Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

Madeleine Ramstedt; Isabel A. C. Ribeiro; Helena Bujdakova; Filipe J. M. Mergulhão; Luisa Jordao; Peter Thomsen; Martin Alm; Mette Burmølle; Todorka Vladkova; Fusun Can; Meital Reches; Martijn Riool; Alexandre Barros; Rui L Reis; Emilio Meaurio; Judith Kikhney; Annette Moter; Sebastian A J Zaat; Jelmer Sjollema

doi:10.1002/mabi.201800384

Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

Madeleine Ramstedt, Isabel A. C. Ribeiro, Helena Bujdakova, Filipe J. M. Mergulhão, Luisa Jordao, Peter Thomsen, Martin Alm, Mette Burmølle, Todorka Vladkova, Fusun Can, Meital Reches, Martijn Riool, Alexandre Barros, Rui L Reis, Emilio Meaurio, Judith Kikhney, Annette Moter, Sebastian A J Zaat, Jelmer Sjollema

Microbiology

27 Citations (Scopus)

Abstract

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.

Original language	English
Article number	1800384
Journal	Macromolecular Bioscience
Volume	19
Issue number	5
Number of pages	26
ISSN	1616-5187
DOIs	https://doi.org/10.1002/mabi.201800384
Publication status	Published - May 2019

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Ramstedt, M., Ribeiro, I. A. C., Bujdakova, H., Mergulhão, F. J. M., Jordao, L., Thomsen, P., Alm, M., Burmølle, M., Vladkova, T., Can, F., Reches, M., Riool, M., Barros, A., Reis, R. L., Meaurio, E., Kikhney, J., Moter, A., Zaat, S. A. J., & Sjollema, J. (2019). Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations. Macromolecular Bioscience, 19(5), Article 1800384. https://doi.org/10.1002/mabi.201800384

Ramstedt, M, Ribeiro, IAC, Bujdakova, H, Mergulhão, FJM, Jordao, L, Thomsen, P, Alm, M, Burmølle, M, Vladkova, T, Can, F, Reches, M, Riool, M, Barros, A, Reis, RL, Meaurio, E, Kikhney, J, Moter, A, Zaat, SAJ & Sjollema, J 2019, 'Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations', Macromolecular Bioscience, vol. 19, no. 5, 1800384. https://doi.org/10.1002/mabi.201800384

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abstract = "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.",

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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

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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.

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Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

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