Facile Surface Multi-Functionalization of Biomedical Catheters with Dual-Microcrystalline Broad-Spectrum Antibacterial Drugs and Antifouling Poly(ethylene glycol) for Effective Inhibition of Bacterial Infections

With the development of biomedical materials, the widespread use of implantable medical devices such as biomedical catheters has saved lives and improved therapeutic outcomes in the clinic. Biomedical catheters (BCs) have the ability to connect the body inside and outside and are widely used in clinical sites for fluid discharging, blood indwelling, mechanical ventilating, and so on. However, catheterrelated infections (CRIs) are common nosocomial infections with high morbidity and mortality. The pathogens in the urinary tract, blood, and lung tissue carried by BCs may be the direct cause of CRIs, and the bacterial biofilm on the surface of BCs provides a notable source of persistent diseases. Microcrystalline sulfamethoxazole (SMZ) and trimethoprim (TMP) were prepared in this study to increase both the specific surface area and water-solubility of antibacterial drugs, as well as to enhance the antibacterial and antifouling effects on the surface of BCs. As-prepared drugs and the excellent antifouling agent polyethylene glycol (PEG) were then used for the functionalization of BCs. The result indicated that the sizes of microcrystalline SMZ and TMP were 0.5-3 mu m, 1-5 mu m, respectively. The coating of BC-PEG-drugs exhibited excellent antibacterial efficacy in culture as well as preeminent antibacterial and antifouling abilities on the surface of BCs toward Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Moreover, the BC-PEG-drugs groups exhibited outstanding antibacterial and antifouling abilities in vivo by an animal infection model with S. aureus. This study offers a simple and effective approach for the synthesis of antibacterial and antifouling coatings that consist of microcrystalline drugs, with promising clinical applicability.