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INFECTION PREVENTION & CONTROL


Positiveresultsfor catheter coating


In the UK, as many as 10,000 people die from Hospital Acquired Infections (HAIs) every year – 38% of these cases are the result of catheter-associated urinary infections. Inabid to pave the way in the battle against superbugs, Cambridge based Camstent has created the world’s first ‘bacteria-phobic’ catheter. CSJ spoke to the company’s CTO, Dr David Hampton, to find out more.


Hospital Acquired Infections (HAIs) affect millions of people around the world and cost healthcare systems billions of pounds. It is estimated that one in 25 patients will get an HAI whilst being treated in hospital – a staggering 300,000 people a year in England. As well as being painful, they lead to longer hospitals stays for patients and seriously endanger health and lives. “HAIs cost the NHS approximately £1 billion every year and one of its biggest contributors is catheter-acquired urinary tract infections (CAUTI) which are caused by bacterial colonisation of a catheter’s surface,” explained Dr David Hampton. “Most CAUTIs develop within days of the catheter being inserted and sadly, the longer it is in the patient, the chances of developing an infection increases. The reason for this is because of the bacteria biofilms that form on the catheter surface. These change the environment around the catheter leading to mineralisation, tissue damage, inflammation and infection in the adjacent tissues. “Biofilms are thin layers of


microorganisms, usually protozoa and bacteria naturally present in the body, which opportunistically colonise exposed surfaces of foreign bodies, including medical devices. The current solution is to kill the bacteria, using silver or antibiotic impregnated coatings once they begin to colonise the surface. In reality, this approach doesn’t prevent the initial establishment of bacterial biofilms, and may, indeed, affect beneficial flora and contribute to the development of antibiotic resistance. In multi-centre clinical trials, these coated catheters have so far demonstrated very limited success in reducing CAUTIs.” Rather than trying to kill bacteria once it is already on the catheter, Camstent’s approach is to prevent infectious agents from growing on surfaces in the first instance. To achieve this, the company has added a patented molecule, discovered by chemists at the University of Nottingham and first reported in Nature Biotechnology eight years ago, to the polymer covering the interior and exterior surfaces of the catheter.


This monomer changes the physical


properties of the lumen to make it inhospitable to bacterial colonisation preventing bacterial attachment without killing the bugs. Bacteria are effectively ‘blind’ to the device making it ‘bacteria- phobic’. Put another way, the device wears a non-stick jacket with the potential to ultimately reduce infection rates by simply preventing biofilm formation. In addition, it is not based on antibiotics and, therefore, will not contribute to the creation of antibiotic-resistant organisms.


Dr Hampton explained that the reason why Camstent opted for a ‘non-stick’, bacteria-phobic coating – rather than a bacteria destroying alternative – was because of its simplicity and performance: “Multicentre trials performed in the NHS confirmed that existing silver and antibiotic eluting products were not successful at reducing infection rates. Therefore, a truly innovative approach, adapting the pioneering work by the surface chemistry researchers in Nottingham was needed.” The polymers used in the coating were originally discovered by a research team led by Professor Morgan Alexander at the University of Nottingham in 2012. Scientists from the University’s Schools of Pharmacy and Life Sciences discovered a new group of structurally related polymers that dramatically reduced the attachment of pathogenic bacteria including Pseudomonas, Proteus, Staphylococcus and Escherichia coli. Also involved in the ground-breaking research was The Massachusetts Institute of Technology (MIT) in the US, which devised a micro-array process to allow the simultaneous analysis of multiple polymers. The new materials prevented infection by stopping biofilm formation at the earliest possible stage – when the bacteria attempt to stick irreversibly to the device. Camstent has taken exclusive license of the polymers for use in urological devices


58 I WWW.CLINICALSERVICESJOURNAL.COM MAY 2019


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