A review of the recent advances in antimicrobial coatings for urinary catheters

Abstract

More than 75% of hospital-acquired or nosocomial urinary tract infections are initiated by urinary catheters, which are used during the treatment of 15–25% of hospitalized patients. Among other purposes, urinary catheters are primarily used for draining urine after surgeries and for urinary incontinence. During catheter-associated urinary tract infections, bacteria travel up to the bladder and cause infection. A major cause of catheter-associated urinary tract infection is attributed to the use of non-ideal materials in the fabrication of urinary catheters. Such materials allow for the colonization of microorganisms, leading to bacteriuria and infection, depending on the severity of symptoms. The ideal urinary catheter is made out of materials that are biocompatible, antimicrobial, and antifouling. Although an abundance of research has been conducted over the last forty-five years on the subject, the ideal biomaterial, especially for long-term catheterization of more than a month, has yet to be developed. The aim of this review is to highlight the recent advances (over the past 10 years) in developing antimicrobial materials for urinary catheters and to outline future requirements and prospects that guide catheter materials selection and design.

Zinc‐oxide nanoparticles act catalytically and synergistically with nitric oxide donors to enhance antimicrobial efficacy

“…Passive materials such as polyethylene glycol, zwitterionic polymers, and other hydrophilic polymers are unable to kill the pathogens themselves and can also be fouled over time through the settling of other biomacromolecules, which in turn can attract microbes. Therefore, agents such as silver nanoparticles (Ag‐NPs), antibiotics, chlorhexidine, triclosan, quaternary ammonium ions, antimicrobial peptides, and nitric oxide (NO) have been studied widely …”

“…S ‐nitrosothiols degrade to release NO and form a disulfide . However, over the last two decades, NO release from both endogenous and synthetic donors has also been studied for the purpose of antimicrobial medical device coatings and wound healing applications . While NO donors like N ‐diazeniumdiolates have been researched extensively, their disadvantages include low NO release, cytotoxicity toward mammalian cells, and by‐products that are not approved by the FDA .…”

Antimicrobial strategies for urinary catheters

“…The innovation of more effective antimicrobial urinary catheter coatings is the central endeavor to eliminate the pathogen biofilm on medical implant . Commonly, the solutions are based on our current understanding of the biofilm‐formation mechanisms, and can be divided into five major categories (Fig.…”

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

“…Coating of a polymer on biomaterial surface has been used to develop antimicrobial surfaces. Both the natural as well as synthetic polymers may be used for coating . Antimicrobial agents such as furanones, antibiotics (ciprofloxacin, ofloxacin, norfloxacin), a combination of antibiotics (minocycline with rifampin), have shown encouraging results for the eradication of bacterial colonization of urinary catheters .…”

“…Both the natural as well as synthetic polymers may be used for coating. [76] Antimicrobial agents such as furanones, antibiotics (ciprofloxacin, ofloxacin, norfloxacin), a combination of antibiotics (minocycline with rifampin), have shown encouraging results for the eradication of bacterial colonization of urinary catheters. [77][78][79][80] Kowalczuk et al coated small specimens of latex siliconized catheter pieces with an antibiotic sparfloxacin conjugated with heparin for the antimicrobial prevention.…”