School of Chemical, Materials & Biomedical Engineering, University of Georgia, Athens, GA, USA.
School of Chemical, Materials & Biomedical Engineering, University of Georgia, Athens, GA, USA.
J Control Release. 2024 Nov;375:667-680. doi: 10.1016/j.jconrel.2024.09.027. Epub 2024 Sep 24.
Medical device-associated infections are a pervasive global healthcare concern, often leading to severe complications. Bacterial biofilms that form on indwelling medical devices, such as catheters, are significant contributors to infections like bloodstream and urinary tract infections. This study addresses the challenge of biofilms on medical devices by introducing a portable antimicrobial catheter insert (PACI) designed to be efficient, biocompatible, and anti-infective. The PACI utilizes nitric oxide (NO), known for its potent antimicrobial properties, to deter bacterial adhesion and biofilm formation. To achieve this, a photoinitiated NO donor, S-nitroso-N-acetylpenicillamine (SNAP), is covalently linked to a polydimethylsiloxane (PDMS) polymer. This design allows for higher NO loading for long-term impact and prevents premature donor leaching, a common challenge with SNAP-blended polymers. The SNAP-PDMS material was applied to a side-glowing fiber optic and connected to a wearable light module emitting 450 nm light, creating a functional antimicrobial insert. Activation of the fiber optic, accomplished with a one-click mechanism, enables real-time NO release, maintaining controlled NO levels for a minimum of 24 hours. The therapeutic levels of NO released via photocatalysis from the PACI demonstrated remarkable efficacy, with >90 % reduction in bacterial viability against S. aureus, S. epidermidis, and P. mirabilis without any cytotoxic impact on mammalian cells. This study underscores the potential of the NO-releasing insert in clinical settings, providing a portable and adaptable solution for preventing catheter-associated infections.
医疗器械相关感染是一个普遍存在的全球医疗保健问题，往往会导致严重的并发症。在留置医疗器械（如导管）上形成的细菌生物膜是导致血流感染和尿路感染等感染的重要因素。本研究通过引入一种便携式抗菌导管插入物（PACI）来解决医疗器械上的生物膜问题，该插入物旨在具有高效、生物相容和抗感染的特性。PACI 利用一氧化氮（NO）来阻止细菌黏附和生物膜形成，因为一氧化氮具有很强的抗菌特性。为此，将一种光引发的一氧化氮供体 S-亚硝基-N-乙酰青霉胺（SNAP）通过共价键连接到聚二甲基硅氧烷（PDMS）聚合物上。这种设计可以实现更高的 NO 负载，以产生长期影响，并防止 SNAP 混合聚合物中常见的供体提前浸出。将 SNAP-PDMS 材料应用于侧发光光纤，并连接到可穿戴的 450nm 光发射模块上，制造出一种功能性的抗菌插入物。通过一键式机制激活光纤，实现实时的 NO 释放，将 NO 水平维持在至少 24 小时的受控状态。通过 PACI 中的光催化释放出的治疗水平的 NO 表现出显著的功效，对金黄色葡萄球菌、表皮葡萄球菌和奇异变形杆菌的细菌活力减少了>90%，而对哺乳动物细胞没有任何细胞毒性影响。这项研究强调了 NO 释放插入物在临床环境中的潜力，为预防导管相关感染提供了一种便携式和可适应的解决方案。
