Journal
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
Volume 117, Issue 37, Pages 22967-22973Publisher
NATL ACAD SCIENCES
DOI: 10.1073/pnas.2006759117
Keywords
hospital-acquired infection; ventilator-associated pneumonia; biofilms; endotracheal tube; photodynamic therapy
Categories
Funding
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [CEPOF 2013/07276-1]
- INCT Basic Optics and Applied to Life Sciences Grant [FAPESP 2014/50857-8]
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [465360/2014-9]
- Fundacao para a Ciencia e a Tecnologia (FCT)
- QREN/FEDER [UID/QUI/00313/2019, POCI-01-0145-FEDER-027996]
- FAPESP [2019/13569-8, 2019/12694-3]
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior
- FCT [PD/BD/128317/2017]
- CNPq
- Fundação para a Ciência e a Tecnologia [PD/BD/128317/2017] Funding Source: FCT
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Hospital-acquired infections are a global health problem that threatens patients' treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient's trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality. Under these circumstances, there has been a need to administrate antibiotics together. Although necessary, it has led to a rapid increase in bacterial resistance to antibiotics. Therefore, it becomes necessary to develop alternatives to prevent and combat these bacterial infections. One possibility is to turn the ETT itself into a bactericide. Some examples reported in the literature present drawbacks. To overcome those issues, we have designed a photosensitizer-containing ETT to be used in photodynamic inactivation (PDI) to avoid bacteria biofilm formation and prevent VAP occurrence during tracheal intubation. This work describes ETT's functionalization with curcumin photosensitizer, as well as its evaluation in PDI against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. A significant photoinactivation (up to 95%) against Gram-negative and Gram-positive bacteria was observed when curcumin-functionalized endotracheal (ETT-curc) was used. These remarkable results demonstrate this strategy's potential to combat hospital-acquired infections and contribute to fighting antimicrobial resistance.
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