School of Engineering, Brown University, Providence, RI 02912, USA.
Int J Nanomedicine. 2012;7:537-45. doi: 10.2147/IJN.S27957. Epub 2012 Feb 1.
Patients on mechanical ventilators for extended periods of time often face the risk of developing ventilator-associated pneumonia. During the ventilation process, patients incapable of breathing are intubated with polyvinyl chloride (PVC) endotracheal tubes (ETTs). PVC ETTs provide surfaces where bacteria can attach and proliferate from the contaminated oropharyngeal space to the sterile bronchoalveolar area. To overcome this problem, ETTs can be coated with antimicrobial agents. However, such coatings may easily delaminate during use. Recently, it has been shown that changes in material topography at the nanometer level can provide antibacterial properties. In addition, some metabolites, such as fructose, have been found to increase the efficiency of antibiotics used to treat Staphylococcus aureus (S. aureus) infections. In this study, we combined the antibacterial effect of nanorough ETT topographies with sugar metabolites to decrease bacterial growth and biofilm formation on ETTs. We present for the first time that the presence of fructose on the nanorough surfaces decreases the number of planktonic S. aureus bacteria in the solution and biofilm formation on the surface after 24 hours. We thus envision that this method has the potential to impact the future of surface engineering of biomaterials leading to more successful clinical outcomes in terms of longer ETT lifetimes, minimized infections, and decreased antibiotic usage; all of which can decrease the presence of antibiotic resistant bacteria in the clinical setting.
长时间使用机械呼吸机的患者常常面临呼吸机相关性肺炎的风险。在通气过程中，无法自主呼吸的患者需要通过聚氯乙烯（PVC）气管内导管（ETT）进行插管。PVC ETT 提供了细菌可以附着和繁殖的表面，从污染的口咽腔扩散到无菌的支气管肺泡区域。为了解决这个问题，可以在 ETT 上涂覆抗菌剂。然而，这样的涂层在使用过程中可能很容易分层。最近，已经证明纳米级别的材料形貌变化可以提供抗菌性能。此外，一些代谢物，如果糖，已被发现可以提高用于治疗金黄色葡萄球菌（S. aureus）感染的抗生素的效率。在这项研究中，我们将纳米粗糙 ETT 形貌的抗菌效果与糖代谢物相结合，以减少 ETT 上细菌的生长和生物膜形成。我们首次提出，纳米粗糙表面上的果糖存在可以减少溶液中浮游 S. aureus 细菌的数量，并减少 24 小时后表面上生物膜的形成。因此，我们设想这种方法有可能影响生物材料表面工程的未来，从而在更长的 ETT 寿命、最小化感染和减少抗生素使用方面取得更成功的临床结果；所有这些都可以减少临床环境中抗生素耐药菌的存在。
