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

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.

Anti-biofilm and Virulence Factor-Reducing Activities of Essential Oils and Oil Components as a Possible Option for Bacterial Infection Control

“…The studies presented in this review show that nano-encapsulated EOs ideally combine the special properties of nano-carrier systems with the antibacterial activity of EOs. Thus, EO-loaded nano-carrier systems are therefore interesting antimicrobial agents to eradicate biofilms on catheters, prosthesis, and other medical devices [110] and for managing acute and chronic wounds [111].…”

Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections

“…A variety of bioactive molecules that are natural in origin have been tested for antimicrobial properties, a revolution brought about by the push for more eco-sustainable anti-biofilm molecules [47,138]. Examples of these include natural oils such as eucalyptus and tea tree oils [139][140][141].…”

Antimicrobial Adaptation in Uropathogenic Escherichia coli

“…The catheter material is 'functionalised' first (introduction of polar, ionic, or radical groups on the surface) to allow the binding of the antimicrobial molecules. This is usually done with plasma, gamma, or ultraviolet radiation [134].…”

“…Hydrogels are polymer networks with hydrophilic structures, meaning they are able to retain large amounts of water [137]. The nature of hydrogels being wet and slippery is advantageous for use in a catheter since this helps prevent damage to the urethral mucosa when inserted, in situ, and removed [134]. Vimala, et al created a hydrogelbased coating that releases silver nanoparticles [138].…”

“…The nature of hydrogels being wet and slippery is advantageous for use in a catheter as this helps prevent damage to the urethral mucosa when inserted, and removed, in situ [134]. The sol gel process involves the formation of an inorganic colloidal suspension (sol) and gelation of the sol in a continuous liquid phase (gel) to form a 3D network structure [141].…”