Abstract
Catheter-associated urinary tract infections (CAUTIs), caused by biofilms, are the most frequent health-care associated infections. Novel antibiofilm coatings are needed to increase the urinary catheters' life-span, decrease the prevalence of CAUTIs and reduce the development of antimicrobial resistance. Herein, antibacterial zinc oxide nanoparticles (ZnO NPs) were decorated with a biofilm matrix-degrading enzyme amylase (AM) and simultaneously deposited onto silicone urinary catheters in a one-step sonochemical process. The obtained nano-enabled coatings inhibited the biofilm formation of Escherichia coli and Staphylococcus aureus by 80% and 60%, respectively, for up to 7 days in vitro in a model of catheterized bladder with recirculation of artificial urine due to the complementary mode of antibacterial and antibiofilm action provided by the NPs and the enzyme. Over this period, the coatings did not induce toxicity to mammalian cell lines. In vivo, the nano-engineered ZnO@AM coated catheters demonstrated lower incidence of bacteriuria and prevent the early onset of CAUTIs in a rabbit model, compared to the animals treated with pristine silicone devices. The nano-functionalization of catheters with hybrid ZnO@AM coatings appears as a promising strategy for prevention and control of CAUTIs in the clinic.
Highlights
Indwelling medical devices such as urinary catheters have become an indispensable part of the modern medicine, aiding to improve the pa tient's quality of life [1]
The surface morphology of the catheters coated with ZnO@AM NPs was observed using high-resolution scanning electron microscope (HRSEM) (Fig. 1c)
Silicone urinary catheters were simultaneously coated with matrixdegrading amylase and antibacterial zinc oxide nanoparticles (ZnO NPs) in a one-step US pro cess
Summary
Indwelling medical devices such as urinary catheters have become an indispensable part of the modern medicine, aiding to improve the pa tient's quality of life [1]. All types of urinary catheters are vulnerable to microbial contamination and create an ideal environment for pathogenic bacteria to form biofilms originating severe urinary tract infections (UTIs) [2]. Catheter-associated UTIs (CAUTIs) account for over 40% of all hospital-acquired infections and more than 80% of all UTIs [3]. These infections are global health concern responsible for increased mortality and morbidity, prolonged time of hospitalization, elevated healthcare costs, lengthy antibiotic therapy and risk of resis tance development [4]. Matrix exopoly saccharides (EPS) are integral part of the biofilm structure that assist bacteria to strongly adhere to the catheter surfaces and provide pro tection against antibiotic treatments. Bacteria within bio films effectively circumvent the existing antibiotic therapies and host immune defenses, causing difficult-to-treat infections, systemic dissemination of the pathogen and dysfunction of the medical device [7]
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