4.8 Article

Smartphone compatible nitric oxide releasing insert to prevent catheter-associated infections

Journal

JOURNAL OF CONTROLLED RELEASE
Volume 349, Issue -, Pages 227-240

Publisher

ELSEVIER
DOI: 10.1016/j.jconrel.2022.06.043

Keywords

Antibacterial; In situ disinfection; Nitric oxide; Catheter infections; Fiber optic

Funding

  1. National Institute of Health [R01HL151473]

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This study reports a novel medical device that utilizes the antimicrobial properties of light and nitric oxide to both prevent and treat catheter-related infections. By incorporating a photo-initiated nitric oxide donor molecule into the device, tunable levels of nitric oxide can be released, reducing microbial attachment and eradicating bacteria on pre-colonized catheters. This smart, mobile-operated device shows promise as a biocompatible solution for catheter-related bloodstream infections, eliminating the need for complex surgical interventions.
A large fraction of nosocomial infections is associated with medical devices that are deemed life-threatening in immunocompromised patients. Medical device-related infections are a result of bacterial colonization and biofilm formation on the device surface that affects >1 million people annually in the US alone. Over the past few years, light-based antimicrobial therapy has made substantial advances in tackling microbial colonization. Taking the advantage of light and antibacterial properties of nitric oxide (NO), for the first time, a robust, biocompatible, anti-infective approach to design a universal disposable catheter disinfection insert (DCDI) that can both prevent bacterial adhesion and disinfect indwelling catheters in situ is reported. The DCDI is engineered using a photo-initiated NO donor molecule, incorporated in polymer tubing that is mounted on a side glow fiber optic connected to an LED light source. Using a smartphone application, the NO release from DCDI is photo-activated via white light resulting in tunable physiological levels of NO for up to 24 h. When challenged with microorganisms S. aureus and E. coli, the NO-releasing DCDI statistically reduced microbial attachment by >99% versus the controls with just 4 h of exposure. The DCDI also eradicated similar to 97% of pre-colonized bacteria on the CVC catheter model demonstrating the ability to exterminate an established catheter infection. The smart, mobile-operated novel universal antibacterial device can be used to both prevent catheter infections or can be inserted within an infected catheter to eradicate the bacteria without complex surgical interventions. The therapeutic levels of NO generated via illuminating fiber optics can be the next-generation biocompatible solution for catheter-related bloodstream infections.

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