LIN Cheng-xiong,HUANG Zheng-yu,WANG Yao-cheng,ZHANG Jin,HUANG De-qun,XU Zhi-biao.Research Progress of Bacteriostatic Coating for Urethral Catheter[J],51(8):156-167
Research Progress of Bacteriostatic Coating for Urethral Catheter
  
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DOI:10.16490/j.cnki.issn.1001-3660.2022.08.013
KeyWord:catheter  surface modification  antibacterial  lubrication  urinary infection
                 
AuthorInstitution
LIN Cheng-xiong National Engineering Research Center for Healthcare Devices, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou , China
HUANG Zheng-yu National Engineering Research Center for Healthcare Devices, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou , China;School of Rail Transportation, Wuyi University, Guangdong Jiangmen , China
WANG Yao-cheng National Engineering Research Center for Healthcare Devices, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou , China;School of Rail Transportation, Wuyi University, Guangdong Jiangmen , China
ZHANG Jin National Engineering Research Center for Healthcare Devices, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou , China
HUANG De-qun National Engineering Research Center for Healthcare Devices, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou , China
XU Zhi-biao School of Rail Transportation, Wuyi University, Guangdong Jiangmen , China
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Abstract:
      Catheter-related urinary tract infection (CAUTI) is a common infection in hospitals, accounting for up to 20%-30% of all nosocomial infections, which greatly affects the quality and health of patients. Urinary tract infections and blocked catheters are mainly caused by the following processes:Urethral infection induced by urethral mucosa injury and invasion of external pathogens are the main sources for CAUTI; bacterial colonization and the formation of biofilm; expression of bacterial urease and catalyses conversion of urease to ammonia and carbon dioxide; elevation of urinary pH and local supersaturation and precipitation of struvite and apatite salts; formation of crystalline biofilms and obstruction of urine flow and catheter blockage. Based on the formation of biofilm and deposition of inorganic salts on catheter, researchers have proposed many methods to prevent CAUTI to realize the antibacterial and anti-blocking capability, such as catheter surface coating, structure design of the catheter , short time for clinical use, etc. There are different methods, directions and ranges to review and conclude the latest research progress concerning the antibacterial coatings on urethral catheter. For example, it can review the research progress from engineering and medical perspectives in prevention of encrustation and blockage of long-term indwelling catheters; it can also review current understanding of bacterial biofilm formation on urethral catheters, crystalline biofilm formation as well as approaches that may be used to control biofilm formation on these devices. This paper mainly reviewed the research progress of antibacterial coating on ureter surface from physical modification and chemical modification in recent years, especially paying attention to the antibacterial activity and anti-blocking effect. The physical modification methods were mainly aimed at inhibiting bacterial adhesion, and acting on the initial stage of bacterial adhesion, colonization, proliferation and biofilm formation. The physical modification method usually used polyethylene glycol, bacteriostatic enzymes or polyzwitterion hydrogel coating to wrap the surface of catheter, or modify the surface micro-nano structure of the catheter to achieve the effect of lubrication and reduce the inhibition of bacterial adhesion. Chemical modification methods were based on the direct action of drugs or proteins on bacteria, which can affect the whole process of bacterial adhesion, colonization, proliferation and biofilm formation. Chemical modification methods mainly summarized the substances that can directly act on bacteria, including molecular pump inhibitors, antibiotics, nitric oxide and antimicrobial peptides, and attached these drugs or factors on the surface of catheter to achieve bacteriostasis, and prolonged the plugging time of the catheter. On this basis, by summarizing the current research process of antibacterial coating on urethral catheters, the function, antibacterial mechanism and validation of urethral catheters in the future were prospected in order to provide some guidance for the selection and design of urethral bacteriostatic materials in the future. It mainly included:multi-antibacterial mechanism can be used to reduce bacterial resistance and prolong the effective time of indwelling catheter, and the important factors during the process from bacterial infection to catheter blockage can be real-time monitored. It can transform the current continuous passive release of drugs into active intelligent release, in vitro culture can be combined with in vivo experiments to test its effectiveness.
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