Modification of Polymer Surfaces of Medical Devices to Prevent Infections

HIDEHARU SHINTANI

doi:10.4265/bio.10.3

HIDEHARU SHINTANI

Author information

Keywords: Modification, Polymer surface, Medical device, Anti-infection

JOURNAL FREE ACCESS

2005 Volume 10 Issue 1-2 Pages 3-11

DOI https://doi.org/10.4265/bio.10.3

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Published: June 01, 2005 Received: August 30, 2004 Available on J-STAGE: June 28, 2010 Accepted: November 20, 2004 Advance online publication: - Revised: -
Correction information
Date of correction: June 28, 2010 Reason for correction: - Correction: CITATION Details: Wrong : Bach, A., Bohrer, H., Motsch, J., Martin, E., Geiss, H. K., and Sonntag, H. G.(1993) Prevention of catheter-related infections by antiseptic bonding. J. Surg. Res., 55, 640-646.
Bayston, R., Path, F. R. C., and Lambert, E.(1997) Duration of protective activity of cerebrospinal fluid shunt catheters impregnated with antimicrobial agents to prevent bacterial catheter-related infection. J. Neurosurg., 87, 247-251.
Bridgett, M. J., Davies, M. C., and Denyer, S. P.(1992) Control of Staphylococcal adhesion to polystyrene surfaces by polymer surface modification with surfactants. Biomateria/s, 13, 411-416.
Brisset, L., Vernet-Garnier, V., Carquin, J., Burde, A., Flament, J.B., and Choisy, C.(1996) In vivo and in vitro analysis of the ability of urinary catheter to microbial colonization. Pathol. Biol., 44, 397-404.
Bull, E., Chilton, C. P., Gould, C. A. L., and Sutton, T. M.(1991) Single-blind, randomized, parallel group study of the bard biocath catheter and a silicon elastomer coated catheter. Br. J. Urol., 68, 394-399.
Collinge, C. A., Goll, G., Seligson, D., and Easley, K. J.(1994) Pin tract infections: silver vs. uncoated pins'', Orthopedics, 17, 445-448.
Duran, L., Driemeyer, J. E., Jelle, B. M., Jenderko, J. A., Muggli, M.E., Sitarz, K.E., and Daws, K.M.(1995) Surface modification to reduce urinary catheter infection. In Surfaces in Biomaterials: Symposium Notebook, pp.45.
Harvey, R. A., Kim, H. C., Pincus, J., Trooskin, S. Z., Wilco, J. N., and Greco, R. S.(1989) Binding of tissue plasminogen activator to vascular grafts. Thromb. Haemost. 61, 131-136.
Hogt, A. H., Dankert, T. J., Hulstaert, C. E., and Feijen, J.(1986) Cell surface characteristics of coagulasenegative Staphylococci and their adherence to fluorinated poly (ethylenepropylene). Infect. Immun., 51, 294-301.
Hogt, A. H., Dankert, T. J., and Feijen, J.(1985) Adhesion of Staphylococcus epidermidis and Staphylococcus saprophyticus onto a hydrophobic biomaterial. J. Gen. Microbiol., 131, 2485-2491.
Hogt, A. H., Dankert, T. J., De Vries, J. A., and Feijen, J.(1983) Adhesion of coagulase-negative Staphlococci to biomaterials. J. Gen. Microbiol., 129, 2959-2968.
Ista, L. K., Fan, H., Baca, O., and Lopez, G. P.(1996) Attachment of bacteria to model solid surfaces: oligo (ethylene glycol) surfaces inhibit bacterial attachment. FEMS Microbiol. Lett., 142, 59-63.
Johnson, J. R., Roberts, P. L., Olsen, R. J., Moyer, K. A., and Stamm, W. E.(1990) Prevention of catheterassociated urinary tract infection with a silver oxidecoated urinary catheter: Clinical and microbiologic Correlates. J. Infect., Dis., 162, 1145-1150.
Kamal, G. D., Pfaller, M. A., Rempe, M. E., and Jebson, P. J. R.(1991) Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. J. Am. Med. Assoc., 265, 2364-2368.
Klotz, S. A., Drutz, D. S., and Zajic, J. E.(1985) Factors governing adherence of Candida species to plastic surfaces. Infect. Immun., 50, 97-101.
Liedberg, H., and Lundeberg, T.(1990) Silver alloy coated catheters reduce catheter-associated bacteriuria. Br. J. Urol., 65, 379-381.
Liedberg, H., and Lundeberg, T.(1989) Assessment of silver-coated urinary catheter toxicity by cell culture. Urol. Res., 17, 357-360.
Lundeberg, T.(1986) Prevention of catheter-associated urinary tract infections by use of silver-impregnated catheter. Lancet, 2, 1031.
Maki, D. G., Stolz, S. M., Wheeler, S., and Mermel, L. A.(1997) Prevention of central venous catheter-related bloodstream infection by use of an antisepticimpregnated catheter: A randomized, controlled trial. Ann. Intern. Med., 127, 257-266.
Maki, D. G., Cobb, L., and Galman, J. K.(1988) An attachable silver-impregnated cuff for prevention of infection with central venous catheters: A prospective randomized multicenter trial. Am. J. Med., 85, 307-314.
Mermel, L. A., Stolz, S. M., and Maki, D. G.(1993) Surface antimicrobial activity of heparin-bonded and antisepticimpregnated vascular catheters. J. Infect. Dis., 167, 920-924.
Morris N. S., Stickler, D. J., and Winters, C.(1997) Which indwelling urethral catheters resist encrustation by Proteus mirabilis biofilms? Br. J. Urol.,. 80, 58-63.
Ostermann, P. A. W., Henry, S. L., and Seligson, D.(1994) Timing of wound closure in severe compound fractures. Orthopedics, 17, 397-399.
Pearson, M. L., and Abrutyn, E.(1997) Reducing the risk for catheter-related infections: A new strategy. Ann. Intern. Med., 127, 304- 306.
Raad, I., Darouich, R., Dupuis, J., Abi-Said, D., Gabrielli, A., Hachem, R., Wall, M., Harris, R., Jones, J., Buzaid, A., Robertson, C., Shenaq, S., Curling, P., Burke, T., Ericsson, C., and Raad, I.(1997) Central venous catheter coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. Ann. Intern. Med, 127, 267-274.
Raad, I., Darouiche, R., Hachem, R., Mansour, M., and Bodey, G. P.(1996) The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J. Infect. Dis., 173, 418-424.
Riley, D. K., Classen, D. C., Stevens, L. E., and Burke, J. P.(1995) A large randomized clinical trial of a silverimpregnated urinary catheter: Lack of efficacy and Staphylococcal Supurinfection. Am. J. Med., 98, 349-356.
Rosenberg, E., Gottlieb, A., and Rosenberg, M.(1983) Inhibition of bacterial adherence to hydrocarbons and epithelial cells by emulsan. Infect. Immun., 39, 1024-1028.
Sakamoto, I., Umemura, Y., Nakano, H., Nihira, H., and Kitano, T.(1985) Efficacy of an antibiotic coated indwelling catheter: A preliminary report. J. Biomed. Mat. Res., 19, 1031-1041.
Schierholz, J., Jansen, B., Jaenicke, L., and Pulverer, G.(1994) In-vitro efficacy of an antibiotic releasing silicone ventricle catheter to prevent shunt infection. Biomaterials, 15, 996-1000.
Shintani, H., Taniai, E., Miki, A., Kurosu, S., and Hayashi, F.(2004) Comparison of the collecting efficiency of microbiological air samplers. J. Hosp. Infect., 56, 42-48.
Shintani, H.(2003) Nosocomial infection and control, Bokin Bobai, 31, 31-337.
Tobgi, R. S., Samaranjake, L. P., and MacFarlane, T. W.(1987) Adhesion of Candida albicans to buccal epithelial cells exposed to chlorhexidine. J. Med. Vet. Mycol., 25, 335-338.
Trooskin, S. Z., Donetz, A. P., Harvey, R. A., and Greco, R. S.(1985) Prevention of catheter sepsis by antibiotic bonding. Surgery, 97, 547-551.
U. S. Food and Drug Administration, Center for devices and radiological health.(1998) Potential hypersensitivity reactions to chlorhexidine-impregnated medical devices.
Veenstra, D. L., Saint, S., Saha, S., Lumley, T., and Sullivan, S. D.(1999) Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection. J. Am. Med. Assoc., 281, 261-267.
Wang, I. W., Anderson, J. M., Jacobs, M. R. and Marchant, R. E.(1995) Adhesion of Staphylococcus epidermidis to biomedical polymers: contributions of surface thermodynamics and hemodynamic shear conditions. J. Biomed. Mater. Res., 29, 485-93.
Wassall, M. A., Santin, M., Isalberti, C., Cannas, M., and Denyer, S. P.(1997) Adhesion of bacteria to stainless steel and silver-coated orthopedic external fixation pins. J. Biomed. Mater. Res., 36, 325-330.
Winters, C., Stickler, D. J., Howe, N. S., Williams T. J., Wilkinson N., and Buckley, C. J.(1995) Some observations on the structure of encrusting biofilms of Proteus mirabilis on urethral catheters. Cells Mat., 5, 245-249.

Right : Bach, A., Bohrer, H., Motsch, J., Martin, E., Geiss, H. K., and Sonntag, H. G.(1993) Prevention of catheter-related infections by antiseptic bonding. J. Surg. Res., 55, 640-646.
Bayston, R., Path, F. R. C., and Lambert, E.(1997) Duration of protective activity of cerebrospinal fluid shunt catheters impregnated with antimicrobial agents to prevent bacterial catheter-related infection. J. Neurosurg., 87, 247-251.
Bridgett, M. J., Davies, M. C., and Denyer, S. P.(1992) Control of Staphylococcal adhesion to polystyrene surfaces by polymer surface modification with surfactants. Biomateria/s, 13, 411-416.
Brisset, L., Vernet-Garnier, V., Carquin, J., Burde, A., Flament, J.B., and Choisy, C.(1996) In vivo and in vitro analysis of the ability of urinary catheter to microbial colonization. Pathol. Biol., 44, 397-404.
Bull, E., Chilton, C. P., Gould, C. A. L., and Sutton, T. M.(1991) Single-blind, randomized, parallel group study of the bard biocath catheter and a silicon elastomer coated catheter. Br. J. Urol., 68, 394-399.
Collinge, C. A., Goll, G., Seligson, D., and Easley, K. J.(1994) Pin tract infections: silver vs. uncoated pins'', Orthopedics, 17, 445-448.
Duran, L., Driemeyer, J. E., Jelle, B. M., Jenderko, J. A., Muggli, M.E., Sitarz, K.E., and Daws, K.M.(1995) Surface modification to reduce urinary catheter infection. In Surfaces in Biomaterials: Symposium Notebook, pp.45.
Harvey, R. A., Kim, H. C., Pincus, J., Trooskin, S. Z., Wilco, J. N., and Greco, R. S.(1989) Binding of tissue plasminogen activator to vascular grafts. Thromb. Haemost. 61, 131-136.
Hogt, A. H., Dankert, T. J., Hulstaert, C. E., and Feijen, J.(1986) Cell surface characteristics of coagulase negative Staphylococci and their adherence to fluorinated poly (ethylenepropylene). Infect. Immun., 51, 294-301.
Hogt, A. H., Dankert, T. J., and Feijen, J.(1985) Adhesion of Staphylococcus epidermidis and Staphylococcus saprophyticus onto a hydrophobic biomaterial. J. Gen. Microbiol., 131, 2485-2491.
Hogt, A. H., Dankert, T. J., De Vries, J. A., and Feijen, J.(1983) Adhesion of coagulase-negative Staphylococci to biomaterials. J. Gen. Microbiol., 129, 2959-2968.
Ista, L. K., Fan, H., Baca, O., and Lopez, G. P.(1996) Attachment of bacteria to model solid surfaces: oligo (ethylene glycol) surfaces inhibit bacterial attachment. FEMS Microbiol. Lett., 142, 59-63.
Johnson, J. R., Roberts, P. L., Olsen, R. J., Moyer, K. A., and Stamm, W. E.(1990) Prevention of catheterassociated urinary tract infection with a silver oxidecoated urinary catheter: Clinical and microbiologic Correlates. J. Infect., Dis., 162, 1145-1150.
Kamal, G. D., Pfaller, M. A., Rempe, M. E., and Jebson, P. J. R.(1991) Reduced intravascular catheter infection by antibiotic bonding. A prospective, randomized, controlled trial. J. Am. Med. Assoc., 265, 2364-2368.
Klotz, S. A., Drutz, D. S., and Zajic, J. E.(1985) Factors governing adherence of Candida species to plastic surfaces. Infect. Immun., 50, 97-101.
Liedberg, H., and Lundeberg, T.(1990) Silver alloy coated catheters reduce catheter-associated bacteriuria. Br. J. Urol., 65, 379-381.
Liedberg, H., and Lundeberg, T.(1989) Assessment of silver-coated urinary catheter toxicity by cell culture. Urol. Res., 17, 357-360.
Lundeberg, T.(1986) Prevention of catheter-associated urinary tract infections by use of silver-impregnated catheter. Lancet, 2, 1031.
Maki, D. G., Stolz, S. M., Wheeler, S., and Mermel, L. A.(1997) Prevention of central venous catheter-related bloodstream infection by use of an antisepticimpregnated catheter: A randomized, controlled trial. Ann. Intern. Med., 127, 257-266.
Maki, D. G., Cobb, L., and Galman, J. K.(1988) An attachable silver-impregnated cuff for prevention of infection with central venous catheters: A prospective randomized multicenter trial. Am. J. Med., 85, 307-314.
Mermel, L. A., Stolz, S. M., and Maki, D. G.(1993) Surface antimicrobial activity of heparin-bonded and antisepticimpregnated vascular catheters. J. Infect. Dis., 167, 920-924.
Morris N. S., Stickler, D. J., and Winters, C.(1997) Which indwelling urethral catheters resist encrustation by Proteus mirabilis biofilms? Br. J. Urol.,. 80, 58-63.
Ostermann, P. A. W., Henry, S. L., and Seligson, D.(1994) Timing of wound closure in severe compound fractures. Orthopedics, 17, 397-399.
Pearson, M. L., and Abrutyn, E.(1997) Reducing the risk for catheter-related infections: A new strategy. Ann. Intern. Med., 127, 304- 306.
Raad, I., Darouich, R., Dupuis, J., Abi-Said, D., Gabrielli, A., Hachem, R., Wall, M., Harris, R., Jones, J., Buzaid, A., Robertson, C., Shenaq, S., Curling, P., Burke, T., Ericsson, C., and Raad, I.(1997) Central venous catheter coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. Ann. Intern. Med, 127, 267-274.
Raad, I., Darouiche, R., Hachem, R., Mansour, M., and Bodey, G. P.(1996) The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J. Infect. Dis., 173, 418-424.
Riley, D. K., Classen, D. C., Stevens, L. E., and Burke, J. P.(1995) A large randomized clinical trial of a silverimpregnated urinary catheter: Lack of efficacy and Staphylococcal Supurinfection. Am. J. Med., 98, 349-356.
Rosenberg, E., Gottlieb, A., and Rosenberg, M.(1983) Inhibition of bacterial adherence to hydrocarbons and epithelial cells by emulsan. Infect. Immun., 39, 1024-1028.
Sakamoto, I., Umemura, Y., Nakano, H., Nihira, H., and Kitano, T.(1985) Efficacy of an antibiotic coated indwelling catheter: A preliminary report. J. Biomed. Mat. Res., 19, 1031-1041.
Schierholz, J., Jansen, B., Jaenicke, L., and Pulverer, G.(1994) In-vitro efficacy of an antibiotic releasing silicone ventricle catheter to prevent shunt infection. Biomaterials, 15, 996-1000.
Shintani, H., Taniai, E., Miki, A., Kurosu, S., and Hayashi, F.(2004) Comparison of the collecting efficiency of microbiological air samplers. J. Hosp. Infect., 56, 42-48.
Shintani, H.(2003) Nosocomial infection and control, Bokin Bobai, 31, 31-337.
Tobgi, R. S., Samaranjake, L. P., and MacFarlane, T. W.(1987) Adhesion of Candida albicans to buccal epithelial cells exposed to chlorhexidine. J. Med. Vet. Mycol., 25, 335-338.
Trooskin, S. Z., Donetz, A. P., Harvey, R. A., and Greco, R. S.(1985) Prevention of catheter sepsis by antibiotic bonding. Surgery, 97, 547-551.
U. S. Food and Drug Administration, Center for devices and radiological health.(1998) Potential hypersensitivity reactions to chlorhexidine-impregnated medical devices.
Veenstra, D. L., Saint, S., Saha, S., Lumley, T., and Sullivan, S. D.(1999) Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection. J. Am. Med. Assoc., 281, 261-267.
Wang, I. W., Anderson, J. M., Jacobs, M. R. and Marchant, R. E.(1995) Adhesion of Staphylococcus epidermidis to biomedical polymers: contributions of surface thermodynamics and hemodynamic shear conditions. J. Biomed. Mater. Res., 29, 485-93.
Wassall, M. A., Santin, M., Isalberti, C., Cannas, M., and Denyer, S. P.(1997) Adhesion of bacteria to stainless steel and silver-coated orthopedic external fixation pins. J. Biomed. Mater. Res., 36, 325-330.
Winters, C., Stickler, D. J., Howe, N. S., Williams T. J., Wilkinson N., and Buckley, C. J.(1995) Some observations on the structure of encrusting biofilms of Proteus mirabilis on urethral catheters. Cells Mat., 5, 245-249.

Abstract

The extensive use of antibiotics to treat device-associated infections has contributed to the acceleration of the appearance of antibiotic-resistant bacteria by spreading them through contaminated hospital environments to patients (Shintani, 2003 and Shintani et al., 2004). Comprehensive research has had limited success in the reduction of device-associated infections, and usually the only therapy to treat the infections is the removal of the infected devices from patients. Recent strategies to minimize the risks of device-associated infections have focused on the following areas: good clinical practices, prudent selection of biomaterials used for device construction, and modification of device surfaces by increasing surface biocompatibility and decreasing bacterial adherence. This paper discusses from several aspects the elements of bacterial adhesion on indwelling device surfaces that may directly relate to infections and surface treatment technologies reducing the incidence of indwelling medical device-related infections.

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