School of Science and Engineering, University of Dundee, Dundee, UK.
School of Medicine, University of Dundee & Ninewells Hospital, Dundee, UK.
J Hosp Infect. 2019 Sep;103(1):55-63. doi: 10.1016/j.jhin.2019.02.012. Epub 2019 Feb 22.
BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections, leading to increased morbidity and mortality. A major reason for this is that urinary catheters are not yet capable of preventing CAUTIs. AIM: To develop an anti-infective urinary catheter. METHODS: An efficient silver-polytetrafluoroethylene (Ag-PTFE) nanocomposite coating was deposited on whole silicone catheters, and two in-vitro bladder models were designed to test antibacterial (against Escherichia coli) and anti-encrustation (against Proteus mirabilis) performances. Each model was challenged with two different concentrations of bacterial suspension. FINDINGS: Compared with uncoated catheters, coated catheters significantly inhibited bacterial migration and biofilm formation on the external catheter surfaces. The time to develop bacteriuria was an average of 1.8 days vs 4 days and 6 days vs 41 days when the urethral meatus was infected with 10 and 10 cells/mL, respectively. For anti-encrustation tests, the coated catheter significantly resisted encrustation, although it did not strongly inhibit the increases in bacterial density and urinary pH. The time to blockage, which was found to be independent of the initial bacterial concentration in the bladder, was extended from 36.2±1.1 h (uncoated) to 89.5±3.54 h (coated) following bacterial contamination with 10 cells/mL in the bladder. Moreover, the coated catheter exhibited excellent biocompatibility with L929 fibroblast cells. CONCLUSION: Ag-PTFE coated Foley catheters should undergo further clinical trials to determine their ability to prevent CAUTIs during catheterization.
背景:导管相关尿路感染(CAUTI)是最常见的医院获得性感染之一,导致发病率和死亡率增加。造成这种情况的一个主要原因是,导尿管还不能预防 CAUTI。
目的:开发一种抗感染导尿管。
方法:在整个硅胶导尿管上沉积了高效的银-聚四氟乙烯(Ag-PTFE)纳米复合材料涂层,并设计了两种膀胱体外模型来测试抗菌(针对大肠杆菌)和抗结垢(针对奇异变形杆菌)性能。每个模型都用两种不同浓度的细菌悬浮液进行了挑战。
发现:与未涂层的导管相比,涂层导管显著抑制了外部导管表面的细菌迁移和生物膜形成。尿道口分别感染 10 和 10 个细胞/mL 时,出现菌尿的时间平均分别为 1.8 天和 4 天以及 6 天和 41 天。对于抗结垢测试,尽管涂层导管并没有强烈抑制细菌密度和尿液 pH 值的增加,但它显著抵抗结垢。阻塞时间与膀胱中初始细菌浓度无关,在膀胱中用 10 个细胞/mL 污染后,从未涂层的 36.2±1.1 h 延长至 89.5±3.54 h。此外,涂层导管与 L929 成纤维细胞具有出色的生物相容性。
结论:Ag-PTFE 涂层 Foley 导尿管应进行进一步的临床试验,以确定其在导尿过程中预防 CAUTI 的能力。
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