Shravanthi T. Reddy

Micropatterned Surfaces for Reducing the Risk of Catheter-Associated Urinary Tract Infection: An In Vitro Study on the Effect of Sharklet Micropatterned Surfaces to Inhibit Bacterial Colonization and Migration of Uropathogenic Escherichia coli

BACKGROUND AND PURPOSE Catheter-associated urinary tract infection (CAUTI) is the most common device-associated infection and can result in serious medical consequences. We studied the efficacy of a novel microscopic physical surface modification (Sharklet) for preventing bacterial colonization and migration of uropathogenic Escherichia coli on silicone elastomer. MATERIALS AND METHODS In vitro growth assays evaluated E coli colonization using three variations of micropatterned silicone surfaces vs a smooth silicone control. Enumeration techniques included quantification of colonies on surfaces and analysis of bacterial area coverage and colony size. In vitro migration assays involved placement of micropatterned and smooth silicone rod segments between two agar islands to measure incidence of migration. RESULTS All three variations of the Sharklet micropattern outperformed the control surfaces in inhibiting E coli colonization. On average, 47% reduction in colony-forming units (CFUs) and bacterial area coverage plus 77% reduction in colony size were achieved with the Sharklet surfaces in tryptic soy broth and artificial urine compared with the control nonpatterned surfaces. The incidence of E coli migration over the rod segments was reduced by more than 80% for the Sharklet transverse patterned rods compared with the unpatterned control rods. CONCLUSION The Sharklet micropattern is effective at inhibiting colonization and migration of a common uropathogen. This performance is achieved through a physical surface modification without the use of any antimicrobial agents. Because deterrence of bacterial colonization and migration is a critical step to prevent CAUTI, the Sharklet micropattern offers a novel concept in addressing this important problem.

Surface micropattern limits bacterial contamination.

BackgroundBacterial surface contamination contributes to transmission of nosocomial infections. Chemical cleansers used to control surface contamination are often toxic and incorrectly implemented. Additional non-toxic strategies should be combined with regular cleanings to mitigate risks of human error and further decrease rates of nosocomial infections. The Sharklet micropattern (MP), inspired by shark skin, is an effective tool for reducing bacterial load on surfaces without toxic additives. The studies presented here were carried out to investigate the MP surfaces capability to reduce colonization of methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) compared to smooth control surfaces.MethodsThe MP and smooth surfaces produced in acrylic film were compared for remaining bacterial contamination and colonization following inoculation. Direct sampling of surfaces was carried out after inoculation by immersion, spray, and/or touch methods. Ultimately, a combination assay was developed to assess bacterial contamination after touch transfer inoculation combined with drying (persistence) to mimic common environmental contamination scenarios in the clinic or hospital environment. The combination transfer and persistence assay was then used to test antimicrobial copper beside the MP for the ability to reduce MSSA and MRSA challenge.ResultsThe MP reduced bacterial contamination with log reductions ranging from 87-99% (LR = 0.90-2.18; p < 0.05) compared to smooth control surfaces. The MP was more effective than the 99.9% pure copper alloy C11000 at reducing surface contamination of S. aureus (MSSA and MRSA) through transfer and persistence of bacteria. The MP reduced MSSA by as much as 97% (LR = 1.54; p < 0.01) and MRSA by as much as 94% (LR = 1.26; p < 0.005) compared to smooth controls. Antimicrobial copper had no significant effect on MSSA contamination, but reduced MRSA contamination by 80% (LR = 0.70; p < 0.005).ConclusionThe assays developed in this study mimic hospital environmental contamination events to demonstrate the performance of a MP to limit contamination under multiple conditions. Antimicrobial copper has been implemented in hospital room studies to evaluate its impact on nosocomial infections and a decrease in HAI rate was shown. Similar implementation of the MP has potential to reduce the incidence of HAIs although future clinical studies will be necessary to validate the MP’s true impact.

Evaluation of a bilayered, micropatterned hydrogel dressing for full-thickness wound healing.

Nearly 12 million wounds are treated in emergency departments throughout the United States every year. The limitations of current treatments for complex, full-thickness wounds are the driving force for the development of new wound treatment devices that result in faster healing of both dermal and epidermal tissue. Here, a bilayered, biodegradable hydrogel dressing that uses microarchitecture to guide two key steps in the proliferative phase of wound healing, re-epithelialization, and revascularization, was evaluated in vitro in a cell migration assay and in vivo in a bipedicle ischemic rat wound model. Results indicate that the Sharklet™-micropatterned apical layer of the dressing increased artificial wound coverage by up to 64%, P = 0.024 in vitro. In vivo evaluation demonstrated that the bilayered dressing construction enhanced overall healing outcomes significantly compared to untreated wounds and that these outcomes were not significantly different from a leading clinically available wound dressing. Collectively, these results demonstrate high potential for this new dressing to effectively accelerate wound healing.

Surface micropattern reduces colonization and medical device-associated infections

Purpose. Surface microtopography offers a promising approach for infection control. The goal of this study was to provide evidence that micropatterned surfaces significantly reduce the potential risk of medical device‐associated infections. Methodology. Micropatterned and smooth surfaces were challenged in vitro against the colonization and transference of two representative bacterial pathogens ‐ Staphylococcus aureus and Pseudomonas aeruginosa. A percutaneous rat model was used to assess the effectiveness of the micropattern against device‐associated S. aureus infections. After the percutaneous insertion of silicone rods into (healthy or immunocompromised) rats, their backs were inoculated with S. aureus. The bacterial burdens were determined in tissues under the rods and in the spleens. Results. The micropatterns reduced adherence by S. aureus (92.3 and 90.5% reduction for flat and cylindrical surfaces, respectively), while P. aeruginosa colonization was limited by 99.9% (flat) and 95.5% (cylindrical). The micropatterned surfaces restricted transference by 95.1% for S. aureus and 94.9% for P. aeruginosa, compared to smooth surfaces. Rats with micropatterned devices had substantially fewer S. aureus in subcutaneous tissues (91%) and spleens (88%) compared to those with smooth ones. In a follow‐up study, immunocompromised rats with micropatterned devices had significantly lower bacterial burdens on devices (99.5 and 99.9% reduction on external and internal segments, respectively), as well as in subcutaneous tissues (97.8%) and spleens (90.7%) compared to those with smooth devices. Conclusion. Micropatterned surfaces exhibited significantly reduced colonization and transference in vitro, as well as lower bacterial burdens in animal models. These results indicate that introducing this micropattern onto surfaces has high potential to reduce medical device‐associated infections.