are known to cause an increasing number of chronic inflammatory and infectious conditions. A classical example is chronic periodontal disease, a condition initiated by the subgingival dental plaque biofilm on gingival epithelial tissues. We describe here a new model that permits the examination of interactions between the bacterial biofilm and host cells in general. We use primary human gingival epithelial cells (HGEC) and an in vitro grown biofilm, comprising nine frequently studied and representative subgingival plaque bacteria. Results We describe the growth of a mature 'subgingival' in vitro biofilm, its composition during development, its ability to adapt to aerobic conditions and how we expose in vitro a HGEC monolayer to this biofilm. Challenging the host derived HGEC with the biofilm invoked apoptosis in the epithelial cells, triggered release of pro-inflammatory cytokines and in parallel induced rapid degradation of the cytokines by biofilm-generated enzymes. Conclusion We developed an experimental in vitro model to study processes taking place in the gingival crevice during the initiation of inflammation. The new model takes into account that the microbial challenge derives from a biofilm community and not from planktonically cultured bacterial strains. It will facilitate easily the introduction of additional host cells such as neutrophils for future biofilm:host cell challenge studies. Our methodology may generate particular interest, as it should be widely applicable to other biofilm-related chronic inflammatory diseases.
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Affiliation(s)
- Bernhard Guggenheim
- Institute for Oral Biology, Section for Oral Microbiology and General Immunology, University of Zürich, Plattenstrasse 11, CH-8032 Zürich, Switzerland.
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Abstract
PURPOSE OF REVIEW Biofilms continue to be a major limiting factor in the long-term use of ureteral stents, promoting the development of chronic infections and antibiotic resistance and encrustation. Apart from stent removal in conjunction with antibiotic therapy, there is currently no treatment proven successful for completely eradicating a biofilm-related infection, highlighting the need for continued research in this area. RECENT FINDINGS Research continues to focus mainly on biofilm prevention, specifically the development of novel coatings comprising antibacterial, antifouling or bacterial signalling compounds. Notably, all three strategies have generated candidate coatings showing recent success both in vitro and in vivo. SUMMARY Despite the current lack of a completely biofilm-resistant device, coating or treatment strategy, continued research into the causation of bacterial biofilm formation and the continued development of novel antibacterial, antifouling and antibiofilm compounds is promising. Future work should be aimed at more rigorous testing of candidate coatings from both physical and bacterial challenge standpoints as well as increased in-vivo investigation via clinical trials.
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