Abstract
Indwelling urethral catheters are widely used in hospitalized patients however they are associated with bacterial infection and biofilm formation due to the suboptimal surface properties of the elastic materials used for the catheters. Although there are several antibacterial coating technologies to modify the surface properties of the catheter including hydrophilic polymeric coating, the risk of infection is still high given the absence of reactive functional groups on the surface of elastomers. In this study, we describe the use of catechol-functionalized hydrophilic polymers and explore strategies to create antibacterial hydrogel coatings. Three different types of catechol-functionalized polymers, chitosan, hyaluronic acid, and human serum albumin were synthesized and deposited using simple dip-coating method. All of the tested polymers could coat different types of elastomers widely used for urethral catheters independent to the surface properties, and the thickness of the coating could be controlled by the number of depositions. The coating formed stable water-containing lubricant surface beneficial as a physical repellant of microbial attachment. In addition, the coating could be combined with additional antibacterial agents such as silver nanoparticles to maximize the antibacterial effect on the surface of urethral catheter materials.
Highlights
Urethral catheters are inserted through urinary tract to drain urine from urethra and it is estimated to be used by 15–25% of hospitalized patients and 75% of patients at critical care (Shackley et al, 2017; Singha et al, 2017), including patients with urethral incontinence who require short- and long-term usage of urethral catheters
Most of the elastomers used in urethral catheters such as silicone, PU, and polyvinyl chloride (PVC) have no functional groups on the surface, and the surface coating should be preceded with toxic chemical functionalization process to introduce functional groups
This strategy showed potential, the reaction process is often cumbersome and the reaction is limited to the surface forming a very thin layer limiting the stability and the amount of additional antibacterial agents that can be potentially added to the chitosan layer
Summary
Urethral catheters are inserted through urinary tract to drain urine from urethra and it is estimated to be used by 15–25% of hospitalized patients and 75% of patients at critical care (Shackley et al, 2017; Singha et al, 2017), including patients with urethral incontinence who require short- and long-term usage of urethral catheters. In the presence of urease-producing bacteria forming salt crystals on the surface, the catheter can be roughened to further increase friction, if not treated timely, causing massive obstruction (i.e., encrustation), antibiotic resistance of bacteria, and severe bacterial infection (Wang et al, 2015) To solve this problem, several antibacterial coating strategies have been developed including passive anti-adhesion to repel bacterial adhesion [e.g., poly(N-hydroxyethylacrylamide), and zwitterionic polymers], and active biocidal coating that can directly kill the bacteria on the surface (e.g., chitosan, N-halamine polymer, and other polymers with strong positive charges) combined with antibiotic agents to maximize the efficacy (e.g., silver; Dallas et al, 2011; Zhao et al, 2013; Ng et al, 2014; GhavamiNejad et al, 2016; Li et al, 2017; Yong et al, 2019). There is a critical unmet need for a method producing robust and long-lasting low-friction antibacterial coating on elastomeric materials used in urethral catheters potentially capable of antibacterial drug loading and sustained release
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