TY - JOUR
T1 - Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices
T2 - Challenges and Recommendations
AU - Ramstedt, Madeleine
AU - Ribeiro, Isabel A.C.
AU - Bujdakova, Helena
AU - Mergulhão, Filipe J.M.
AU - Jordao, Luisa
AU - Thomsen, Peter
AU - Alm, Martin
AU - Burmølle, Mette
AU - Vladkova, Todorka
AU - Can, Fusun
AU - Reches, Meital
AU - Riool, Martijn
AU - Barros, Alexandre
AU - Reis, Rui L.
AU - Meaurio, Emilio
AU - Kikhney, Judith
AU - Moter, Annette
AU - Zaat, Sebastian A.J.
AU - Sjollema, Jelmer
N1 - Publisher Copyright:
© 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim
PY - 2019/5
Y1 - 2019/5
N2 - In Europe, the mean incidence of urinary tract infections in intensive care units is 1.1 per 1000 patient-days. Of these cases, catheter-associated urinary tract infections (CAUTI) account for 98%. In total, CAUTI in hospitals is estimated to give additional health-care costs of £1–2.5 billion in the United Kingdom alone. This is in sharp contrast to the low cost of urinary catheters and emphasizes the need for innovative products that reduce the incidence rate of CAUTI. Ureteral stents and other urinary-tract devices suffer similar problems. Antimicrobial strategies are being developed, however, the evaluation of their efficacy is very challenging. This review aims to provide considerations and recommendations covering all relevant aspects of antimicrobial material testing, including surface characterization, biocompatibility, cytotoxicity, in vitro and in vivo tests, microbial strain selection, and hydrodynamic conditions, all in the perspective of complying to the complex pathology of device-associated urinary tract infection. The recommendations should be on the basis of standard assays to be developed which would enable comparisons of results obtained in different research labs both in industry and in academia, as well as provide industry and academia with tools to assess the antimicrobial properties for urinary tract devices in a reliable way.
AB - In Europe, the mean incidence of urinary tract infections in intensive care units is 1.1 per 1000 patient-days. Of these cases, catheter-associated urinary tract infections (CAUTI) account for 98%. In total, CAUTI in hospitals is estimated to give additional health-care costs of £1–2.5 billion in the United Kingdom alone. This is in sharp contrast to the low cost of urinary catheters and emphasizes the need for innovative products that reduce the incidence rate of CAUTI. Ureteral stents and other urinary-tract devices suffer similar problems. Antimicrobial strategies are being developed, however, the evaluation of their efficacy is very challenging. This review aims to provide considerations and recommendations covering all relevant aspects of antimicrobial material testing, including surface characterization, biocompatibility, cytotoxicity, in vitro and in vivo tests, microbial strain selection, and hydrodynamic conditions, all in the perspective of complying to the complex pathology of device-associated urinary tract infection. The recommendations should be on the basis of standard assays to be developed which would enable comparisons of results obtained in different research labs both in industry and in academia, as well as provide industry and academia with tools to assess the antimicrobial properties for urinary tract devices in a reliable way.
KW - antimicrobial
KW - device-associated urinary tract infections
KW - in vitro
KW - in vivo
KW - material testing
UR - http://www.scopus.com/inward/record.url?scp=85065484534&partnerID=8YFLogxK
U2 - 10.1002/mabi.201800384
DO - 10.1002/mabi.201800384
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C2 - 30884146
AN - SCOPUS:85065484534
SN - 1616-5187
VL - 19
JO - Macromolecular Bioscience
JF - Macromolecular Bioscience
IS - 5
M1 - 1800384
ER -