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用于开发抗菌导尿管的生物改性策略:概述与进展

Biomodification Strategies for the Development of Antimicrobial Urinary Catheters: Overview and Advances.

作者信息

Anjum Sadiya, Singh Surabhi, Benedicte Lepoittevin, Roger Philippe, Panigrahi Manoj, Gupta Bhuvanesh

机构信息

Bioengineering Laboratory Department of Textile Technology Indian Institute of Technology New Delhi 110016 India.

ICMMO - LG2M - Bât 420 Université Paris-Sud XI, 15 rue Georges Clémenceau 91405 Orsay Cedex France.

出版信息

Glob Chall. 2017 Dec 27;2(1):1700068. doi: 10.1002/gch2.201700068. eCollection 2018 Jan 22.

Abstract

Microbial burden associated with medical devices poses serious health challenges and is accountable for an increased number of deaths leading to enormous medical costs. Catheter-associated urinary tract infections are the most common hospital-acquired infections with enhanced patient morbidity. Quite often, catheter-associated bacteriuria produces apparent adverse outcomes such as urosepsis and even death. Taking this into account, the methods to modify urinary catheters to control microbial infections with relevance to clinical drug resistance are systematically evaluated in this review. Technologies to restrict biofilm formation at initial stages by using functional nanomaterials are elucidated. The conventional methodology of using single therapeutic intervention for developing an antimicrobial catheter lacks clinically meaningful benefit. Therefore, catheter modification using naturally derived antimicrobials such as essential oils, curcumin, enzymes, and antimicrobial peptides in combination with synthetic antibiotics/nanoantibiotics is likely to exert sufficient inhibitory effect on uropathogens and is extensively discussed. Futuristic efforts in this area are projected here that demand clinical studies to address areas of uncertainty to avoid development of bacterial resistance to the new generation therapy with minimum discomfort to the patients.

摘要

与医疗器械相关的微生物负荷带来了严重的健康挑战,并导致死亡人数增加,造成了巨大的医疗成本。导尿管相关的尿路感染是最常见的医院获得性感染,会增加患者的发病率。通常,导尿管相关的菌尿会产生明显的不良后果,如尿脓毒症甚至死亡。考虑到这一点,本综述系统地评估了与临床耐药性相关的改良导尿管以控制微生物感染的方法。阐明了使用功能性纳米材料在初始阶段限制生物膜形成的技术。使用单一治疗干预来开发抗菌导尿管的传统方法缺乏临床意义上的益处。因此,使用天然来源的抗菌剂(如精油、姜黄素、酶和抗菌肽)与合成抗生素/纳米抗生素相结合来改良导尿管,可能会对尿路病原体产生足够的抑制作用,并对此进行了广泛讨论。本文预测了该领域未来的努力方向,这些努力需要进行临床研究,以解决不确定性领域,从而避免细菌对新一代疗法产生耐药性,并使患者的不适感降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6efc/6607219/eaa330722b81/GCH2-2-1700068-g001.jpg

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