Multipronged Approach to Combat Catheter-Associated Infections and Thrombosis by Combining Nitric Oxide and a Polyzwitterion: a 7 Day In Vivo Study in a Rabbit Model

ACS Appl Mater Interfaces. 2020 Feb 26;12(8):9070-9079. doi: 10.1021/acsami.9b22442. Epub 2020 Feb 17.

Abstract

The development of nonfouling and antimicrobial materials has shown great promise for reducing thrombosis and infection associated with medical devices with aims of improving device safety and decreasing the frequency of antibiotic administration. Here, the design of an antimicrobial, anti-inflammatory, and antithrombotic vascular catheter is assessed in vivo over 7 d in a rabbit model. Antimicrobial and antithrombotic activity is achieved through the integration of a nitric oxide donor, while the nonfouling surface is achieved using a covalently bound phosphorylcholine-based polyzwitterionic copolymer topcoat. The effect of sterilization on the nonfouling nature and nitric oxide release is presented. The catheters reduced viability of Staphylococcus aureus in long-term studies (7 d in a CDC bioreactor) and inflammation in the 7 d rabbit model. Overall, this approach provides a robust method for decreasing thrombosis, inflammation, and infections associated with vascular catheters.

Keywords: CLABSI; antifouling; antimicrobial; catheter; in vivo; nitric oxide; zwitterion.

MeSH terms

  • Animals
  • Anti-Bacterial Agents* / chemistry
  • Anti-Bacterial Agents* / pharmacology
  • Catheter-Related Infections / prevention & control*
  • Catheters*
  • Coated Materials, Biocompatible* / chemistry
  • Coated Materials, Biocompatible* / pharmacology
  • Nitric Oxide* / chemistry
  • Nitric Oxide* / pharmacology
  • Rabbits
  • Staphylococcal Infections / prevention & control*
  • Staphylococcus aureus / growth & development*
  • Thrombosis / prevention & control*

Substances

  • Anti-Bacterial Agents
  • Coated Materials, Biocompatible
  • Nitric Oxide