A Glance at Antimicrobial Strategies to Prevent Catheter-Associated Medical Infections

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.

New Functionalized Macroparticles for Environmentally Sustainable Biofilm Control in Water Systems

“…Moreover, for the interaction between BAC molecules and bacteria to occur, the particles need to be in close contact with bacteria. Of course, the BAC molecules inside the pores will not be readily available for bacteria [ 62 ], since the particles are mesoporous (pore diameters between 2 and 50 nm [ 63 ]) and bacteria (due to their bigger size) cannot enter the pores. In the work of He et al [ 56 ], they found that bacteria are dead upon contact with the immobilized QACs.…”

Broad spectrum antimicrobial PDMS-based biomaterial for catheter fabrication

“…Extended spectrum β-lactamase (ESBL) and carbapenemase producing Gram negative bacteria have emerged as a recalcitrant therapeutic challenge. These MDR microbes are the most notorious group of bacteria that pose a serious global health threat [ 32 , 33 ]. We found that our antimicrobial biomaterials ( PDMS-PIM1 ) inhibited the growth of all the ESKAPE group of clinical isolates as well as MRSA and Vancomycin-resistant Enterococcus ( VRE ) pathogens (Fig.…”

Biocompatibility pathways and mechanisms for bioactive materials: The bioactivity zone

“…One of the most clinically relevant aspects of biomaterial-related infection control is that of catheter-associated infections. As reviewed by Ricado et al , despite several decades of intensive research and development involving those strategies discussed in the previous sections, and others, efficacy data obtained from in vitro studies is not properly reflected in the clinical setting [ 133 ].…”