An antimicrobial modified silicone peritoneal catheter with activity against both Gram-positive and Gram-negative...

Area of Science:

• Biomaterials Science
• Infectious Diseases
• Nephrology

Background:

• Peritonitis and catheter-related infections are significant complications in continuous ambulatory peritoneal dialysis (CAPD), often leading to catheter removal.
• Current antimicrobial catheter coatings provide only transient protection against bacterial colonization.
• Developing durable antimicrobial properties is crucial to mitigate CAPD-associated infections.

Purpose of the Study:

• To develop CAPD catheters with sustained, broad-spectrum antimicrobial activity.
• To evaluate the duration of antimicrobial efficacy and the potential for bacterial resistance.
• To assess the effectiveness of antimicrobial-impregnated catheters in preventing colonization by common CAPD pathogens.

Main Methods:

• Catheters were impregnated with a combination of rifampicin, triclosan, and trimethoprim.
• Antimicrobial activity duration was tested until bacterial resistance emerged.
• The ability to achieve a 100% kill rate of attached bacteria (tK100) was determined.
• A flow model assessed catheter resistance to colonization by high loads of Staphylococcus aureus and Escherichia coli over time.

Main Results:

• Antimicrobial activity persisted for at least 280 days without the emergence of resistant bacterial strains.
• tK100 tests demonstrated a reduction of over 99.9% of attached bacteria.
• The flow model showed no colonization after 90 days of repeated high-challenge loads with MRSA and E. coli.

Conclusions:

• Impregnation with rifampicin, triclosan, and trimethoprim confers long-duration, broad-spectrum antimicrobial activity on CAPD catheters.
• This approach effectively prevents bacterial resistance and significantly reduces colonization by common CAPD pathogens.
• These antimicrobial catheters show promise in reducing the incidence of clinical infections in CAPD patients.