Efficacy of silver/hydrophilic poly(p-xylylene) on preventing bacterial growth and biofilm formation in urinary catheters.

Catheter associated urinary tract infections (CAUTI), caused by several strains of bacteria, are a common complication for catheterized patients. This may eventually lead to a blockage of the catheter due to the formation of a crystalline or amorphous biofilm. Inhibiting bacteria should result in a longer application time free of complaints. This issue has been investigated using an innovative type of silver-coated catheter with a semipermeable cap layer to prevent CAUTI. In this work, two different types of silver catheters were investigated, both of which were capped with poly(p-xylylene) (PPX-N) and exhibited different surface properties that completely changed their wetting conduct with water. The contact angle of conventionally deposited PPX-N is approximately 80°. After O2 plasma treatment, the contact angle drops to approximately 30°. These two systems, Ag/PPX-N and Ag/PPX-N-O2, were tested in synthetic urine at a body temperature of 37 °C. First, the optical density and the inhibition zones of both bacteria strains (Escherichia coli and Staphylococcus cohnii) were examined to confirm the antibacterial effect of these silver-coated catheters. Afterward, the efficacy of silver catheters with different treatments of biofilm formed by E. coli and S. cohnii were tested with crystal violet staining assays. To estimate the life cycles of silver/PPX-catheters, the eluted amount of silver was assessed at several time intervals by anodic stripping voltammetry. The silver catheter with hydrophilic PPX-N coating limited bacterial growth in synthetic urine and prevented biofilm formation. The authors attribute the enhanced bacteriostatic effect to increased silver ion release detected under these conditions. With this extensive preparatory analytic work, the authors studied the ability of the two different cap layers (without silver), PPX-N and oxygen plasma treated PPX-N, to control the growth of a crystalline biofilm by measuring the concentrations of the Ca2+ and Mg2+ ions after exposure of the catheters to saturated urine for 24 h. The higher concentrations of Ca2+ and Mg2+ in the precipitates on the PPX-N catheters indicates that the hydrophilic PPX-N coating is superior to the simple PPX-N coating, with regard to the formation of a crystalline biofilm. Moreover, hydrophilic PPX-N as a cap layer may promote wettability and increase silver ion release rate and thus reduce the adhesion of suspended crystals to the catheter. Reduced bacterial growth and reduced adhesion may help to prevent CAUTI.

Silver ions eluted from partially protected silver nanoparticles.

The most prominent character of a new type of antibacterial urological catheters is the zebra-stripe pattern of a silver film, which is plated electroless on their interior wall and capped by a very thin semipermeable layer of parylene. This design effectively controls the release rate of Ag(+) ions in artificial urine, which has been measured as function of time with optical emission spectroscopy. By evaluating the minimum inhibitory concentration against certain strains of bacteria with solutions of AgNO3 of known concentration with the method of optical density and applying this analysis to the silver-eluting catheters, it was shown that this moderation prolongs the period of their application significantly. But to act as antibacterial agent in chlorine-containing solutions, as in urine, the presence of urea is required to avoid precipitation of AgCl and to meet or even exceed the minimum inhibitory concentration of Ag(+). The quality of the silver depot layer was further determined by the deposition rate and its morphology, which revealed that the film consisted of grains with a mean size of 150 nm.

Microbiological investigation of an antibacterial sandwich layer system.

To allow medical application of an artificial bladder made of biocompatible polyurethane, a long-term stable antibacterial coating is required. Alone, the artificial bladder exhibits no defense against microorganisms. Silver coating provides long-term antibacterial protection by the continuous release of silver ions into aqueous solutions. To control and to prolong the rate of silver ion release, the deposited silver film has to be protected by an inert film of biocompatible polyparylene by means of chemical vapor deposition. In this study, an antibacterial artificial bladder surface was developed by the formation of a sandwich structure consisting of silver and a biocompatible polymer (polyparylene) as a diffusion barrier. Specifically, this study analyzed the correlation between polyparylene thickness and silver release to determine optimal concentrations to combat common bacteria in vitro. The release of silver from sandwich structures was investigated in vitro by testing different thicknesses of polyparylene (0, 190, 540, and 1000 nm) as a diffusion barrier. The best result was demonstrated with a thickness of 190 nm of polyparylene, which yielded a silver dispense rate of 650 pg/(cm(2)⋅min), which would yield bacteriozidal concentrations above 30 µg/l in the bladder volume. The authors confirmed the antibacterial effect in vitro against common urinary tract infection pathogens, namely, Escherichia coli and Staphylococcus cohnii. Inhibition of bacterial growth could be detected within 8 h. A diffusion assay with spherical silver spots showed concentric zones free of bacterial growth. Our results suggest the possible utility of silver-polyparylene coatings as antibacterial agents.