1
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Zhu B, Xin H, Yang M, Pan L, Zou X, Lv Z, Yao X, Jin X, Xu Y, Gui S, Lu X. Visualized and pH-responsive hydrogel antibacterial coating for ventilator-associated pneumonia. Biomed Pharmacother 2024; 178:117224. [PMID: 39084079 DOI: 10.1016/j.biopha.2024.117224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/23/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Abstract
Ventilator-associated pneumonia (VAP) is a common healthcare-acquired infection often arising during artificial ventilation using endotracheal intubation (ETT), which offers a platform for bacterial colonization and biofilm development. In particular, the effects of prolonged COVID-19 on the respiratory system. Herein, we developed an antimicrobial coating (FK-MEM@CMCO-CS) capable of visualizing pH changes based on bacterial infection and releasing meropenem (MEM) and FK13-a1 in a controlled manner. Using a simple dip-coating process with controlled loading, chitosan was cross-linked with sodium carboxymethyl cellulose oxidation (CMCO) and coated onto PVC-based ETT to form a hydrogel coating. Subsequently, the coated segments were immersed in an indicator solution containing bromothymol blue (BTB), MEM, and FK13-a1 to fabricate the FK-MEM@CMCO-CS coating. In vitro studies have shown that MEM and FK13-a1 can be released from coatings in a pH-responsive manner. Moreover, anti-biofilm and antibacterial adhesion results showed that FK-MEM@CMCO-CS coating significantly inhibited biofilm formation and prevented their colonization of the coating surface. In the VAP rat model, the coating inhibited bacterial growth, reduced lung inflammation, and had good biocompatibility. The coating can be applied to the entire ETT and has the potential for industrial production.
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Affiliation(s)
- Baokang Zhu
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China; Intensive Care Unit, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518031, China
| | - Hui Xin
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China; Intensive Care Unit, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518031, China
| | - Musheng Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China; Intensive Care Unit, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518031, China
| | - Lingling Pan
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China; Intensive Care Unit, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518031, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Xiangjie Yao
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Xiaobao Jin
- Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Yinghua Xu
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotechnology Products, National Institutes for Food and Drug Control, Beijing 102629, China.
| | - Shuiqing Gui
- Intensive Care Unit, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518031, China.
| | - Xuemei Lu
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China.
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2
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Puertas-Segura A, Ivanova K, Ivanova A, Ivanov I, Todorova K, Dimitrov P, Ciardelli G, Tzanov T. Mussel-Inspired Sonochemical Nanocomposite Coating on Catheters for Prevention of Urinary Infections. ACS APPLIED MATERIALS & INTERFACES 2024; 16:34656-34668. [PMID: 38916599 PMCID: PMC11247429 DOI: 10.1021/acsami.4c05713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Catheter-associated urinary tract infections are the most common hospital-acquired infections and cause patient discomfort, increased morbidity, and prolonged stays, altogether posing a huge burden on healthcare services. Colonization occurs upon insertion, or later by ascending microbes from the rich periurethral flora, and is therefore virtually unavoidable by medical procedures. Importantly, the dwell time is a significant risk factor for bacteriuria because it gives biofilms time to develop and mature. This is why we engineer antibacterial and antibiofilm coating through ultrasound- and nanoparticle-assisted self-assembly on silicone surfaces and validate it thoroughly in vitro and in vivo. To this end, we combine bimetallic silver/gold nanoparticles, which exercise both biocidal and structural roles, with dopamine-modified gelatin in a facile and substrate-independent sonochemical coating process. The latter mussel-inspired bioadhesive potentiates the activity and durability of the coating while attenuating the intrinsic toxicity of silver. As a result, our approach effectively reduces biofilm formation in a hydrodynamic model of the human bladder and prevents bacteriuria in catheterized rabbits during a week of placement, outperforming conventional silicone catheters. These results substantiate the practical use of nanoparticle-biopolymer composites in combination with ultrasound for the antimicrobial functionalization of indwelling medical devices.
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Affiliation(s)
- Antonio Puertas-Segura
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, Terrassa 08222, Spain
| | - Kristina Ivanova
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, Terrassa 08222, Spain
| | - Aleksandra Ivanova
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, Terrassa 08222, Spain
| | - Ivan Ivanov
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, Terrassa 08222, Spain
| | - Katerina Todorova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, Sofia 1113, Bulgaria
| | - Petar Dimitrov
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, Sofia 1113, Bulgaria
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
| | - Tzanko Tzanov
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, Terrassa 08222, Spain
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3
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Bastos CG, Livio DF, de Oliveira MA, Meira HGR, Tarabal VS, Colares HC, Parreira AG, Chagas RCR, Speziali MG, da Silva JA, Granjeiro JM, Millán RDS, Gonçalves DB, Granjeiro PA. Exploring the biofilm inhibitory potential of Candida sp. UFSJ7A glycolipid on siliconized latex catheters. Braz J Microbiol 2024:10.1007/s42770-024-01431-w. [PMID: 38954220 DOI: 10.1007/s42770-024-01431-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 06/19/2024] [Indexed: 07/04/2024] Open
Abstract
Biosurfactants, sustainable alternatives to petrochemical surfactants, are gaining attention for their potential in medical applications. This study focuses on producing, purifying, and characterizing a glycolipid biosurfactant from Candida sp. UFSJ7A, particularly for its application in biofilm prevention on siliconized latex catheter surfaces. The glycolipid was extracted and characterized, revealing a critical micellar concentration (CMC) of 0.98 mg/mL, indicating its efficiency at low concentrations. Its composition, confirmed through Fourier transform infrared spectroscopy (FT-IR) and thin layer chromatography (TLC), identified it as an anionic biosurfactant with a significant ionic charge of -14.8 mV. This anionic nature contributes to its biofilm prevention capabilities. The glycolipid showed a high emulsification index (E24) for toluene, gasoline, and soy oil and maintained stability under various pH and temperature conditions. Notably, its anti-adhesion activity against biofilms formed by Escherichia coli, Enterococcus faecalis, and Candida albicans was substantial. When siliconized latex catheter surfaces were preconditioned with 2 mg/mL of the glycolipid, biofilm formation was reduced by up to 97% for E. coli and C. albicans and 57% for E. faecalis. These results are particularly significant when compared to the efficacy of conventional surfactants like SDS, especially for E. coli and C. albicans. This study highlights glycolipids' potential as a biotechnological tool in reducing biofilm-associated infections on medical devices, demonstrating their promising applicability in healthcare settings.
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Affiliation(s)
- Cibele Garcia Bastos
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Diego Fernandes Livio
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Maria Auxiliadora de Oliveira
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Hiure Gomes Ramos Meira
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Vinícius Souza Tarabal
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Heloísa Carneiro Colares
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Adriano Guimarães Parreira
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Rafael César Russo Chagas
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Marcelo Gomes Speziali
- Chemistry Department, Federal University of Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
| | - José Antônio da Silva
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - José Mauro Granjeiro
- National Institute of Metrology, Quality, and Technology, Duque de Caxias, RJ, 25250-020, Brazil
| | | | - Daniel Bonoto Gonçalves
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - Paulo Afonso Granjeiro
- Campus Centro Oeste, Federal University of São João del-Rei, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil.
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4
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Fong C, Andersen MJ, Kunesh E, Leonard E, Durand D, Coombs R, Flores-Mireles AL, Howell C. Effect of free liquid layer quantity on bacteria and protein adhesion to liquid infused polymers. Biointerphases 2024; 19:041003. [PMID: 39136648 PMCID: PMC11324329 DOI: 10.1116/6.0003776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/09/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Liquid-infused polymers are recognized for their ability to repel foulants, making them promising for biomedical applications including catheter-associated urinary tract infections (CAUTIs). However, the impact of the quantity of free liquid layer covering the surface on protein and bacterial adhesion is not well understood. Here, we explore how the amount of free silicone liquid layer in infused silicone catheter materials influences the adhesion of bacteria and proteins relevant to CAUTIs. To alter the quantity of the free liquid layer, we either physically removed excess liquid from fully infused catheter materials or partially infused them. We then evaluated the impact on bacterial and host protein adhesion. Physical removal of the free liquid layer from the fully infused samples reduced the height of the liquid layer from 60 μm to below detection limits and silicone liquid loss into the environment by approximately 64% compared to controls, without significantly increasing the deposition of protein fibrinogen or the adhesion of the common uropathogen Enterococcus faecalis. Partially infused samples showed even greater reductions in liquid loss: samples infused to 70%-80% of their maximum capacity exhibited about an 85% decrease in liquid loss compared to fully infused controls. Notably, samples with more than 70% infusion did not show significant increases in fibrinogen or E. faecalis adhesion. These findings suggest that adjusting the levels of the free liquid layer in infused polymers can influence protein and bacterial adhesion on their surfaces. Moreover, removing the free liquid layer can effectively reduce liquid loss from these polymers while maintaining their functionality.
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Affiliation(s)
- ChunKi Fong
- Author to whom correspondence should be addressed:
| | - Marissa Jeme Andersen
- Department of Biological Sciences and Department of Chemistry and Biochemistry, College of Science, Notre Dame University, South Bend, Indiana 46556
| | - Emma Kunesh
- Department of Chemical and Biomedical Engineering, Maine College of Engineering and Computing, University of Maine, Orono, Maine 04469
| | - Evan Leonard
- Department of Chemical and Biomedical Engineering, Maine College of Engineering and Computing, University of Maine, Orono, Maine 04469
| | - Donovan Durand
- Department of Chemical and Biomedical Engineering, Maine College of Engineering and Computing, University of Maine, Orono, Maine 04469
| | - Rachel Coombs
- Department of Chemical and Biomedical Engineering, Maine College of Engineering and Computing, University of Maine, Orono, Maine 04469
| | - Ana Lidia Flores-Mireles
- Department of Biological Sciences and Department of Chemistry and Biochemistry, College of Science, Notre Dame University, South Bend, Indiana 46556
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5
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Moore JV, Burns J, McClelland N, Quinn J, McCoy CP. Understanding the properties of intermittent catheters to inform future development. Proc Inst Mech Eng H 2024; 238:713-727. [PMID: 37300485 PMCID: PMC11318220 DOI: 10.1177/09544119231178468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/10/2023] [Indexed: 06/12/2023]
Abstract
Despite the extensive use of intermittent catheters (ICs) in healthcare, various issues persist for long-term IC users, such as pain, discomfort, infection, and tissue damage, including strictures, scarring and micro-abrasions. A lubricous IC surface is considered necessary to reduce patient pain and trauma, and therefore is a primary focus of IC development to improve patient comfort. While an important consideration, other factors should be routinely investigated to inform future IC development. An array of in vitro tests should be employed to assess IC's lubricity, biocompatibility and the risk of urinary tract infection development associated with their use. Herein, we highlight the importance of current in vitro characterisation techniques, the demand for optimisation and an unmet need to develop a universal 'toolkit' to assess IC properties.
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Affiliation(s)
| | | | | | | | - Colin P McCoy
- School of Pharmacy, Queen’s University Belfast, Belfast, Northern Ireland, UK
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6
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Bouhrour N, Nibbering PH, Bendali F. Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens. Pathogens 2024; 13:393. [PMID: 38787246 PMCID: PMC11124157 DOI: 10.3390/pathogens13050393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Medical devices such as venous catheters (VCs) and urinary catheters (UCs) are widely used in the hospital setting. However, the implantation of these devices is often accompanied by complications. About 60 to 70% of nosocomial infections (NIs) are linked to biofilms. The main complication is the ability of microorganisms to adhere to surfaces and form biofilms which protect them and help them to persist in the host. Indeed, by crossing the skin barrier, the insertion of VC inevitably allows skin flora or accidental environmental contaminants to access the underlying tissues and cause fatal complications like bloodstream infections (BSIs). In fact, 80,000 central venous catheters-BSIs (CVC-BSIs)-mainly occur in intensive care units (ICUs) with a death rate of 12 to 25%. Similarly, catheter-associated urinary tract infections (CA-UTIs) are the most commonlyhospital-acquired infections (HAIs) worldwide.These infections represent up to 40% of NIs.In this review, we present a summary of biofilm formation steps. We provide an overview of two main and important infections in clinical settings linked to medical devices, namely the catheter-asociated bloodstream infections (CA-BSIs) and catheter-associated urinary tract infections (CA-UTIs), and highlight also the most multidrug resistant bacteria implicated in these infections. Furthermore, we draw attention toseveral useful prevention strategies, and advanced antimicrobial and antifouling approaches developed to reduce bacterial colonization on catheter surfaces and the incidence of the catheter-related infections.
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Affiliation(s)
- Nesrine Bouhrour
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
| | - Peter H. Nibbering
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands;
| | - Farida Bendali
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
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7
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Berglin M, Cavanagh JP, Caous JS, Thakkar BS, Vasquez JM, Stensen W, Lyvén B, Svendsen JS, Svenson J. Flexible and Biocompatible Antifouling Polyurethane Surfaces Incorporating Tethered Antimicrobial Peptides through Click Reactions. Macromol Biosci 2024; 24:e2300425. [PMID: 38009664 DOI: 10.1002/mabi.202300425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/30/2023] [Indexed: 11/29/2023]
Abstract
Efficient, simple antibacterial materials to combat implant-associated infections are much in demand. Herein, the development of polyurethanes, both cross-linked thermoset and flexible and versatile thermoplastic, suitable for "click on demand" attachment of antibacterial compounds enabled via incorporation of an alkyne-containing diol monomer in the polymer backbone, is described. By employing different polyolic polytetrahydrofurans, isocyanates, and chain extenders, a robust and flexible material comparable to commercial thermoplastic polyurethane is prepared. A series of short synthetic antimicrobial peptides are designed, synthesized, and covalently attached in a single coupling step to generate a homogenous coating. The lead material is shown to be biocompatible and does not display any toxicity against either mouse fibroblasts or reconstructed human epidermis according to ISO and OECD guidelines. The repelling performance of the peptide-coated materials is illustrated against colonization and biofilm formation by Staphylococcus aureus and Staphylococcus epidermidis on coated plastic films and finally, on coated commercial central venous catheters employing LIVE/DEAD staining, confocal laser scanning microscopy, and bacterial counts. This study presents the successful development of a versatile and scalable polyurethane with the potential for use in the medical field to reduce the impact of bacterial biofilms.
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Affiliation(s)
- Mattias Berglin
- Department of Materials and Production, RISE Research Institutes of Sweden, Gothenburg, 413 46, Sweden
- Department of Chemistry and Molecular Biology, Gothenburg University, Gothenburg, 413 90, Sweden
| | - Jorunn Pauline Cavanagh
- Amicoat A/S, Oslo Science Park, Oslo, 1386, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, 9019, Norway
| | - Josefin Seth Caous
- Department of Materials and Production, RISE Research Institutes of Sweden, Gothenburg, 413 46, Sweden
| | | | - Jeddah Marie Vasquez
- Department of Materials and Production, RISE Research Institutes of Sweden, Gothenburg, 413 46, Sweden
| | - Wenche Stensen
- Department of Chemistry, UiT The Arctic University of Norway, Tromsø, 9019, Norway
| | - Benny Lyvén
- Department of Materials and Production, RISE Research Institutes of Sweden, Gothenburg, 413 46, Sweden
| | - John-Sigurd Svendsen
- Amicoat A/S, Oslo Science Park, Oslo, 1386, Norway
- Department of Chemistry, UiT The Arctic University of Norway, Tromsø, 9019, Norway
| | - Johan Svenson
- Department of Materials and Production, RISE Research Institutes of Sweden, Gothenburg, 413 46, Sweden
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8
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Molina JJ, Kohler KN, Gager C, Andersen MJ, Wongso E, Lucas ER, Paik A, Xu W, Donahue DL, Bergeron K, Klim A, Caparon MG, Hultgren SJ, Desai A, Ploplis VA, Flick MJ, Castellino FJ, Flores-Mireles AL. Fibrinolytic-deficiencies predispose hosts to septicemia from a catheter-associated UTI. Nat Commun 2024; 15:2704. [PMID: 38538626 PMCID: PMC10973455 DOI: 10.1038/s41467-024-46974-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Catheter-associated urinary tract infections (CAUTIs) are amongst the most common nosocomial infections worldwide and are difficult to treat partly due to development of multidrug-resistance from CAUTI-related pathogens. Importantly, CAUTI often leads to secondary bloodstream infections and death. A major challenge is to predict when patients will develop CAUTIs and which populations are at-risk for bloodstream infections. Catheter-induced inflammation promotes fibrinogen (Fg) and fibrin accumulation in the bladder which are exploited as a biofilm formation platform by CAUTI pathogens. Using our established mouse model of CAUTI, here we identified that host populations exhibiting either genetic or acquired fibrinolytic-deficiencies, inducing fibrin deposition in the catheterized bladder, are predisposed to severe CAUTI and septicemia by diverse uropathogens in mono- and poly-microbial infections. Furthermore, here we found that Enterococcus faecalis, a prevalent CAUTI pathogen, uses the secreted protease, SprE, to induce fibrin accumulation and create a niche ideal for growth, biofilm formation, and persistence during CAUTI.
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Affiliation(s)
- Jonathan J Molina
- Integrated Biomedical Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Kurt N Kohler
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Christopher Gager
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Marissa J Andersen
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Ellsa Wongso
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Elizabeth R Lucas
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Andrew Paik
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Wei Xu
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Women's Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Deborah L Donahue
- W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN, 46556, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Karla Bergeron
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Aleksandra Klim
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Michael G Caparon
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Women's Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Scott J Hultgren
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Center for Women's Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Alana Desai
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Urology, University of Washington Medical Center, Seattle, WA, 98133-9733, USA
| | - Victoria A Ploplis
- W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN, 46556, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Matthew J Flick
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA
- UNC Blood Research Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Francis J Castellino
- W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN, 46556, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Ana L Flores-Mireles
- Integrated Biomedical Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA.
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA.
- W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN, 46556, USA.
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9
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Chadha J, Thakur N, Chhibber S, Harjai K. A comprehensive status update on modification of foley catheter to combat catheter-associated urinary tract infections and microbial biofilms. Crit Rev Microbiol 2024; 50:168-195. [PMID: 36651058 DOI: 10.1080/1040841x.2023.2167593] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/01/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
Present-day healthcare employs several types of invasive devices, including urinary catheters, to improve medical wellness, the clinical outcome of disease, and the quality of patient life. Among urinary catheters, the Foley catheter is most commonly used in patients for bladder drainage and collection of urine. Although such devices are very useful for patients who cannot empty their bladder for various reasons, they also expose patients to catheter-associated urinary tract infections (CAUTIs). Catheter provides an ideal surface for bacterial colonization and biofilm formation, resulting in persistent bacterial infection and severe complications. Hence, rigorous efforts have been made to develop catheters that harbour antimicrobial and anti-fouling properties to resist colonization by bacterial pathogens. In this regard, catheter modification by surface functionalization, impregnation, blending, or coating with antibiotics, bioactive compounds, and nanoformulations have proved to be effective in controlling biofilm formation. This review attempts to illustrate the complications associated with indwelling Foley catheters, primarily focussing on challenges in fighting CAUTI, catheter colonization, and biofilm formation. In this review, we also collate scientific literature on catheter modification using antibiotics, plant bioactive components, bacteriophages, nanoparticles, and studies demonstrating their efficacy through in vitro and in vivo testing.
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Affiliation(s)
- Jatin Chadha
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Navdisha Thakur
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Sanjay Chhibber
- Department of Microbiology, Panjab University, Chandigarh, India
| | - Kusum Harjai
- Department of Microbiology, Panjab University, Chandigarh, India
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10
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Hu Y, Yuan M, Julian A, Tuz K, Juárez O. Identification of complex III, NQR, and SDH as primary bioenergetic enzymes during the stationary phase of Pseudomonas aeruginosa cultured in urine-like conditions. Front Microbiol 2024; 15:1347466. [PMID: 38468849 PMCID: PMC10926992 DOI: 10.3389/fmicb.2024.1347466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
Pseudomonas aeruginosa is a common cause of urinary tract infections by strains that are often multidrug resistant, representing a major challenge to the world's health care system. This microorganism has a highly adaptable metabolism that allows it to colonize many environments, including the urinary tract. In this work, we have characterized the metabolic strategies used by stationary phase P. aeruginosa cells cultivated in urine-like media to understand the adaptations used by this microorganism to survive and produce disease. Our proteomics results show that cells rely on the Entner-Duodoroff pathway, pentose phosphate pathway, the Krebs cycle/ glyoxylate shunt and the aerobic oxidative phosphorylation to survive in urine-like media and other conditions. A deep characterization of the oxidative phosphorylation showed that the respiratory rate of stationary phase cells is increased 3-4 times compared to cells in the logarithmic phase of growth, indicating that the aerobic metabolism plays critical roles in the stationary phase of cells grown in urine like media. Moreover, the data show that respiratory complex III, succinate dehydrogenase and the NADH dehydrogenase NQR have important functions and could be used as targets to develop new antibiotics against this bacterium.
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Affiliation(s)
| | | | | | | | - Oscar Juárez
- Department of Biological Sciences, Illinois Institute of Technology, Chicago, IL, United States
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11
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Periyasami G, Karuppiah P, Karthikeyan P, Palaniappan S. Anti-infective Efficacy of Duloxetine against Catheter-Associated Urinary Tract Infections Caused by Gram-Positive Bacteria. ACS OMEGA 2023; 8:48317-48325. [PMID: 38144107 PMCID: PMC10734014 DOI: 10.1021/acsomega.3c07676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/31/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023]
Abstract
Catheter-associated urinary tract infections (CAUTIs) frequently occur following the insertion of catheters in hospitalized patients, often leading to severe clinical complications. These complications are exacerbated by biofilm-forming organisms such as Staphylococcus aureus, contributing to the emergence of multidrug-resistant (MDR) strains, which complicates treatment strategies. This study aims to investigate the antibacterial, antibiofilm, and antiadhesive properties of duloxetine against S. aureus in the context of CAUTI. Our findings demonstrate that duloxetine exhibits significant antibacterial activity, as evidenced by the agar diffusion method. A minimal inhibitory concentration (MIC) of 37.5 μg/mL was established using the microdilution method. Notably, duloxetine displayed inhibitory effects against biofilm formation on polystyrene surfaces up to its MIC level, as demonstrated by the crystal violet method. Intriguingly, the study also revealed that duloxetine could prevent biofilm formation at lower concentrations and reduce mature biofilms, as confirmed by scanning electron microscopy (SEM) and quantitative biofilm assays. Furthermore, duloxetine-coated silicone catheter tubes exhibited antibacterial properties against S. aureus in a bladder model, visualized by confocal laser scanning microscopy (CLSM) and corroborated through FDA and PI staining, highlighting noticeable morphological changes in S. aureus post-treatment. In conclusion, this study presents duloxetine as a promising alternative agent with antibacterial and antiadhesive properties against S. aureus in the prevention and management of CAUTI, warranting further exploration in the clinical setting.
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Affiliation(s)
- Govindasami Periyasami
- Department
of Chemistry, College of Science, King Saud
University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Ponmurugan Karuppiah
- Department
of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Perumal Karthikeyan
- Department
of Chemistry and Biochemistry, Ohio State
University, 170A CBEC, 151 Woodruff Avenue, Columbus, Ohio 43210, United States
| | - Selvakumar Palaniappan
- Department
of Food Science and Postharvest Technology, Haramaya Institute of
Technology, Haramaya University, Dire Dawa-P.O. Box 138, Ethiopia
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12
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Bouhrour N, van der Reijden TJK, Voet MM, Schonkeren-Ravensbergen B, Cordfunke RA, Drijfhout JW, Bendali F, Nibbering PH. Novel Antibacterial Agents SAAP-148 and Halicin Combat Gram-Negative Bacteria Colonizing Catheters. Antibiotics (Basel) 2023; 12:1743. [PMID: 38136778 PMCID: PMC10741160 DOI: 10.3390/antibiotics12121743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
The antibiotic management of catheter-related infections (CRIs) often fails owing to the emergence of antimicrobial-resistant strains and/or biofilm/persister apparitions. Thus, we investigated the efficacy of two novel antimicrobial agents, i.e., the synthetic peptide SAAP-148 and the novel antibiotic halicin, against Gram-negative bacteria (GNB) colonizing catheters. The antibacterial, anti-biofilm, and anti-persister activities of both agents were evaluated against Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae strains. The enrolled strains were isolated from catheters and selected based on their resistance to at least three antibiotic classes and biofilm formation potential. Furthermore, the hemolysis and endotoxin neutralization abilities of these agents were explored. The bactericidal activity of both agents was reduced in urine and plasma as compared to buffered saline. In a dose-dependent manner, SAAP-148 and halicin reduced bacterial counts in 24 h preformed biofilms on silicone elastomer discs and eliminated persisters originating from antibiotic-exposed mature 7-day biofilms, with halicin being less effective than SAAP-148. Importantly, SAAP-148 and halicin acted synergistically on E. coli and K. pneumoniae biofilms but not on A. baumannii biofilms. The peptide, but not halicin, decreased the production of IL-12p40 upon exposure to UV-killed bacteria. This preliminary study showed that SAAP-148 and halicin alone/in combination are promising candidates to fight GNB colonizing catheters.
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Affiliation(s)
- Nesrine Bouhrour
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (T.J.K.v.d.R.); (M.M.V.); (B.S.-R.); (P.H.N.)
| | - Tanny J. K. van der Reijden
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (T.J.K.v.d.R.); (M.M.V.); (B.S.-R.); (P.H.N.)
| | - Michella M. Voet
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (T.J.K.v.d.R.); (M.M.V.); (B.S.-R.); (P.H.N.)
| | - Bep Schonkeren-Ravensbergen
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (T.J.K.v.d.R.); (M.M.V.); (B.S.-R.); (P.H.N.)
| | - Robert A. Cordfunke
- Department of Immunology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (R.A.C.); (J.W.D.)
| | - Jan Wouter Drijfhout
- Department of Immunology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (R.A.C.); (J.W.D.)
| | - Farida Bendali
- Laboratoire de Microbiologie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria
| | - Peter H. Nibbering
- Department of Infectious Diseases, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (T.J.K.v.d.R.); (M.M.V.); (B.S.-R.); (P.H.N.)
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13
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Wynne KJ, Zolotarskaya O, Jarrell R, Wang C, Amin Y, Brunson K. Facile Modification of Medical-Grade Silicone for Antimicrobial Effectiveness and Biocompatibility: A Potential Therapeutic Strategy against Bacterial Biofilms. ACS APPLIED MATERIALS & INTERFACES 2023; 15:46626-46638. [PMID: 37782835 DOI: 10.1021/acsami.3c08734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
A one-step modification of biomedical silicone tubing with N,N-dimethyltetradecylamine, C14, results in a composition designated WinGard-1 (WG-1, 1.1 wt % C14). A surface-active silicon-amine phase (SAP) is proposed to account for increased wettability and increased surface charge. To understand the mechanism of antimicrobial effectiveness, several procedures were employed to detect whether C14 leaching occurred. An immersion-growth (IG) test was developed that required knowing the bacterial Minimum Inhibitory Concentrations (MICs) and Minimum Biocidal Concentrations (MBCs). The C14 MIC and MBC for Gm- uropathogenic E. coli (UPEC), commonly associated with catheter-associated urinary tract infections (CAUTI), were 10 and 20 μg/mL, respectively. After prior immersion of WG-1 silicone segments in a growth medium from 1 to 28 d, the IG test for the medium showed normal growth for UPEC over 24 h, indicating that the concentration of C14 must be less than the MIC, 10 μg/mL. GC-MS and studies of the medium inside and outside a dialysis bag containing WG-1 silicone segments supported de minimis leaching. Consequently, a 5 log UPEC reduction (99.999% kill) in 24 h using the shake flask test (ASTM E2149) cannot be due to leaching and is ascribed to contact kill. Interestingly, although the MBC was greater than 100 μg/mL for Pseudomonas aeruginosa, WG-1 silicone affected an 80% reduction via a 24 h shake flask test. For other bacteria and Candida albicans, greater than 99.9% shake flask kill may be understood by proposing increased wettability and concentration of charge illustrated in the TOC. De minimis leaching places WG-1 silicone at an advantage over conventional anti-infectives that rely on leaching of an antibiotic or heavy metals such as silver. The facile process for preparation of WG-1 silicone combined with biocidal effectiveness comprises progress toward the goals of device designation from the FDA for WG-1 and clearance.
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Affiliation(s)
- Kenneth J Wynne
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Olga Zolotarskaya
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Rebecca Jarrell
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Chenyu Wang
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Youssef Amin
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
| | - Kennard Brunson
- Virginia Bio+Tech Park, WynnVision LLC, Suite 57 800 East Leigh Street Richmond, Virginia 23219-1551, United States
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14
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Zhang Y, Wang L, Wang Y, Li L, Zhou J, Dou D, Wu Z, Yu L, Fan Y. Degradable Antimicrobial Ureteral Stent Construction with Silver@graphdiyne Nanocomposite. Adv Healthc Mater 2023; 12:e2300885. [PMID: 37256720 DOI: 10.1002/adhm.202300885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/18/2023] [Indexed: 06/02/2023]
Abstract
In the surgical treatment of urinary diseases, ureteral stents are commonly used interventional medical devices. Although polymer ureteral stents with polyurethane as the main constituent are widely used in the clinic, the need for secondary surgery to remove them and their propensity to cause bacterial infections greatly limit their effectiveness. To satisfy clinical requirements, an electrospinning-based strategy to fabricate PLGA ureteral stents with silver@graphdiyne is innovated. Silver (Ag) nanoparticles are uniformly loaded on the surface of graphdiyne (GDY) flakes. It is found that the incorporation of Ag nanoparticles into GDY markedly increases their antibacterial properties. Subsequently, the synthesized and purified Ag@GDY is homogeneously blended with poly(lactic-co-glycolic acid) (PLGA) as an antimicrobial agent, and electrospinning along with high-speed collectors is used to make tubular stents. The antibacterial effect of Ag@GDY and the porous microstructure of the stents can effectively prevent bacterial biofilm formation. Furthermore, the stents gradually decrease in toughness but increase in strength during the degradation process. The cellular and subcutaneous implantation experiments demonstrate the moderate biocompatibility of the stents. In summary, considering these performance characteristics and the technical feasibility of the approach taken, this study opens new possibilities for the design and application of biodegradable ureteral stents.
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Affiliation(s)
- Yang Zhang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Lizhen Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Linhao Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Jin Zhou
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Dandan Dou
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Zebin Wu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Lu Yu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
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15
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Youssef N, Shepherd A, Best C, Hagen S, Mackay W, Waddell D, El Sebaee H. The Quality of Life of Patients Living with a Urinary Catheter and Its Associated Factors: A Cross-Sectional Study in Egypt. Healthcare (Basel) 2023; 11:2266. [PMID: 37628463 PMCID: PMC10454127 DOI: 10.3390/healthcare11162266] [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: 06/15/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND In Arabic countries, no research has focused on the experience of patients with indwelling urinary catheters. This cross-sectional study is the first to evaluate the catheter-specific quality of life (QoL) of patients living with a urinary catheter in Egypt. METHODS This study was conducted from April to September 2017, using a convenience sample of patients from a University Hospital. Data were collected using the International Consultation on Incontinence Questionnaire-Long-Term Catheter QoL (ICIQ-LTCQoL) instrument, along with a demographic datasheet. RESULTS 141 were enrolled, with 47.5% inpatients, 52.5% outpatients. A total of 70.9% reported problems with catheter function, and 92.2% reported that the catheter affected their daily lives. Place (inpatient or outpatient) was significantly associated with the total score of the ICIQ-LTCQoL (mean difference (MD) 6.34 (95% CI: 3.0 to 9.73)) and both subscales (catheter function subscale: MD = 4.92 (95% CI: 2.12 to 7.73) and lifestyle impact subscale: MD = 1.44 (95% CI: 0.3 to 2.63)), suggesting that outpatients have poorer QoL than inpatients. Moreover, catheter material was significantly related to the catheter function domain with Silicone Foley Catheter (100% Silicon) users experiencing poorer QoL related to catheter function than those with Latex Foley Catheter (Silicon-coated) (MD 4.43 (95% CI: 0.62 to 8.24). Workers/employees were found to have poorer QoL than those who were retired (MD = 4.94 (95% CI: 0.3 to 9.63)). CONCLUSION The results highlight the necessity of assessing function and concern regarding urinary catheter use and its impact on QoL, as well as its determinants. Evidence-based educational programs should be designed to enhance patients' self-care abilities to relieve their sense of distress and enhance their confidence in caring for their catheters.
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Affiliation(s)
- Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Ashley Shepherd
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Catherine Best
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Suzanne Hagen
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - William Mackay
- School of Health and Life Sciences, University of the West of Scotland, Paisley PA1 2BE, UK
| | - Debbie Waddell
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
| | - Hanan El Sebaee
- Medical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
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16
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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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17
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Self-Disinfecting Urethral Catheter to Overcome Urinary Infections: From Antimicrobial Photodynamic Action to Antibacterial Biochemical Entities. Microorganisms 2022; 10:microorganisms10122484. [PMID: 36557737 PMCID: PMC9785902 DOI: 10.3390/microorganisms10122484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Medical-device-related infections are considered a worldwide public health problem. In particular, urinary catheters are responsible for 75% of cases of hospital urinary infections (a mortality rate of 2.3%) and present a high cost for public and private health systems. Some actions have been performed and described aiming to avoid it, including clinical guidelines for catheterization procedure, antibiotic prophylaxis, and use of antimicrobial coated-urinary catheters. In this review paper, we present and discuss the functionalization of urinary catheters surfaces with antimicrobial entities (e.g., photosensitizers, antibiotics, polymers, silver salts, oxides, bacteriophage, and enzymes) highlighting the immobilization of photosensitizing molecules for antimicrobial photodynamic applications. Moreover, the characterization techniques and (photo)antimicrobial effects of the coated-urinary catheters are described and discussed. We highlight the most significant examples in the last decade (2011-2021) concerning the antimicrobial coated-urinary catheter and their potential use, limitations, and future perspectives.
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18
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Liu J, Xu Y, Lin X, Ma N, Zhu Q, Yang K, Li X, Liu C, Feng N, Zhao Y, Li X, Zhang W. Immobilization of poly-L-lysine brush via surface initiated polymerization for the development of long-term antibacterial coating for silicone catheter. Colloids Surf B Biointerfaces 2022; 221:113015. [DOI: 10.1016/j.colsurfb.2022.113015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
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19
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Navarro S, Sherman E, Colmer-Hamood JA, Nelius T, Myntti M, Hamood AN. Urinary Catheters Coated with a Novel Biofilm Preventative Agent Inhibit Biofilm Development by Diverse Bacterial Uropathogens. Antibiotics (Basel) 2022; 11:1514. [PMID: 36358169 PMCID: PMC9686518 DOI: 10.3390/antibiotics11111514] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 08/03/2023] Open
Abstract
Despite the implementation of stringent guidelines for the prevention of catheter-associated (CA) urinary tract infection (UTI), CAUTI remains one of the most common health care-related infections. We previously showed that an antimicrobial/antibiofilm agent inhibited biofilm development by Gram-positive and Gram-negative bacterial pathogens isolated from human infections. In this study, we examined the ability of a novel biofilm preventative agent (BPA) coating on silicone urinary catheters to inhibit biofilm formation on the catheters by six different bacterial pathogens isolated from UTIs: three Escherichia coli strains, representative of the most common bacterium isolated from UTI; one Enterobacter cloacae, a multidrug-resistant isolate; one Pseudomonas aeruginosa, common among patients with long-term catheterization; and one isolate of methicillin-resistant Staphylococcus aureus, as both a Gram-positive and a resistant organism. First, we tested the ability of these strains to form biofilms on urinary catheters made of red rubber, polyvinyl chloride (PVC), and silicone using the microtiter plate biofilm assay. When grown in artificial urine medium, which closely mimics human urine, all tested isolates formed considerable biofilms on all three catheter materials. As the biofilm biomass formed on silicone catheters was 0.5 to 1.6 logs less than that formed on rubber or PVC, respectively, we then coated the silicone catheters with BPA (benzalkonium chloride, polyacrylic acid, and glutaraldehyde), and tested the ability of the coated catheters to further inhibit biofilm development by these uropathogens. Compared with the uncoated silicone catheters, BPA-coated catheters completely prevented biofilm development by all the uropathogens, except P. aeruginosa, which showed no reduction in biofilm biomass. To explore the reason for P. aeruginosa resistance to the BPA coating, we utilized two specific lipopolysaccharide (LPS) mutants. In contrast to their parent strain, the two mutants failed to form biofilms on the BPA-coated catheters, which suggests that the composition of P. aeruginosa LPS plays a role in the resistance of wild-type P. aeruginosa to the BPA coating. Together, our results suggest that, except for P. aeruginosa, BPA-coated silicone catheters may prevent biofilm formation by both Gram-negative and Gram-positive uropathogens.
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Affiliation(s)
- Stephany Navarro
- Department of Immunology and Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | | | - Jane A. Colmer-Hamood
- Department of Immunology and Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Medical Education, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Thomas Nelius
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | | | - Abdul N. Hamood
- Department of Immunology and Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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20
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Alfe M, Minopoli G, Tartaglia M, Gargiulo V, Caruso U, Pepe GP, Ausanio G. Coating of Flexible PDMS Substrates through Matrix-Assisted Pulsed Laser Evaporation (MAPLE) with a New-Concept Biocompatible Graphenic Material. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3663. [PMID: 36296853 PMCID: PMC9610489 DOI: 10.3390/nano12203663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/10/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
In this study, matrix-assisted pulsed laser evaporation (MAPLE) was used to deposit graphene-like materials (GL), a new class of biocompatible graphene-related materials (GRMs) obtained from a controlled top-down demolition of a carbon black, on silicone slices to test their potential use as functional coating on invasive medical devices as indwelling urinary catheters. Results indicate that the relevant chemical-physical features of the deposit (controlled by FTIR and AFM) were maintained after MAPLE deposition. After deposition, GL films underwent a biological survey toward target cellular lines (murine fibroblast NIH3T3, human keratinocytes HaCAT and the human cervical adenocarcinoma epithelial-like HeLa). Results indicate that the GL films did not lead to any perturbations in the different biological parameters evaluated. The presented results and the possibility to further functionalize the GL or combine them with other functional materials in a hybrid fashion to assure a tighter adhesion onto the substrate for use in harsh conditions open the door to practical applications of these new-concept medical devices (drug delivery, next generation flexible devices, multifunctional coatings) paving the way to the prevention of nosocomial infections driven by catheterization through antibiotics-free approaches.
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Affiliation(s)
- Michela Alfe
- Institute of Sciences and Technologies for Sustainable Energy and Mobility (CNR-STEMS), P.le V. Tecchio 80, 80125 Naples, Italy
| | - Giuseppina Minopoli
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, via Pansini, 5, 80131 Naples, Italy
| | - Massimiliano Tartaglia
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, via Pansini, 5, 80131 Naples, Italy
| | - Valentina Gargiulo
- Institute of Sciences and Technologies for Sustainable Energy and Mobility (CNR-STEMS), P.le V. Tecchio 80, 80125 Naples, Italy
| | - Ugo Caruso
- Department of Chemical Sciences, University of Naples Federico II, via Cinthia 4, 80126 Naples, Italy
| | - Giovanni Piero Pepe
- Department of Physics “E. Pancini”, University of Naples Federico II, via Cinthia 4, 80126 Naples, Italy
| | - Giovanni Ausanio
- Department of Physics “E. Pancini”, University of Naples Federico II, via Cinthia 4, 80126 Naples, Italy
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21
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Gauhar V, Castellani D, Teoh JYC, Nedbal C, Chiacchio G, Gabrielson AT, Heldwein FL, Wroclawski ML, de la Rosette J, Donalisio da Silva R, Galosi AB, Somani BK. Catheter-Associated Urinary Infections and Consequences of Using Coated versus Non-Coated Urethral Catheters-Outcomes of a Systematic Review and Meta-Analysis of Randomized Trials. J Clin Med 2022; 11:jcm11154463. [PMID: 35956080 PMCID: PMC9369369 DOI: 10.3390/jcm11154463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Coated urethral catheters were introduced in clinical practice to reduce the risk of catheter-acquired urinary tract infection (CAUTI). We aimed to systematically review the incidence of CAUTI and adverse effects in randomized clinical trials of patients requiring indwelling bladder catheterization by comparing coated vs. non-coated catheters. This review was performed according to the 2020 PRISMA framework. The incidence of CAUTI and catheter-related adverse events was evaluated using the Cochran−Mantel−Haenszel method with a random-effects model and reported as the risk ratio (RR), 95% CI, and p-values. Significance was set at p < 0.05 and a 95% CI. Twelve studies including 36,783 patients were included for meta-analysis. There was no significant difference in the CAUTI rate between coated and non-coated catheters (RR 0.87 95% CI 0.75−1.00, p = 0.06). Subgroup analysis demonstrated that the risk of CAUTI was significantly lower in the coated group compared with the non-coated group among patients requiring long-term catheterization (>14 days) (RR 0.82 95% CI 0.68−0.99, p = 0.04). There was no difference between the two groups in the incidence of the need for catheter exchange or the incidence of lower urinary tract symptoms after catheter removal. The benefit of coated catheters in reducing CAUTI risk among patients requiring long-term catheterization should be balanced against the increased direct costs to health care systems when compared to non-coated catheters.
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Affiliation(s)
- Vineet Gauhar
- Department of Urology, Ng Teng Fong General Hospital (NUHS), Singapore 609606, Singapore;
| | - Daniele Castellani
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
- Correspondence: ; Tel.: +39-71-5963367
| | - Jeremy Yuen-Chun Teoh
- S.H.Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China;
| | - Carlotta Nedbal
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
| | - Giuseppe Chiacchio
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
| | - Andrew T. Gabrielson
- Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA;
| | - Flavio Lobo Heldwein
- Department of Urology, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil;
| | - Marcelo Langer Wroclawski
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil;
- Beneficência Portuguesa de São Paulo (BP), São Paulo 01323-001, Brazil
| | - Jean de la Rosette
- Department of Urology, Medipol Mega University Hospital, Istanbul Medipol University, 34214 Istanbul, Turkey;
| | | | - Andrea Benedetto Galosi
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy; (C.N.); (G.C.); (A.B.G.)
| | - Bhaskar Kumar Somani
- Department of Urology, University Hospitals Southampton, NHS Trust, Southampton SO16 6YD, UK;
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22
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Rugaie OA, Abdellatif AAH, El-Mokhtar MA, Sabet MA, Abdelfattah A, Alsharidah M, Aldubaib M, Barakat H, Abudoleh SM, Al-Regaiey KA, Tawfeek HM. Retardation of Bacterial Biofilm Formation by Coating Urinary Catheters with Metal Nanoparticle-Stabilized Polymers. Microorganisms 2022; 10:1297. [PMID: 35889016 PMCID: PMC9319761 DOI: 10.3390/microorganisms10071297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 02/06/2023] Open
Abstract
Urinary catheter infections remain an issue for many patients and can complicate their health status, especially for individuals who require long-term catheterization. Catheters can be colonized by biofilm-forming bacteria resistant to the administered antibiotics. Therefore, this study aimed to investigate the efficacy of silver nanoparticles (AgNPs) stabilized with different polymeric materials generated via a one-step simple coating technique for their ability to inhibit biofilm formation on urinary catheters. AgNPs were prepared and characterized to confirm their formation and determine their size, charge, morphology, and physical stability. Screening of the antimicrobial activity of nanoparticle formulations and determining minimal inhibitory concentration (MIC) and their cytotoxicity against PC3 cells were performed. Moreover, the antibiofilm activity and efficacy of the AgNPs coated on the urinary catheters under static and flowing conditions were examined against a clinical isolate of Escherichia coli. The results showed that the investigated polymers could form physically stable AgNPs, especially those prepared using polyvinyl pyrrolidone (PVP) and ethyl cellulose (EC). Preliminary screening and MIC determinations suggested that the AgNPs-EC and AgNPs-PVP had superior antibacterial effects against E. coli. AgNPs-EC and AgNPs-PVP inhibited biofilm formation to 58.2% and 50.8% compared with AgNPs-PEG, silver nitrate solution and control samples. In addition, coating urinary catheters with AgNPs-EC and AgNPs-PVP at concentrations lower than the determined IC50 values significantly (p < 0.05; t-test) inhibited bacterial biofilm formation compared with noncoated catheters under both static and static and flowing conditions using two different types of commercial Foley urinary catheters. The data obtained in this study provide evidence that AgNP-coated EC and PVP could be useful as potential antibacterial and antibiofilm catheter coating agents to prevent the development of urinary tract infections caused by E. coli.
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Affiliation(s)
- Osamah Al Rugaie
- Department of Basic Medical Sciences, College of Medicine and Medical Sciences, Qassim University, P.O. Box 991, Unaizah 51911, Saudi Arabia
| | - Ahmed A. H. Abdellatif
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia;
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt
| | - Mohamed A. El-Mokhtar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Marwa A. Sabet
- Department of Microbiology and Immunology, Faculty of Pharmacy, Sphinx University, New-Assiut 71684, Egypt;
| | - Ahmed Abdelfattah
- Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt;
| | - Mansour Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraydah 51452, Saudi Arabia;
| | - Musaed Aldubaib
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51911, Saudi Arabia;
| | - Hassan Barakat
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51452, Saudi Arabia;
- Food Technology Department, Faculty of Agriculture, Benha University, Moshtohor 13736, Egypt
| | - Suha Mujahed Abudoleh
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, Isra University, Amman 11622, Jordan;
| | - Khalid A. Al-Regaiey
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Hesham M. Tawfeek
- Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt;
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23
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Sarvari R, Naghili B, Agbolaghi S, Abbaspoor S, Bannazadeh Baghi H, Poortahmasebi V, Sadrmohammadi M, Hosseini M. Organic/polymeric antibiofilm coatings for surface modification of medical devices. INT J POLYM MATER PO 2022. [DOI: 10.1080/00914037.2022.2066668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Raana Sarvari
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrooz Naghili
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samira Agbolaghi
- Chemical Engineering Department, Faculty of Engineering, Azarbaijan Shahid Madani University, Tabriz, Iran
| | | | - Hossein Bannazadeh Baghi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahdat Poortahmasebi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Sadrmohammadi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Hosseini
- Chemical Engineering Department, Faculty of Engineering, Azarbaijan Shahid Madani University, Tabriz, Iran
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24
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Caldara M, Belgiovine C, Secchi E, Rusconi R. Environmental, Microbiological, and Immunological Features of Bacterial Biofilms Associated with Implanted Medical Devices. Clin Microbiol Rev 2022; 35:e0022120. [PMID: 35044203 PMCID: PMC8768833 DOI: 10.1128/cmr.00221-20] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The spread of biofilms on medical implants represents one of the principal triggers of persistent and chronic infections in clinical settings, and it has been the subject of many studies in the past few years, with most of them focused on prosthetic joint infections. We review here recent works on biofilm formation and microbial colonization on a large variety of indwelling devices, ranging from heart valves and pacemakers to urological and breast implants and from biliary stents and endoscopic tubes to contact lenses and neurosurgical implants. We focus on bacterial abundance and distribution across different devices and body sites and on the role of environmental features, such as the presence of fluid flow and properties of the implant surface, as well as on the interplay between bacterial colonization and the response of the human immune system.
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Affiliation(s)
- Marina Caldara
- Interdepartmental Center on Safety, Technologies, and Agri-food Innovation (SITEIA.PARMA), University of Parma, Parma, Italy
| | - Cristina Belgiovine
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Scuola di Specializzazione in Microbiologia e Virologia, Università degli Studi di Pavia, Pavia, Italy
| | - Eleonora Secchi
- Institute of Environmental Engineering, ETH Zürich, Zürich, Switzerland
| | - Roberto Rusconi
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele–Milan, Italy
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25
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Werneburg GT. Catheter-Associated Urinary Tract Infections: Current Challenges and Future Prospects. Res Rep Urol 2022; 14:109-133. [PMID: 35402319 PMCID: PMC8992741 DOI: 10.2147/rru.s273663] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/27/2022] [Indexed: 12/15/2022] Open
Abstract
Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection and cause of secondary bloodstream infections. Despite many advances in diagnosis, prevention and treatment, CAUTI remains a severe healthcare burden, and antibiotic resistance rates are alarmingly high. In this review, current CAUTI management paradigms and challenges are discussed, followed by future prospects as they relate to the diagnosis, prevention, and treatment. Clinical and translational evidence will be evaluated, as will key basic science studies that underlie preventive and therapeutic approaches. Novel diagnostic strategies and treatment decision aids under development will decrease the time to diagnosis and improve antibiotic accuracy and stewardship. These include several classes of biomarkers often coupled with artificial intelligence algorithms, cell-free DNA, and others. New preventive strategies including catheter coatings and materials, vaccination, and bacterial interference are being developed and investigated. The antibiotic pipeline remains insufficient, and new strategies for the identification of new classes of antibiotics, and rational design of small molecule inhibitor alternatives, are under development for CAUTI treatment.
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Affiliation(s)
- Glenn T Werneburg
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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26
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Andersen MJ, Fong C, La Bella AA, Molina JJ, Molesan A, Champion MM, Howell C, Flores-Mireles AL. Inhibiting host-protein deposition on urinary catheters reduces associated urinary tract infections. eLife 2022; 11:e75798. [PMID: 35348114 PMCID: PMC8986317 DOI: 10.7554/elife.75798] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
Microbial adhesion to medical devices is common for hospital-acquired infections, particularly for urinary catheters. If not properly treated these infections cause complications and exacerbate antimicrobial resistance. Catheter use elicits bladder inflammation, releasing host serum proteins, including fibrinogen (Fg), into the bladder, which deposit on the urinary catheter. Enterococcus faecalis uses Fg as a scaffold to bind and persist in the bladder despite antibiotic treatments. Inhibition of Fg-pathogen interaction significantly reduces infection. Here, we show deposited Fg is advantageous for uropathogens E. faecalis, Escherichia coli, Pseudomonas aeruginosa, K. pneumoniae, A. baumannii, and C. albicans, suggesting that targeting catheter protein deposition may reduce colonization creating an effective intervention for catheter-associated urinary tract infections (CAUTIs). In a mouse model of CAUTI, host-protein deposition was reduced, using liquid-infused silicone catheters, resulting in decreased colonization on catheters, in bladders, and dissemination in vivo. Furthermore, proteomics revealed a significant decrease in deposition of host-secreted proteins on liquid-infused catheter surfaces. Our findings suggest targeting microbial-binding scaffolds may be an effective antibiotic-sparing intervention for use against CAUTIs and other medical device infections.
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Affiliation(s)
- Marissa Jeme Andersen
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, United States
| | - ChunKi Fong
- Department of Chemical and Biomedical Engineering, College of Engineering, University of Maine, Orono, United States
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Alyssa Ann La Bella
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, United States
| | - Jonathan Jesus Molina
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, United States
| | - Alex Molesan
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, United States
| | - Matthew M Champion
- Department of Chemistry and Biochemistry, College of Science, University of Notre Dame, Notre Dame, United States
| | - Caitlin Howell
- Department of Chemical and Biomedical Engineering, College of Engineering, University of Maine, Orono, United States
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Ana L Flores-Mireles
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, United States
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27
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Tarawneh O, Abu Mahfouz H, Hamadneh L, Deeb AA, Al-Sheikh I, Alwahsh W, Fadhil Abed A. Assessment of persistent antimicrobial and anti-biofilm activity of p-HEMA hydrogel loaded with rifampicin and cefixime. Sci Rep 2022; 12:3900. [PMID: 35273262 PMCID: PMC8913786 DOI: 10.1038/s41598-022-07953-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/28/2022] [Indexed: 02/03/2023] Open
Abstract
Catheter-associated urinary tract infections (CAUTIs) are nosocomial infections causing more than one million hospital cases annually. The progress of CAUTIs leads to severe health complications. Infections result in blockage of the medical device due to biofilm formation, which necessitates the replacement of the device. The objective of this study is to improve urological biomaterials to minimize microbial growth and reduce the incidence of CAUTIs. Challenges from mixed biofilm are crucial and need to be addressed in the development of new coating materials. Herein, an investigation highlighted the reduction of mixed biofilm overgrowth and attachment tendency on poly-2-hydroxyethyl methacrylate (p-HEMA) surface by loading the hydrogel with rifampicin (RIF), cefixime trihydrate (CFX), and combined ratios of RIF and CFX. Mixed biofilm-formation ability in (3:1) RIF: CFX-loading p-HEMA (F6) surface showed best tendency to resist form biofilm. Persistent antimicrobial activity increased in p-HEMA loaded with combined ratios of RIF and CFX surface compared to p-HEMA alone, antimicrobial activity lasted for 8 days. All fabricated films exhibited %cell viability higher than 75% on HEK 293 cells. The addition of RIF and CFX may improve the duration of urological device employment before replacement.
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Affiliation(s)
- Ola Tarawneh
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan.
| | - Hadeel Abu Mahfouz
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan
| | - Lama Hamadneh
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan
| | - Ahmad A Deeb
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan
| | - Iyad Al-Sheikh
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan
| | - Wasan Alwahsh
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan
| | - Abdulqader Fadhil Abed
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P. O. Box 130, Amman, 11733, Jordan
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28
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Surface Functionalization of Ureteral Stents-Based Polyurethane: Engineering Antibacterial Coatings. MATERIALS 2022; 15:ma15051676. [PMID: 35268903 PMCID: PMC8910958 DOI: 10.3390/ma15051676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 12/10/2022]
Abstract
Bacterial colonization of polyurethane (PU) ureteral stents usually leads to severe and challenging clinical complications. As such, there is an increasing demand for an effective response to this unmet medical challenge. In this study, we offer a strategy based on the functionalization of PU stents with chitosan-fatty acid (CS-FA) derivatives to prevent bacterial colonization. Three different fatty acids (FAs), namely stearic acid (SA), oleic acid (OA), and linoleic acid (LinA), were successfully grafted onto chitosan (CS) polymeric chains. Afterwards, CS-FA derivatives-based solutions were coated on the surface of PU stents. The biological performance of the modified PU stents was evaluated against the L929 cell line, confirming negligible cytotoxicity of the developed coating formulations. The antibacterial potential of coated PU stents was also evaluated against several microorganisms. The obtained data indicate that the base material already presents an adequate performance against Staphylococcus aureus, which slightly improved with the coating. However, the performance of the PU stents against Gram-negative bacteria was markedly increased with the surface functionalization approach herein used. As a result, this study reveals the potential use of CS-FA derivatives for surface functionalization of ureteral PU stents and allows for conjecture on its successful application in other biomedical devices.
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29
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Shein AMS, Hongsing P, Abe S, Luk-In S, Ragupathi NKD, Wannigama DL, Chatsuwan T. Will There Ever Be Cure for Chronic, Life-Changing Colistin-Resistant Klebsiella pneumoniae in Urinary Tract Infection? Front Med (Lausanne) 2022; 8:806849. [PMID: 35004783 PMCID: PMC8740227 DOI: 10.3389/fmed.2021.806849] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Aye Mya Sithu Shein
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Antimicrobial Resistance and Stewardship Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Interdisciplinary Program of Medical Microbiology, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Parichart Hongsing
- Mae Fah Luang University Hospital, Chiang Rai, Thailand.,School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Shuichi Abe
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Sirirat Luk-In
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Naveen Kumar Devanga Ragupathi
- Biofilms and Antimicrobial Resistance Consortium of ODA Receiving Countries, The University of Sheffield, Sheffield, United Kingdom.,Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield, United Kingdom.,Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Dhammika Leshan Wannigama
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Antimicrobial Resistance and Stewardship Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Biofilms and Antimicrobial Resistance Consortium of ODA Receiving Countries, The University of Sheffield, Sheffield, United Kingdom.,School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Tanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Antimicrobial Resistance and Stewardship Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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30
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Sharma S, Basu B. Biomaterials assisted reconstructive urology: The pursuit of an implantable bioengineered neo-urinary bladder. Biomaterials 2021; 281:121331. [PMID: 35016066 DOI: 10.1016/j.biomaterials.2021.121331] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 12/14/2021] [Accepted: 12/24/2021] [Indexed: 12/27/2022]
Abstract
Urinary bladder is a dynamic organ performing complex physiological activities. Together with ureters and urethra, it forms the lower urinary tract that facilitates urine collection, low-pressure storage, and volitional voiding. However, pathological disorders are often liable to cause irreversible damage and compromise the normal functionality of the bladder, necessitating surgical intervention for a reconstructive procedure. Non-urinary autologous grafts, primarily derived from gastrointestinal tract, have long been the gold standard in clinics to augment or to replace the diseased bladder tissue. Unfortunately, such treatment strategy is commonly associated with several clinical complications. In absence of an optimal autologous therapy, a biomaterial based bioengineered platform is an attractive prospect revolutionizing the modern urology. Predictably, extensive investigative research has been carried out in pursuit of better urological biomaterials, that overcome the limitations of conventional gastrointestinal graft. Against the above backdrop, this review aims to provide a comprehensive and one-stop update on different biomaterial-based strategies that have been proposed and explored over the past 60 years to restore the dynamic function of the otherwise dysfunctional bladder tissue. Broadly, two unique perspectives of bladder tissue engineering and total alloplastic bladder replacement are critically discussed in terms of their status and progress. While the former is pivoted on scaffold mediated regenerative medicine; in contrast, the latter is directed towards the development of a biostable bladder prosthesis. Together, these routes share a common aspiration of designing and creating a functional equivalent of the bladder wall, albeit, using fundamentally different aspects of biocompatibility and clinical needs. Therefore, an attempt has been made to systematically analyze and summarize the evolution of various classes as well as generations of polymeric biomaterials in urology. Considerable emphasis has been laid on explaining the bioengineering methodologies, pre-clinical and clinical outcomes. Some of the unaddressed challenges, including vascularization, innervation, hollow 3D prototype fabrication and urinary encrustation, have been highlighted that currently delay the successful commercial translation. More importantly, the rapidly evolving and expanding concepts of bioelectronic medicine are discussed to inspire future research efforts towards the further advancement of the field. At the closure, crucial insights are provided to forge the biomaterial assisted reconstruction as a long-term therapeutic strategy in urological practice for patients' care.
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Affiliation(s)
- Swati Sharma
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore, 560012, India
| | - Bikramjit Basu
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bangalore, 560012, India; Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore, 560012, India.
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31
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Ivanova A, Ivanova K, Perelshtein I, Gedanken A, Todorova K, Milcheva R, Dimitrov P, Popova T, Tzanov T. Sonochemically engineered nano-enabled zinc oxide/amylase coatings prevent the occurrence of catheter-associated urinary tract infections. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 131:112518. [PMID: 34857297 DOI: 10.1016/j.msec.2021.112518] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/20/2021] [Accepted: 10/22/2021] [Indexed: 10/20/2022]
Abstract
Catheter-associated urinary tract infections (CAUTIs), caused by biofilms, are the most frequent health-care associated infections. Novel antibiofilm coatings are needed to increase the urinary catheters' life-span, decrease the prevalence of CAUTIs and reduce the development of antimicrobial resistance. Herein, antibacterial zinc oxide nanoparticles (ZnO NPs) were decorated with a biofilm matrix-degrading enzyme amylase (AM) and simultaneously deposited onto silicone urinary catheters in a one-step sonochemical process. The obtained nano-enabled coatings inhibited the biofilm formation of Escherichia coli and Staphylococcus aureus by 80% and 60%, respectively, for up to 7 days in vitro in a model of catheterized bladder with recirculation of artificial urine due to the complementary mode of antibacterial and antibiofilm action provided by the NPs and the enzyme. Over this period, the coatings did not induce toxicity to mammalian cell lines. In vivo, the nano-engineered ZnO@AM coated catheters demonstrated lower incidence of bacteriuria and prevent the early onset of CAUTIs in a rabbit model, compared to the animals treated with pristine silicone devices. The nano-functionalization of catheters with hybrid ZnO@AM coatings appears as a promising strategy for prevention and control of CAUTIs in the clinic.
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Affiliation(s)
- Aleksandra Ivanova
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222, Terrassa, Spain
| | - Kristina Ivanova
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222, Terrassa, Spain
| | - Ilana Perelshtein
- The Department of Chemistry and Institute for Advanced Materials and Nanotechnology, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Aharon Gedanken
- The Department of Chemistry and Institute for Advanced Materials and Nanotechnology, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Katerina Todorova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, 1113 Sofia, Bulgaria
| | - Rositsa Milcheva
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, 1113 Sofia, Bulgaria
| | - Petar Dimitrov
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Geo Milev, 1113 Sofia, Bulgaria
| | - Teodora Popova
- Faculty of Veterinary Medicine, University of Forestry, 10 Sveti Kliment Ohridski Ave, 1756 Sofia, Bulgaria
| | - Tzanko Tzanov
- Group of Molecular and Industrial Biotechnology, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Rambla Sant Nebridi 22, 08222, Terrassa, Spain.
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The urobiome, urinary tract infections, and the need for alternative therapeutics. Microb Pathog 2021; 161:105295. [PMID: 34801647 DOI: 10.1016/j.micpath.2021.105295] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
Improvements in bacterial culturing and DNA sequencing techniques have revealed a diverse, and hitherto unknown, urinary tract microbiome (urobiome). The potential role of this microbial community in contributing to health and disease, particularly in the context of urinary tract infections (UTIs) is of significant clinical importance. However, while several studies have confirmed the existence of a core urobiome, the role of its constituent microbes is not yet fully understood, particularly in the context of health and disease. Herein, we review the current state of the art, concluding that the urobiome represents an important component of the body's innate immune defences, and a potentially rich resource for the development of alternative treatment and control strategies for UTIs.
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Ivanova A, Ivanova K, Tzanov T. Simultaneous Ultrasound-Assisted Hybrid Polyzwitterion/Antimicrobial Peptide Nanoparticles Synthesis and Deposition on Silicone Urinary Catheters for Prevention of Biofilm-Associated Infections. NANOMATERIALS 2021; 11:nano11113143. [PMID: 34835911 PMCID: PMC8618290 DOI: 10.3390/nano11113143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 01/07/2023]
Abstract
Nosocomial infections caused by antibiotic-resistant bacteria are constantly growing healthcare threats, as they are the reason for the increased mortality, morbidity, and considerable financial burden due to the poor infection outcomes. Indwelling medical devices, such as urinary catheters, are frequently colonized by bacteria in the form of biofilms that cause dysfunction of the device and severe chronic infections. The current treatment strategies of such device-associated infections are impaired by the resistant pathogens but also by a risk of prompting the appearance of new antibiotic-resistant bacterial mechanisms. Herein, the one-step sonochemical synthesis of hybrid poly(sulfobetaine) methacrylate/Polymyxin B nanoparticles (pSBMA@PM NPs) coating was employed to engineer novel nanoenabled silicone catheters with improved antifouling, antibacterial, and antibiofilm efficiencies. The synergistic mode of action of nanohybridized zwitterionic polymer and antimicrobial peptide led to complete inhibition of the nonspecific protein adsorption and up to 97% reduction in Pseudomonas aeruginosa biofilm formation, in comparison with the pristine silicone. Additionally, the bactericidal activity in the hybrid coating reduced the free-floating and surface-attached bacterial growth by 8 logs, minimizing the probability for further P. aeruginosa spreading and host invasion. This coating was stable for up to 7 days under conditions simulating the real scenario of catheter usage and inhibited by 80% P. aeruginosa biofilms. For the same time of use, the pSBMA@PM NPs coating did not affect the metabolic activity and morphology of mammalian cells, demonstrating their capacity to control antibiotic-resistant biofilm-associated bacterial infections.
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Affiliation(s)
| | | | - Tzanko Tzanov
- Correspondence: ; Tel.: +34-93-739-85-70; Fax: +34-93-739-82-25
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Optimized Silica-Binding Peptide-Mediated Delivery of Bactericidal Lysin Efficiently Prevents Staphylococcus aureus from Adhering to Device Surfaces. Int J Mol Sci 2021; 22:ijms222212544. [PMID: 34830425 PMCID: PMC8619460 DOI: 10.3390/ijms222212544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 01/18/2023] Open
Abstract
Staphylococcal-associated device-related infections (DRIs) represent a significant clinical challenge causing major medical and economic sequelae. Bacterial colonization, proliferation, and biofilm formation after adherence to surfaces of the indwelling device are probably the primary cause of DRIs. To address this issue, we incorporated constructs of silica-binding peptide (SiBP) with ClyF, an anti-staphylococcal lysin, into functionalized coatings to impart bactericidal activity against planktonic and sessile Staphylococcus aureus. An optimized construct, SiBP1-ClyF, exhibited improved thermostability and staphylolytic activity compared to its parental lysin ClyF. SiBP1-ClyF-functionalized coatings were efficient in killing MRSA strain N315 (>99.999% within 1 h) and preventing the growth of static and dynamic S. aureus biofilms on various surfaces, including siliconized glass, silicone-coated latex catheter, and silicone catheter. Additionally, SiBP1-ClyF-immobilized surfaces supported normal attachment and growth of mammalian cells. Although the recycling potential and long-term stability of lysin-immobilized surfaces are still affected by the fragility of biological protein molecules, the present study provides a generic strategy for efficient delivery of bactericidal lysin to solid surfaces, which serves as a new approach to prevent the growth of antibiotic-resistant microorganisms on surfaces in hospital settings and could be adapted for other target pathogens as well.
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Namasivayam SKR, Rabel AM, Prasana R, Arvind Bharani RS, Nachiyar CV. Gum acacia PEG iron oxide nanocomposite (GA-PEG-IONC) induced pharmacotherapeutic activity on the Las R gene expression of Pseudomonas aeruginosa and HOXB13 expression of prostate cancer (Pc 3) cell line. A green therapeutic approach of molecular mechanism inhibition. Int J Biol Macromol 2021; 190:940-959. [PMID: 34478798 DOI: 10.1016/j.ijbiomac.2021.08.162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 08/15/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022]
Abstract
Among the diverse nanomaterials, polymer-based nanocomposites are gained more attention due to their high efficacy, target biological activities, biodegradability and biocompatibility-gum acacia (GA) - a polymer obtained from acacia trees-is considering the multifunctional nanocomposite synthesis. Distinctive Physico-chemical and biocompatibility properties of gum acacia are utilised to prepare a highly stable, biologically active, eco-friendly Nanocomposite. In this current investigation, gum acacia - poly ethylene glycol grafted iron oxide nanocomposite (GA-PEG-IONC) was synthesised by in situ green science principles. The synthesised Nanocomposite was evaluated against the molecular mechanism of urinary tract pathogenic bacterial strains and prostate cancer cells (Pc 3). Nanocomposite prepared in this examination exhibited notable structural, functional stability with nanoarchitecture which was affirmed by Fourier transform infrared spectroscopy (FTIR), electron microscopic studies, atomic force microscopy (AFM), vibrating sample magnetometric analysis (VSM) and X-ray diffraction (XRD), Synthesised Nanocomposite brought about notable antibacterial activity against urinary tract pathogenic strains by recording potential inhibitory effect on the expression of Las R gene. Inhibition of Las R gene expression reduced notable effect on biofilm development. Anticancer activity against prostate cancer cells (Pc3) was investigated by measurement of HOXB13 gene expression level. Inhibition of HOXB13 gene expression by the IONC brought about structural, functional changes. HOXB13 gene expression inhibition reveals a remarkable cytotoxic effect by recording decreased cell viability. Morphometric analysis by phase-contrast and DAPI fluorescence staining demonstrates that the Nanocomposite prompted cell morphology anomalies or apoptotic changes. Nanocomposite treatment brought about a good sign of Apoptosis by recording enhanced caspase 3 and 9 activities, DNA fragmentation and elevated reactive oxygen species generation (ROS). Hemocompatibility studies were carried out to determine the biocompatibility of the Nanocomposite. Spectrophotometric estimation of plasma haemoglobin, microscopic examination of whole blood cells shows the Nanocomposite was not inciting any indication of toxicity. These findings infer that IONC synthesised in the present study is the promising contender for a broad scope of biomedical applications, especially as an antibacterial and anticancer agent.
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Affiliation(s)
- S Karthick Raja Namasivayam
- CBIRD (Centre of Bioresource Research and Development, C-BIRD), Department of Biotechnology, Sathyabama Institute of Science & Technology, Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai 600 119, Tamil Nadu, India.
| | - Arul Maximus Rabel
- CBIRD (Centre of Bioresource Research and Development, C-BIRD), Department of Biotechnology, Sathyabama Institute of Science & Technology, Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai 600 119, Tamil Nadu, India
| | - R Prasana
- CBIRD (Centre of Bioresource Research and Development, C-BIRD), Department of Biotechnology, Sathyabama Institute of Science & Technology, Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai 600 119, Tamil Nadu, India
| | - R S Arvind Bharani
- CBIRD (Centre of Bioresource Research and Development, C-BIRD), Department of Biotechnology, Sathyabama Institute of Science & Technology, Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai 600 119, Tamil Nadu, India
| | - C Valli Nachiyar
- CBIRD (Centre of Bioresource Research and Development, C-BIRD), Department of Biotechnology, Sathyabama Institute of Science & Technology, Jeppiaar Nagar, Rajiv Gandhi Salai, Chennai 600 119, Tamil Nadu, India
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Armugam A, Teong SP, Lim DSW, Chan SP, Yi G, Yew DS, Beh CW, Zhang Y. Broad spectrum antimicrobial PDMS-based biomaterial for catheter fabrication. Biomater Res 2021; 25:33. [PMID: 34674766 PMCID: PMC8529379 DOI: 10.1186/s40824-021-00235-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background In addition to the widespread use of antibiotics in healthcare settings, the current COVID-19 pandemic has escalated the emergence of antibiotic resistance. Nosocomial infections among hospitalized patients is a leading site for such resistant microbial colonization due to prolonged use of invasive devices and antibiotics in therapies. Invasive medical devices, especially catheters, are prone to infections that could accelerate the development of resistant microbes. Often, catheters - particularly urinary catheters - are prone to high infection rates. Antibiotic-coated catheters can reduce infection rates and although commercially available, are limited in efficacy and choices. Methods Herein, a novel and facile method to fabricate PMDS-based biomaterial for the development of antimicrobial eluting catheters is presented. Silicone based organic polymer polydimethylsiloxane (PDMS) was used to prepare a biomaterial containing novel polymeric imidazolium antimicrobial compound. Results It was found that the PDMS-based biomaterials could eradicate microbial colonization even after 60 days in culture with continuous microbial challenge, be recycled over multiple uses, stored at room temperature for long-term usage and importantly is biocompatible. Conclusion The PDMS-based biomaterial displayed biocidal functionality on microbes of clinical origin, which form major threats in hospital acquired infections. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40824-021-00235-5.
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Affiliation(s)
- Arunmozhiarasi Armugam
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Siew Ping Teong
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Diane S W Lim
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Shook Pui Chan
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Guangshun Yi
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore
| | - Dionis S Yew
- Molecular Engineering Lab, Institute of Molecular and Cell Biology, 61 Biopolis Drive, The Proteos, Singapore, 138673, Singapore
| | - Cyrus W Beh
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore.,Molecular Engineering Lab, Institute of Molecular and Cell Biology, 61 Biopolis Drive, The Proteos, Singapore, 138673, Singapore
| | - Yugen Zhang
- Institute of Bioengineering and Bioimaging, 31 Biopolis Way, The Nanos, Singapore, 138669, Singapore.
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Trizna E, Baidamshina D, Gorshkova A, Drucker V, Bogachev M, Tikhonov A, Kayumov A. Improving the Efficacy of Antimicrobials against Biofilm-Embedded Bacteria Using Bovine Hyaluronidase Azoximer (Longidaza ®). Pharmaceutics 2021; 13:1740. [PMID: 34834156 PMCID: PMC8622991 DOI: 10.3390/pharmaceutics13111740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
While in a biofilm, bacteria are extremely resistant to both antimicrobials and the immune system, leading to the development of chronic infection. Here, we show that bovine hyaluronidase fused with a copolymer of 1,4-ethylenepiperazine N-oxide and (N-carboxymethyl) -1,4-ethylenepiperazinium bromide (Longidaza®) destroys both mono- and dual-species biofilms formed by various bacteria. After 4 h of treatment with 750 units of the enzyme, the residual biofilms of Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae preserved about 50-70% of their initial mass. Biomasses of dual-species biofilms formed by S. aureus and the four latter species were reduced 1.5-fold after 24 h treatment, while the significant destruction of S. aureus-P. aeruginosa and S. aureus-K. pneumoniae was also observed after 4 h of treatment with Longidaza®. Furthermore, when applied in combination, Longidaza® increased the efficacy of various antimicrobials against biofilm-embedded bacteria, although with various increase-factor values depending on both the bacterial species and antimicrobials chosen. Taken together, our data indicate that Longidaza® destroys the biofilm structure, facilitating the penetration of antimicrobials through the biofilm, and in this way improving their efficacy, lowering the required dose and thus also potentially reducing the associated side effects.
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Affiliation(s)
- Elena Trizna
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (E.T.); (D.B.)
| | - Diana Baidamshina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (E.T.); (D.B.)
| | - Anna Gorshkova
- Limnological Institute of the Siberian Branch of the Russian Academy of Sciences, 664000 Irkutsk, Russia; (A.G.); (V.D.)
| | - Valentin Drucker
- Limnological Institute of the Siberian Branch of the Russian Academy of Sciences, 664000 Irkutsk, Russia; (A.G.); (V.D.)
| | - Mikhail Bogachev
- Biomedical Engineering Research Centre, St. Petersburg Electrotechnical University, 197022 St. Petersburg, Russia;
| | | | - Airat Kayumov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (E.T.); (D.B.)
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Rosli NA, Teow YH, Mahmoudi E. Current approaches for the exploration of antimicrobial activities of nanoparticles. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2021; 22:885-907. [PMID: 34675754 PMCID: PMC8525934 DOI: 10.1080/14686996.2021.1978801] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/11/2021] [Accepted: 09/02/2021] [Indexed: 05/09/2023]
Abstract
Infectious diseases of bacterial and viral origins contribute to substantial mortality worldwide. Collaborative efforts have been underway between academia and the industry to develop technologies for a more effective treatment for such diseases. Due to their utility in various industrial applications, nanoparticles (NPs) offer promising potential as antimicrobial agents against bacterial and viral infections. NPs have been established to possess potent antimicrobial activities against various types of pathogens due to their unique characteristics and cell-damaging ability through several mechanisms. The recently accepted antimicrobial mechanisms possessed by NPs include metal ion release, oxidative stress induction, and non-oxidative mechanisms. Another merit of NPs lies in the low likelihood of the development of microbial tolerance towards NPs, given the multiple simultaneous mechanisms of action against the pathogens targeting numerous gene mutations in these pathogens. Moreover, NPs provide a fascinating opportunity to curb microbial growth before infections: this outstanding feature has led to their utilization as active antimicrobial agents in different industrial applications, e.g. the coating of medical devices, incorporation in food packaging, promoting wound healing and encapsulation with other potential materials for wastewater treatment. This review discusses the progress and achievements in the antimicrobial applications of NPs, factors contributing to their actions, mechanisms underlying their efficiency, and risks of their applications, including the antimicrobial action of metal nanoclusters (NCs). The review concludes with a discussion of the restrictions on present studies and future prospects of nanotechnology-based NPs development.
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Affiliation(s)
- Nur Ameera Rosli
- Department of Chemical and Process Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Yeit Haan Teow
- Department of Chemical and Process Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
- Research Centre for Sustainable Process Technology (Cespro), Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Ebrahim Mahmoudi
- Department of Chemical and Process Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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Stolarek P, Bernat P, Szczerbiec D, Różalski A. Phospholipids and Fatty Acids Affect the Colonization of Urological Catheters by Proteus mirabilis. Int J Mol Sci 2021; 22:ijms22168452. [PMID: 34445157 PMCID: PMC8395112 DOI: 10.3390/ijms22168452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 01/10/2023] Open
Abstract
Proteus mirabilis-mediated CAUTIs are usually initiated by the adherence of bacteria to a urinary catheter surface. In this paper, three isolates of different origin and exhibiting different adhesion abilities were investigated in search of any changes in lipidome components which might contribute to P. mirabilis adhesion to catheters. Using GC-MS and LC-MS/MS techniques, 21 fatty acids and 27 phospholipids were identified in the examined cells. The comparison of the profiles of phospholipids and fatty acids obtained for catheter-attached cells and planktonic cells of the pathogens indicated C11:0 and PE 37:2 levels as values which could be related to P. mirabilis adhesion to a catheter, as well as cis C16:1, PE 32:0, PE 33:0, PE 38:2, PG 33:1, PG 34:0, PE 30:1, PE 32:1 and PG 30:2 levels as values which could be associated with cell hydrophobicity. Based on DiBAC4 (3) fluorescence intensity and an affinity to p-xylene, it was found that the inner membrane depolarization, as well as strong cell-surface hydrophobicity, were important for P. mirabilis adhesion to a silicone catheter. A generalized polarization of Laurdan showed lower values for P. mirabilis cells attached to the catheter surface than for planktonic cells, suggesting lower packing density of membrane components of the adherent cells compared with tightly packed, stiffened membranes of the planktonic cells. Taken together, these data indicate that high surface hydrophobicity, fluidization and depolarization of P. mirabilis cell membranes enable colonization of a silicone urinary catheter surface.
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Affiliation(s)
- Paulina Stolarek
- Department of Biology of Bacteria, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland; (D.S.); (A.R.)
- Correspondence: ; Tel.: +48-42-635-43-24; Fax: +48-42-665-58-18
| | - Przemysław Bernat
- Department of Industrial Microbiology and Biotechnology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland;
| | - Dominika Szczerbiec
- Department of Biology of Bacteria, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland; (D.S.); (A.R.)
| | - Antoni Różalski
- Department of Biology of Bacteria, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland; (D.S.); (A.R.)
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Rathinam P, Murari BM, Viswanathan P. Biofilm inhibition and antifouling evaluation of sol-gel coated silicone implants with prolonged release of eugenol against Pseudomonas aeruginosa. BIOFOULING 2021; 37:521-537. [PMID: 34139901 DOI: 10.1080/08927014.2021.1933960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The incidence of biofilm-linked catheter-associated urinary tract infections (CAUTIs) is increasing across the world. However, there is no clinical evidence to support the modifications of biomaterials, such as antimicrobial agent-coated catheters, that are known to reduce the risk of bacterial colonization and resistance development. The present study developed and tested silicone segments coated with an antivirulence agent, eugenol. The parameters for sol-gel preparation and coating were tailored to achieve a prolonged release of eugenol (for >35 days) at predefined antivirulence doses from dip-coated thin films. The eugenol-coated segments could prevent biofilm formation by Pseudomonas aeruginosa PAO1 as well as bacterial adhesion. Significant repression in the expression of virulence and biofilm-associated genes were recorded, confirming the antivirulence and biofilm inhibition properties of silicone segments coated with eugenol. The drug release profiles, efficacy analysis, neutrophil-response studies, and in vitro toxicity profiling further supported the contention that the activity of the eugenol-coated sections was effective and safe.
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Affiliation(s)
- Prasanth Rathinam
- Medical Biotechnology Laboratory, Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India
- Renal Research Lab, Centre for Bio-Medical Research, School of Bio-Sciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Bhasker Mohan Murari
- Sol-Gel-Biosensor Lab, Centre for Bio-Medical Research, School of Electronics Engineering, Vellore Institute of Technology, Vellore, India
| | - Pragasam Viswanathan
- Renal Research Lab, Centre for Bio-Medical Research, School of Bio-Sciences and Technology, Vellore Institute of Technology, Vellore, India
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Zhang S, Liang X, Gadd GM, Zhao Q. Marine Microbial-Derived Antibiotics and Biosurfactants as Potential New Agents against Catheter-Associated Urinary Tract Infections. Mar Drugs 2021; 19:255. [PMID: 33946845 PMCID: PMC8145997 DOI: 10.3390/md19050255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022] Open
Abstract
Catheter-associated urinary tract infections (CAUTIs) are among the leading nosocomial infections in the world and have led to the extensive study of various strategies to prevent infection. However, despite an abundance of anti-infection materials having been studied over the last forty-five years, only a few types have come into clinical use, providing an insignificant reduction in CAUTIs. In recent decades, marine resources have emerged as an unexplored area of opportunity offering huge potential in discovering novel bioactive materials to combat human diseases. Some of these materials, such as antimicrobial compounds and biosurfactants synthesized by marine microorganisms, exhibit potent antimicrobial, antiadhesive and antibiofilm activity against a broad spectrum of uropathogens (including multidrug-resistant pathogens) that could be potentially used in urinary catheters to eradicate CAUTIs. This paper summarizes information on the most relevant materials that have been obtained from marine-derived microorganisms over the last decade and discusses their potential as new agents against CAUTIs, providing a prospective proposal for researchers.
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Affiliation(s)
- Shuai Zhang
- School of Mechanical and Aerospace Engineering, Queen’s University Belfast, Belfast BT9 5AH, UK;
| | - Xinjin Liang
- The Bryden Center, School of Chemical and Chemistry Engineering, Queen’s University Belfast, Belfast BT7 1NN, UK;
- School of Life Sciences, University of Dundee, Dundee DD1 5EH, UK;
| | | | - Qi Zhao
- School of Science and Engineering, University of Dundee, Dundee DD1 4HN, UK
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Olmos D, González-Benito J. Polymeric Materials with Antibacterial Activity: A Review. Polymers (Basel) 2021; 13:613. [PMID: 33670638 PMCID: PMC7922637 DOI: 10.3390/polym13040613] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 12/21/2022] Open
Abstract
Infections caused by bacteria are one of the main causes of mortality in hospitals all over the world. Bacteria can grow on many different surfaces and when this occurs, and bacteria colonize a surface, biofilms are formed. In this context, one of the main concerns is biofilm formation on medical devices such as urinary catheters, cardiac valves, pacemakers or prothesis. The development of bacteria also occurs on materials used for food packaging, wearable electronics or the textile industry. In all these applications polymeric materials are usually present. Research and development of polymer-based antibacterial materials is crucial to avoid the proliferation of bacteria. In this paper, we present a review about polymeric materials with antibacterial materials. The main strategies to produce materials with antibacterial properties are presented, for instance, the incorporation of inorganic particles, micro or nanostructuration of the surfaces and antifouling strategies are considered. The antibacterial mechanism exerted in each case is discussed. Methods of materials preparation are examined, presenting the main advantages or disadvantages of each one based on their potential uses. Finally, a review of the main characterization techniques and methods used to study polymer based antibacterial materials is carried out, including the use of single force cell spectroscopy, contact angle measurements and surface roughness to evaluate the role of the physicochemical properties and the micro or nanostructure in antibacterial behavior of the materials.
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Affiliation(s)
- Dania Olmos
- Department of Materials Science and Engineering and Chemical Engineering, Instituto de Química y Materiales Álvaro Alonso Barba (IQMAA), Universidad Carlos III de Madrid, Leganés, 28911 Madrid, Spain
| | - Javier González-Benito
- Department of Materials Science and Engineering and Chemical Engineering, Instituto de Química y Materiales Álvaro Alonso Barba (IQMAA), Universidad Carlos III de Madrid, Leganés, 28911 Madrid, Spain
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Zmejkoski DZ, Marković ZM, Zdravković NM, Trišić DD, Budimir MD, Kuzman SB, Kozyrovska NO, Orlovska IV, Bugárová N, Petrović ĐŽ, Kováčová M, Kleinová A, Špitalský Z, Pavlović VB, Todorović Marković BM. Bactericidal and antioxidant bacterial cellulose hydrogels doped with chitosan as potential urinary tract infection biomedical agent. RSC Adv 2021; 11:8559-8568. [PMID: 35423394 PMCID: PMC8695209 DOI: 10.1039/d0ra10782d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/15/2021] [Indexed: 12/29/2022] Open
Abstract
Therapy of bacterial urinary tract infections (UTIs) and catheter associated urinary tract infections (CAUTIs) is still a great challenge because of the resistance of bacteria to nowadays used antibiotics and encrustation of catheters. Bacterial cellulose (BC) as a biocompatible material with a high porosity allows incorporation of different materials in its three dimensional network structure. In this work a low molecular weight chitosan (Chi) polymer is incorporated in BC with different concentrations. Different characterization techniques are used to investigate structural and optical properties of these composites. Radical scavenging activity test shows moderate antioxidant activity of these biocompatible composites whereas in vitro release test shows that 13.3% of chitosan is released after 72 h. Antibacterial testing of BC–Chi composites conducted on Gram-positive and Gram-negative bacteria causing UTIs and CAUTIs (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and encrustation (Proteus mirabilis) show bactericidal effect. The morphology analysis of bacteria after the application of BC–Chi shows that they are flattened with a rough surface, with a tendency to agglomerate and with decreased length and width. All obtained results show that BC–Chi composites might be considered as potential biomedical agents in treatment of UTIs and CAUTIs and as a urinary catheter coating in encrustation prevention. Bacterial cellulose–chitosan composite with antibacterial and moderate antioxidant activity for potential UTI/CAUTI treatment and catheter coating in encrustation prevention.![]()
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Ricardo SIC, Anjos IIL, Monge N, Faustino CMC, Ribeiro IAC. A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections. ACS Infect Dis 2020; 6:3109-3130. [PMID: 33245664 DOI: 10.1021/acsinfecdis.0c00526] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Urinary and intravascular catheters are two of the most used invasive medical devices; however, microbial colonization of catheter surfaces is responsible for most healthcare-associated infections (HAIs). Several antimicrobial-coated catheters are available, but recurrent antibiotic therapy can decrease their potential activity against resistant bacterial strains. The aim of this Review is to question the actual effectiveness of currently used (coated) catheters and describe the progress and promise of alternative antimicrobial coatings. Different strategies have been reviewed with the common goal of preventing biofilm formation on catheters, including release-based approaches using antibiotics, antiseptics, nitric oxide, 5-fluorouracil, and silver as well as contact-killing approaches employing quaternary ammonium compounds, chitosan, antimicrobial peptides, and enzymes. All of these strategies have given proof of antimicrobial efficacy by modifying the physiology of pathogens or disrupting their structural integrity. The aim for synergistic approaches using multitarget processes and the combination of both antifouling and bactericidal properties holds potential for the near future. Despite intensive research in biofilm preventive strategies, laboratorial studies still present some limitations since experimental conditions usually are not the same and also differ from biological conditions encountered when the catheter is inserted in the human body. Consequently, in most cases, the efficacy data obtained from in vitro studies is not properly reflected in the clinical setting. Thus, further well-designed clinical trials and additional cytotoxicity studies are needed to prove the efficacy and safety of the developed antimicrobial strategies in the prevention of biofilm formation at catheter surfaces.
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Affiliation(s)
- Susana I. C. Ricardo
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Inês I. L. Anjos
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Nuno Monge
- Centro Interdisciplinar de Estudos Educacionais (CIED), Escola Superior de Educação de Lisboa, Instituto Politécnico de Lisboa, Campus de Benfica do IPL, 1549-003 Lisboa, Portugal
| | - Célia M. C. Faustino
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Isabel A. C. Ribeiro
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
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Olar R, Badea M, Maxim C, Grumezescu AM, Bleotu C, Măruţescu L, Chifiriuc MC. Anti-biofilm Fe 3O 4@C 18-[1,3,4]thiadiazolo[3,2- a]pyrimidin-4-ium-2-thiolate Derivative Core-shell Nanocoatings. MATERIALS 2020; 13:ma13204640. [PMID: 33080907 PMCID: PMC7603173 DOI: 10.3390/ma13204640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 01/11/2023]
Abstract
The derivatives 5,7-dimethyl[1,3,4]thiadiazolo[3,2-a]pyrimidin-4-ium-2-thiolate (1) and 7-methyl-5-phenyl[1,3,4]thiadiazolo[3,2-a]pyrimidin-4-ium-2-thiolate (2) were fully characterized by single-crystal X-ray diffraction. Their supramolecular structure is built through both π–π stacking and C=S–π interactions for both compounds. The embedment of the tested compounds into Fe3O4@C18 core-shell nanocoatings increased the protection degree against Candida albicans biofilms on the catheter surface, suggesting that these bioactive nanocoatings could be further developed as non-cytotoxic strategies for fighting biofilm-associated fungal infections.
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Affiliation(s)
- Rodica Olar
- Department of Inorganic Chemistry, Faculty of Chemistry, University of Bucharest, 90–92 Panduri Str., 050663 Bucharest, Romania; (M.B.); (C.M.)
- Correspondence: (R.O.); (M.C.C.)
| | - Mihaela Badea
- Department of Inorganic Chemistry, Faculty of Chemistry, University of Bucharest, 90–92 Panduri Str., 050663 Bucharest, Romania; (M.B.); (C.M.)
| | - Cătălin Maxim
- Department of Inorganic Chemistry, Faculty of Chemistry, University of Bucharest, 90–92 Panduri Str., 050663 Bucharest, Romania; (M.B.); (C.M.)
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxidic Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Polizu Street, 011061 Bucharest, Romania;
| | - Coralia Bleotu
- Stefan S Nicolau Institute of Virology, Romanian Academy, 285 Mihai Bravu Ave., 030304 Bucharest, Romania;
| | - Luminiţa Măruţescu
- Department of Microbiology, Faculty of Biology, University of Bucharest, 1–3 Aleea Portocalelor St., 60101 Bucharest, Romania;
- Environment and Earth Sciences Department, Research Institute of the University of Bucharest—ICUB, Splaiul Independenţei 91–95, 050095 Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- Department of Microbiology, Faculty of Biology, University of Bucharest, 1–3 Aleea Portocalelor St., 60101 Bucharest, Romania;
- Environment and Earth Sciences Department, Research Institute of the University of Bucharest—ICUB, Splaiul Independenţei 91–95, 050095 Bucharest, Romania
- Academy of Romanian Scientists, 010071 Bucharest, Romania
- Correspondence: (R.O.); (M.C.C.)
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A strategy to control colonization of pathogens: embedding of lactic acid bacteria on the surface of urinary catheter. Appl Microbiol Biotechnol 2020; 104:9053-9066. [PMID: 32949279 DOI: 10.1007/s00253-020-10903-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 01/13/2023]
Abstract
Indwelling urinary catheterization is one of the major causes of urinary tract infection (UTI) in hospitalized patients worldwide. A catheter serves as a surface for the colonization and formation of biofilm by UTI-related pathogenic bacteria. To combat the biofilm formation on its surface, several strategies have already been employed such as coating it with antibiofilm and antimicrobial compounds. For instance, the application of lactic acid bacteria (LAB) offers a potential strategy for the treatment of biofilm formation on the surface of the urinary catheter due to its ability to kill the pathogenic bacteria. The killing of pathogenic bacteria by LAB occurs via the production of antimicrobial compounds such as lactic acid, bacteriocin, and hydrogen peroxide. LAB also displays a competitive exclusion mechanism to prevent the adhesion of pathogens on the surfaces. Hence, LAB has been extensively applied as a bacteriotherapy to combat infectious diseases. Several strategies have been employed to attach LAB to a surface, but its easy detachment during long time exposure becomes one of the drawbacks in its application. Here, we have proposed a novel strategy for its adhesion on the surface of the urinary catheter with the utilization of mannose-specific adhesin (Msa) protein in a way similar as uropathogenic bacteria interacts between Msa present on the tip of the type I fimbriae/pilus and the mannose moieties on the host epithelial cell surfaces. KEY POINTS: • Urinary tract infection (UTI) is one of the common hospital-acquired infections, which is associated with the application of an indwelling urinary catheter. • Based on the competitive exclusions properties of LAB, attachment of the LAB on the catheter surface would be a promising approach to control the formation of pathogenic biofilm. • The strategy employed for the adhesion of LAB is via a covalent interaction of its mannose-specific adhesin (Msa) protein to the mannose residues grafted on the catheter surface.
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Natural Cyanobacterial Polymer-Based Coating as a Preventive Strategy to Avoid Catheter-Associated Urinary Tract Infections. Mar Drugs 2020; 18:md18060279. [PMID: 32466349 PMCID: PMC7344411 DOI: 10.3390/md18060279] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 12/16/2022] Open
Abstract
Catheter-associated urinary tract infections (CAUTIs) represent about 40% of all healthcare-associated infections. Herein, the authors report the further development of an infection preventive anti-adhesive coating (CyanoCoating) meant for urinary catheters, and based on a natural polymer released by a marine cyanobacterium. CyanoCoating performance was assessed against relevant CAUTI etiological agents, namely Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, methicillin resistant Staphylococcus aureus (MRSA), and Candida albicans in the presence of culture medium or artificial urine, and under biofilm promoting settings. CyanoCoating displayed a broad anti-adhesive efficiency against all the uropathogens tested (68–95%), even in the presence of artificial urine (58–100%) with exception of P. mirabilis in the latter condition. Under biofilm-promoting settings, CyanoCoating reduced biofilm formation by E. coli, P. mirabilis, and C. albicans (30–60%). In addition, CyanoCoating prevented large crystals encrustation, and its sterilization with ethylene oxide did not impact the coating stability. Therefore, CyanoCoating constitutes a step forward for the implementation of antibiotic-free alternative strategies to fight CAUTIs.
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Chau AL, Rosas J, Degen GD, Månsson LK, Chen J, Valois E, Pitenis AA. Aqueous surface gels as low friction interfaces to mitigate implant-associated inflammation. J Mater Chem B 2020; 8:6782-6791. [PMID: 32364211 DOI: 10.1039/d0tb00582g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Aqueous surface gels are fragile yet resilient biopolymer-based networks capable of sustaining extremely low friction coefficients despite tribologically-challenging environments. These superficial networks are ubiquitous in natural sliding interfaces and protect mechanosensitive cells from excessive contact pressures and frictional shear stresses from cell-fluid, cell-cell, or cell-solid interactions. Understanding these complex lubrication mechanisms may aid in the development of materials-based strategies for increasing biocompatibility in medical devices and implants. Equally as important is characterizing the interplay between soft and passive yet mobile implant materials and cellular reactions in response to direct contact and frictional shear stresses. Physically interrogating living biological systems without rupturing them in the process is nontrivial. To this end, custom biotribometers have been designed to precisely modulate contact pressures against living human telomerase-immortalized corneal epithelial (hTCEpi) cell layers using soft polyacrylamide membrane probes. Reverse-transcription quantitative polymerase chain-reaction (RT-qPCR) indicated that increased duration and, to a much greater extent, the magnitude of frictional shear stress lead to increased production of pro-inflammatory (IL-1β, IL-6, MMP9) and pro-apoptotic (DDIT3, FAS) genes, which in clinical studies are linked to pathological pain. The hierarchical structure often found in biological systems has also been investigated through the fabrication of high-water content (polyacrylamide) hydrogels through free-radical polymerization inhibition. Nanoindentation experiments and friction coefficient measurements indicate that these "gradient surface gels" reduce contact pressures and frictional shear stresses at the surface of the material while still maintaining stiffness within the bulk. Reducing frictional shear stresses through informed materials and surface design may concomitantly increase lubricity and quiet the immune response, and thus provide bio-inspired routes to improve patient outcomes and quality of life.
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Affiliation(s)
- Allison L Chau
- Materials Department University of California, Santa Barbara, CA 93106, USA.
| | - Jonah Rosas
- Biomolecular Science and Engineering Department University of California, Santa Barbara, CA 93106, USA
| | - George D Degen
- Department of Chemical Engineering, University of California, Santa Barbara Santa Barbara, CA 93106, USA
| | - Lisa K Månsson
- Department of Physics Chalmers, University of Technology, 412 58 Gothenburg, Sweden
| | - Jonathan Chen
- Department of Chemical Engineering, University of California, Santa Barbara Santa Barbara, CA 93106, USA
| | - Eric Valois
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, CA 93106, USA
| | - Angela A Pitenis
- Materials Department University of California, Santa Barbara, CA 93106, USA.
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Pospíšilová Š, Malík I, Bezouskova K, Kauerova T, Kollar P, Csöllei J, Oravec M, Cizek A, Jampilek J. Dibasic Derivatives of Phenylcarbamic Acid as Prospective Antibacterial Agents Interacting with Cytoplasmic Membrane. Antibiotics (Basel) 2020; 9:E64. [PMID: 32041117 PMCID: PMC7168207 DOI: 10.3390/antibiotics9020064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/17/2022] Open
Abstract
1-[2-[({[2-/3-(Alkoxy)phenyl]amino}carbonyl)oxy]-3-(dipropylammonio)propyl]pyrrolidinium/azepan- ium oxalates or dichlorides (alkoxy = butoxy to heptyloxy) were recently described as very promising antimycobacterial agents. These compounds were tested in vitro against Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212 (reference and control strains), three methicillin-resistant isolates of S. aureus, and three isolates of vancomycin-resistant E. faecalis. 1-[3-(Dipropylammonio)-2-({[3-(pentyloxy-/hexyloxy-/heptyloxy)phenyl]carbamoyl}oxy)propyl]pyrrolidinium dichlorides showed high activity against staphylococci and enterococci comparable with or higher than that of used controls (clinically used antibiotics and antiseptics). The screening of the cytotoxicity of the compounds as well as the used controls was performed using human monocytic leukemia cells. IC50 values of the most effective compounds ranged from ca. 3.5 to 6.3 µM, thus, it can be stated that the antimicrobial effect is closely connected with their cytotoxicity. The antibacterial activity is based on the surface activity of the compounds that are influenced by the length of their alkoxy side chain, the size of the azacyclic system, and hydro-lipophilic properties, as proven by in vitro experiments and chemometric principal component analyses. Synergistic studies showed the increased activity of oxacillin, gentamicin, and vancomycin, which could be explained by the direct activity of the compounds against the bacterial cell wall. All these compounds demonstrate excellent antibiofilm activity, when they inhibit and disrupt the biofilm of S. aureus in concentrations close to minimum inhibitory concentrations against planktonic cells. Expected interactions of the compounds with the cytoplasmic membrane are proven by in vitro crystal violet uptake assays.
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Affiliation(s)
- Šárka Pospíšilová
- Regional Centre of Advanced Technologies and Materials, Faculty of Science, Palacky University, Slechtitelu 27, 783 71 Olomouc, Czech Republic;
| | - Ivan Malík
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, 832 32 Bratislava, Slovakia
| | - Kristyna Bezouskova
- Department of Infectious Diseases and Microbiology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackeho 1946/1, 612 42 Brno, Czech Republic; (K.B.); (A.C.)
| | - Tereza Kauerova
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Palackeho 1, 61242 Brno, Czech Republic; (T.K.); (P.K.)
| | - Peter Kollar
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Palackeho 1, 61242 Brno, Czech Republic; (T.K.); (P.K.)
| | - Jozef Csöllei
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences in Brno, Palackeho 1946/1, 612 42 Brno, Czech Republic;
| | - Michal Oravec
- Global Change Research Institute CAS, Belidla 986/4a, 603 00 Brno, Czech Republic;
| | - Alois Cizek
- Department of Infectious Diseases and Microbiology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackeho 1946/1, 612 42 Brno, Czech Republic; (K.B.); (A.C.)
| | - Josef Jampilek
- Regional Centre of Advanced Technologies and Materials, Faculty of Science, Palacky University, Slechtitelu 27, 783 71 Olomouc, Czech Republic;
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia
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