Antibacterial copper-filled TiO2 coating of cardiovascular implants to prevent infective endocarditis-A pilot study

Artif Organs. 2024 Apr;48(4):356-364. doi: 10.1111/aor.14688. Epub 2023 Nov 27.

Abstract

Background: Infective endocarditis (IE) poses a significant health risk, especially in patients with prosthetic heart valves. Despite advances in treatment, mortality rates remain high. This study aims to investigate the antibacterial properties of a copper titanium dioxide (4× Cu-TiO2) coating on cardiovascular implants against Staphylococcus aureus, a common causative agent of IE.

Methods: Titanium oxide carriers functionalized with copper ions were employed as an antibacterial coating for heart and vascular prostheses. The coating's antibacterial efficacy was assessed using S. aureus ATCC 29213. Microscopic evaluations were conducted on both biological and artificial materials. Antibacterial activity was qualitatively assessed via a modified disc diffusion method and quantitatively measured through colony counts in NaCl suspensions.

Results: The coating process was successfully applied to all tested cardiovascular prosthetic materials. Qualitative assessments of antibacterial effectiveness revealed an absence of bacterial growth in the area directly beneath the coated valve. Quantitative evaluations showed a significant reduction in bacterial colonization on coated mechanical valves, with 2.95 × 104 CFU per valve, compared to 1.91 × 105 CFU in control valves.

Conclusions: The 4× Cu-TiO2 coating demonstrated promising antibacterial properties against S. aureus, suggesting its potential as an effective strategy for reducing the risk of bacterial colonization of cardiovascular implants. Further studies are needed to assess the longevity of the coating and its efficacy against other pathogens.

Keywords: TiO2 coating; cardiovascular implants; coated implants; copper‐filled TiO2 coating; endocarditis; infective endocarditis.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Coated Materials, Biocompatible
  • Copper
  • Endocarditis*
  • Endocarditis, Bacterial* / prevention & control
  • Heart Valve Prosthesis*
  • Humans
  • Pilot Projects
  • Prostheses and Implants
  • Staphylococcus aureus
  • Titanium

Substances

  • Copper
  • Coated Materials, Biocompatible
  • Anti-Bacterial Agents
  • titanium dioxide
  • Titanium