Hub Region Disinfecting Nitric Oxide Releasing Insert for Tunnel Dialysis Catheters.,ACS Applied Materials & Interfaces

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Hub Region Disinfecting Nitric Oxide Releasing Insert for Tunnel Dialysis Catheters.
ACS Applied Materials & Interfaces ( IF 8.3 ) Pub Date : 2020-09-15 , DOI: 10.1021/acsami.0c13230
Joshua C Doverspike ₁ , Shale J Mack ₁ , Amy Luo ₁ , Blake Stringer ₁ , Shelby Reno ₂ , Marie S Cornell ₂ , Alvaro Rojas-Pena _{2,

3} , Jianfeng Wu ₄ , Chuanwu Xi ₄ , Alexander Yevzlin ₅ , Mark E Meyerhoff ₁

Affiliation

The use of tunneled dialysis catheters (TDCs) for patients in need of hemodialysis treatments (HDs) causes a significant number of bloodstream infections (BSIs), with very few viable preventative/treatment methods. Use of antibiotics is relatively ineffective due to the development of multidrug-resistant bacterial strains and the inability to penetrate bacterial biofilms. Nitric oxide (NO) is an endogenous gas molecule that has broad-spectrum antimicrobial/antibiofilm activity. In this study, the potential of creating a NO-releasing insert device that is attached onto the hub region cap of TDCs and locally releases NO within the TDC hub is evaluated for its antimicrobial/antibiofilm effectiveness. The NO-releasing insert contains the natural NO donor S-nitrosoglutathione (GSNO), along with zinc oxide (ZnO) nanoparticles to accelerate NO release from the GSNO, within a short silicone tube that is sealed at both ends and attached to the catheter cap. An in vitro 3-d-long antimicrobial study using catheter hubs yielded >6.6 log reductions of both Pseudomonas aeruginosa and Staphylococcus aureus for the NO-releasing insert device compared to controls. Two 14-d-long sheep studies demonstrated that the NO-releasing insert devices are exceptionally potent at preventing bacteria/biofilm growth on the inner lumen walls of TDCs compared to controls that have no preventative treatment devices as well as implanted TDCs that have commercially available chlorhexidine-treated insert devices placed within the hub regions.

中文翻译：

用于隧道透析导管的中心区消毒一氧化氮释放插入物。

对需要血液透析治疗 (HD) 的患者使用隧道式透析导管 (TDC) 会导致大量血流感染 (BSI)，而可行的预防/治疗方法却很少。由于多药耐药菌株的发展和无法穿透细菌生物膜，抗生素的使用相对无效。一氧化氮 (NO) 是一种内源性气体分子，具有广谱抗菌/抗生物膜活性。在这项研究中，评估了创建 NO 释放插入装置的潜力，该装置连接到 TDC 的轮毂区域帽并在 TDC 轮毂内局部释放 NO，以评估其抗菌/抗生物膜有效性。NO 释放插入物包含天然 NO 供体S- 亚硝基谷胱甘肽 (GSNO) 以及氧化锌 (ZnO) 纳米粒子，以加速从 GSNO 释放 NO，在两端密封并连接到导管盖的短硅胶管中。的体外3- d长的抗微生物研究使用产生导管毂>两者的6.6对数减少铜绿假单胞菌和金黄色葡萄球菌的释放NO的插入装置与对照组相比。两项长达 14 天的绵羊研究表明，与没有预防性治疗装置以及已上市的植入 TDC 的对照相比，释放 NO 的插入装置在防止 TDC 内腔壁上的细菌/生物膜生长方面非常有效氯己定处理的插入装置放置在轮毂区域内。

更新日期：2020-10-07

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