According to the CDC each year, about 1 in 25 U.S. hospital patients is diagnosed with at least one infection related to hospital care alone; additional infections occur in other healthcare settings. Many Healthcare Associated Infections are caused by the most urgent and serious antibiotic-resistant bacteria and may lead to sepsis or death.

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Almost 1.7 million Americans get a bad infection each year from a hospital or medical clinic, resulting in nearly 100,000 deaths from infection-related complications and $30 billion in direct medical expenditures.

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Patients who acquire infections in a healthcare setting spend, on average, an additional 6.5 days in the hospital, are five times more likely to be readmitted after discharge and twice as likely to die. Moreover, surgical patients who develop infections are 60 percent more likely to require admission to a hospital's intensive care unit. Surgical infections are believed to account for up to ten billion dollars annually in healthcare expenditures.

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Medical equipment such as ventilators, catheters, stents, heart valves, and pacemakers are the primary culprits, accounting for two-thirds of all infections. Their surfaces often become coated with dangerous bacterial films. However, a unique surface treatment developed by a team led by the University of California, Los Angeles (UCLA) scientists could help improve the safety of these devices while also reducing the financial strain on the healthcare system.

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Researchers at UCLA have found a way to prevent bacterial infections on medical devices such as catheters and stents. It involves a surface treatment that prevents bacteria from sticking to them. 

 

This new technique has been tested in laboratory and clinical settings. It involves depositing a small layer of anti-biofouling zwitterionic material on the surface of the equipment and permanently bonding that layer to the underlying coating using ultraviolet light.  The resultant barrier prevents germs and other potentially dangerous organic materials from adhering to the surface and infecting people.

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The team’s results were published in the journal Advanced Materials on May 19th, 2022. 

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In the laboratory, researchers applied the surface treatment to several commonly used medical device materials, such as catheters and stents, and then tested the modified materials’ resistance to various types of bacteria, fungi, and proteins. They found that the treatment reduced biofilm growth by more than 80% — and in some cases up 93%, depending on the microbial strain.

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“The modified surfaces exhibited robust resistance against microorganisms and proteins, which is precisely what we sought to achieve,” said Richard Kaner, UCLA’s Dr. Myung Ki Hong Professor of Materials Innovation and senior author of the research. “The surfaces greatly reduced or even prevented biofilm formation.

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 “And our early clinical results have been outstanding,” Kaner added.

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The clinical research involved 16 long-term urinary catheter users who switched to silicone catheters with the new zwitterionic surface treatment. This modified catheter is the first product made by a company Kaner founded out of his lab, called SILQ Technologies Corp., and has been cleared for use in patients by the Food and Drug Administration.

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Ten of the patients described their urinary tract condition using the surface-treated catheter as “much better” or “very much better,” and 13 chose to continue using the new catheter over conventional latex and silicone options after the study period ended.

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“One patient came to UCLA a few weeks ago to thank us for changing her life — something that, as a materials scientist, I never thought was possible,” Kaner said. “Her previous catheters would become blocked after four days or so. She was in pain and needed repeated medical procedures to replace them. With our surface treatment, she now comes in every three weeks, and her catheters work perfectly without encrustation or occlusion — a common occurrence with her previous ones.”

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Such catheter-related urinary tract problems are illustrative of the issues plaguing other medical devices, which, once inserted or implanted, can become breeding grounds for bacteria and harmful biofilm growth, said Kaner, a member of the California NanoSystems Institute at UCLA who is also a distinguished professor of chemistry and biochemistry, and of materials science and engineering. The pathogenic cells pumped out by these highly resilient biofilms then cause recurring infections in the body.

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In response, medical staff routinely give strong antibiotics to patients using these devices, a short-term fix that poses a longer-term risk of creating life-threatening, antibiotic-resistant “superbug” infections. The more widely and frequently antibiotics are prescribed, Kaner said, the more likely bacteria are to develop resistance to them. A landmark 2014 report by the World Health Organization recognized this antibiotic overuse as an imminent public health threat, with officials calling for an aggressive response to prevent “a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill.”

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“The beauty of this technology,” Kaner said, “is that it can prevent or minimize the growth of biofilm without the use of antibiotics. It protects patients using medical devices — and therefore protects all of us — against microbial resistance and the proliferation of superbugs.”

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The surface treatment’s zwitterion polymers are known to be extremely biocompatible, and they absorb water very tightly, forming a thin hydration barrier that prevents bacteria, fungi, and other organic materials from adhering to surfaces, Kaner said. And, he noted, the technology is highly effective, non-toxic, and relatively low in cost compared with other current surface treatments for medical devices, like antibiotic- or silver-infused coatings.

Beyond its use in medical devices, the surface treatment technique could have non-medical applications, Kaner said, potentially extending the lifetimes of water-treatment devices and improving lithium-ion battery performance.

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Funding sources for the study included the National Institutes of Health, the National Science Foundation, the Canadian Institutes of Health Research, SILQ Technologies Corp, and the UCLA Sustainability Grand Challenge.

Reference: “A Readily Scalable, Clinically Demonstrated, Antibiofouling Zwitterionic Surface Treatment for Implantable Medical Devices” by Brian McVerry, Alexandra Polasko, Ethan Rao, Reihaneh Haghniaz, Dayong Chen, Na He, Pia Ramos, Joel Hayashi, Paige Curson, Chueh-Yu Wu, Praveen Bandaru, Mackenzie Anderson, Brandon Bui, Aref Sayegh, Shaily Mahendra, Dino Di Carlo, Evgeniy Kreydin, Ali Khademhosseini, Amir Sheikhi and Richard B. Kaner, 22 March 2022, Advanced Materials.DOI: 10.1002/adma.202200254

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