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Nitric oxide charged catheters as a potential strategy for prevention of hospital acquired infections

View Article: PubMed Central - PubMed

ABSTRACT

Background: Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents bacterial colonization and biofilm formation onto catheter surfaces.

Aims and methods: The aim of the study was to assess the anti-infective properties of NO-charged catheters exposed to low concentration (up to 103 CFU/ml) of microbial cells in-vitro. We assessed NO-charged tracheal tubes using Pseudomonas aeruginosa, dialysis and biliary catheters using Escherichia coli, and urinary catheters using E. coli, Candida albicans or Enterococcus faecalis. Safety and tolerability of NO-charged urinary catheters were evaluated in a phase 1 clinical study in 12 patients. Six patients were catheterized with NO-charged catheters (NO-group), followed by 6 patients catheterized with regular control catheters (CT-group). Comparison of safety parameters between the study groups was performed.

Results: NO-charged tracheal, dialysis biliary and urinary catheters prevented P. aeruginosa, E. coli and C. albicans attachment and colonization onto their surfaces and eradicated corresponding planktonic microbial cells in the surrounding media after 24–48 hours, while E. faecalis colonization onto urinary catheters was reduced by 1 log compared to controls. All patients catheterized with an NO-charged urinary catheter successfully completed the study without experiencing NO-related AE's or serious AE's (SAE's).

Conclusion: These data highlight the potential of NO-based technology as potential platform for preventing catheter-associated HAI's.

No MeSH data available.


Release of NO from charged catheters.Twenty four hour accumulation of NO in water after release from charged tracheal, dialysis, biliary and urinary catheters (n = 3 for each catheter). NO levels were determined using Griess reaction.
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pone.0174443.g002: Release of NO from charged catheters.Twenty four hour accumulation of NO in water after release from charged tracheal, dialysis, biliary and urinary catheters (n = 3 for each catheter). NO levels were determined using Griess reaction.

Mentions: NO has a short half-life in-vivo of a few seconds. Therefore, the level of more stable NO metabolite, nitrites, was used for indirect measurement of NO in fluids. As shown (Fig 2) NO release from tracheal, dialysis and biliary catheters was measured during 24 hours, with the largest amounts released during the first hours of immersion in water. After 24 hours the NO levels released per 1-cm of each of the NO-charged tracheal, dialysis and biliary catheters were 5.47 ppm, 6.69 ppm and 6.02 ppm, respectively. NO was not released from non-charged control sections (not shown).


Nitric oxide charged catheters as a potential strategy for prevention of hospital acquired infections
Release of NO from charged catheters.Twenty four hour accumulation of NO in water after release from charged tracheal, dialysis, biliary and urinary catheters (n = 3 for each catheter). NO levels were determined using Griess reaction.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5391919&req=5

pone.0174443.g002: Release of NO from charged catheters.Twenty four hour accumulation of NO in water after release from charged tracheal, dialysis, biliary and urinary catheters (n = 3 for each catheter). NO levels were determined using Griess reaction.
Mentions: NO has a short half-life in-vivo of a few seconds. Therefore, the level of more stable NO metabolite, nitrites, was used for indirect measurement of NO in fluids. As shown (Fig 2) NO release from tracheal, dialysis and biliary catheters was measured during 24 hours, with the largest amounts released during the first hours of immersion in water. After 24 hours the NO levels released per 1-cm of each of the NO-charged tracheal, dialysis and biliary catheters were 5.47 ppm, 6.69 ppm and 6.02 ppm, respectively. NO was not released from non-charged control sections (not shown).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents bacterial colonization and biofilm formation onto catheter surfaces.

Aims and methods: The aim of the study was to assess the anti-infective properties of NO-charged catheters exposed to low concentration (up to 103 CFU/ml) of microbial cells in-vitro. We assessed NO-charged tracheal tubes using Pseudomonas aeruginosa, dialysis and biliary catheters using Escherichia coli, and urinary catheters using E. coli, Candida albicans or Enterococcus faecalis. Safety and tolerability of NO-charged urinary catheters were evaluated in a phase 1 clinical study in 12 patients. Six patients were catheterized with NO-charged catheters (NO-group), followed by 6 patients catheterized with regular control catheters (CT-group). Comparison of safety parameters between the study groups was performed.

Results: NO-charged tracheal, dialysis biliary and urinary catheters prevented P. aeruginosa, E. coli and C. albicans attachment and colonization onto their surfaces and eradicated corresponding planktonic microbial cells in the surrounding media after 24–48 hours, while E. faecalis colonization onto urinary catheters was reduced by 1 log compared to controls. All patients catheterized with an NO-charged urinary catheter successfully completed the study without experiencing NO-related AE's or serious AE's (SAE's).

Conclusion: These data highlight the potential of NO-based technology as potential platform for preventing catheter-associated HAI's.

No MeSH data available.