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Advisor(s)
Abstract(s)
The use of invasive medical devices is becoming more common nowadays, with
catheters representing one of the most used medical devices. However, there is a risk of
infection associated with the use of these devices, since they are made of materials that are
prone to bacterial adhesion with biofilm formation, often requiring catheter removal as the
only therapeutic option. Catheter-related urinary tract infections (CAUTIs) and central lineassociated
bloodstream infections (CLABSIs) are among the most common causes of
healthcare-associated infections (HAIs) worldwide while endotracheal intubation is
responsible for ventilator-associated pneumonia (VAP). Therefore, to avoid the use of
biocides due to the potential risk of bacterial resistance development, antifouling strategies
aiming at the prevention of bacterial adherence and colonization of catheter surfaces represent
important alternative measures. This review is focused on the main strategies that are able to
modify the physical or chemical properties of biomaterials, leading to the creation of
antiadhesive surfaces. The most promising approaches include coating the surfaces with
hydrophilic polymers, such as poly(ethylene glycol) (PEG), poly(acrylamide) and
poly(acrylates), betaine-based zwitterionic polymers and amphiphilic polymers or the use of
bulk-modified poly(urethanes). Natural polysaccharides and association with polysaccharides,
namely with heparin, have also been used to improve hemocompatibility. Recently developed
bioinspired techniques yielding very promising results in the prevention of bacterial adhesion
and colonization of surfaces include slippery liquid-infused porous surfaces (SLIPS) based on
the superhydrophilic rim of the pitcher plant and the Sharklet topography inspired by the
shark skin, which are potential candidates as surface-modifying approaches for biomedical
devices. Concerning the potential application of most of these strategies in catheters, more in
vivo studies and clinical trials are needed to assure their efficacy and safety for possible future
use.
Description
Keywords
Adhesion Antifouling Biofilm Biomaterial Catheter Infection
Citation
C.M.C. Faustino, S.M.C. Lemos, N. Monge, et al., A scope at antifouling strategies to prevent catheter-associated infections, Advances in Colloid and Interface Science (2020), https://doi.org/10.1016/j.cis.2020.102230