Salt‐Triggered Adaptive Dissociation Coating with Dual Effect of Antibacteria and Anti‐Multiple Encrustations in Urological Devices

Abstract

Bacterial infections and multiple encrustations are life‐threatening complications in patients implanted with urological devices. Limited by time‐consuming procedures and substrate dependence, it is difficult to simultaneously prevent the aforementioned complications. Herein, is reported the design of a salt‐triggered chondroitin sulfate complex (CS/Si‐N+) coating with adaptive dissociation, which realizes the dual functions of antibacterial and anti‐multiple encrustations in urological devices with arbitrary shapes. The existence of covalent interactions between the complex and the interface ensures the formation of a robust coating, especially in harsh environments. Benefiting from the adaptive dissociation of the ion pairs in the CS/Si‐N+ coating in urine electrolytes, the exposed ion groups and enhanced hydrophilicity are more conducive to the inhibition of bacterial infection and multiple encrustations simultaneously. The coating exhibits broad‐spectrum bactericidal effects. As a proof of concept, in a simulated metabolic encrustation model, the coating exhibits significant advantages in resisting calcium oxalate encrustation, with a reduction in the calcium content by over 90%. In addition, this non‐leachable all‐in‐one coating shows good biocompatibility in a pig in vivo model. Such a coating strategy is expected to be a practical approach for preventing urological medical device‐related complications.

Smart Lubricant Coating with Urease‐Responsive Antibacterial Functions for Ureteral Stents to Inhibit Infectious Encrustation

“…As shown in Figure A, based on the characteristics of urinary flow in vivo, we established an in vitro dynamic urine flow model to evaluate the ability of the SA‐PU/PVP coating to inhibit infectious encrustation. [ 28 ] In the continuous 30‐day dynamic flow model, the urine flow velocity in the pristine US group gradually decreased by 0.01 mL min −1 from the initial value of 0.2 mL min −1 , indicating a severe blockage in the pristine US (as shown in Figure 6B). In comparison, the commercial PU/PVP‐coated US showed an ≈20% decrease in urine flow velocity within 30 days, maintaining a relatively high flow rate.…”

“…In Vitro Anti-Infectious Encrustation in the Dynamic Flow Model: A sterile silicone tubing, a US segment with or without coating, a peristaltic pump, and two glass apparatuses were used to construct an in vitro flow model simulating urine flow in the human ureter (Figure 6A). [28] Initially, a 5-cm-long segment of the US was immersed in a bacterial suspension of P. mirabilis (2 × 10 8 CFU mL −1 ) for 24 h to facilitate bacterial attachment. Subsequently, two 15-cm-long silicone tubes were connected using the US segment to mimic the ureter.…”

“…One of the concerns is that a fully implanted US with bacterial contamination can easily lead to life-threatening upper urinary tract infections (UUTIs), such as ureteral and kidney infections, which could cause rapid death in the porcine model. [10,28,30] To address this, as displayed in Figure 7A, two types of stent samples were implanted in the porcine model. [28,30] First, sterile double-J (D-J) USs were fully implanted to establish a connection from the kidney to the bladder primarily for assessing in vivo compatibility.…”

“…[10,28,30] To address this, as displayed in Figure 7A, two types of stent samples were implanted in the porcine model. [28,30] First, sterile double-J (D-J) USs were fully implanted to establish a connection from the kidney to the bladder primarily for assessing in vivo compatibility. Second, truncated versions of each stent (5 cm) were contaminated with a P. mirabilis suspension (10 8 CFU mL −1 ) before insertion into the bladder to validate the ability of the stents to inhibit infection and encrustation in vivo.…”

Fabrication of Oleophilic Polypeptide Nanoparticle from Complexing of Cross-Linked Epsilon-poly-l-lysine with Docusate Sodium for Preparation of Bactericidal Thermoplastic Polyurethanes

“…Due to their unique physical and biological properties, thermoplastic polyurethanes (TPUs) have been extensively employed in the biomedical field, encompassing applications such as heart valves, catheters, artificial ligaments, and wound dressings. − Currently, the trade names of medical grade TPU are Carbothane, Pellethane, Tecoflex, Carbosil, and Bionate . However, the absence of antibacterial properties in commercialized TPU results in bacterial adhesion to biomedical device surfaces and subsequent biofilm formation, which can lead to increased antibiotic resistance. − It is estimated that the prevalence rate of nosocomial infections caused by biomedical devices can reach up to a range of 4–10%. Moreover, secondary bacterial infections in coronavirus disease 2019 (COVID-19) patients were a significant cause of mortality, which made us aware of the importance of fighting bacterial infections .…”