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    A novel antibacterial and antifouling nanocomposite coated endotracheal tube to prevent ventilator-associated pneumonia

    Year: 2022

    Journal: J. Nanobiotechnol., Volume 20, MAR 5

    Authors: Wang, Yue; Cai, Bingyue; Ni, Dalong; Sun, Yu; Wang, Gang; Jiang, Hong

    Organizations: National Nature Science Foundation of China [82071177]; Natural Science Foundation of Shanghai [19JC141330]; Science and Technology Commission of Shanghai Municipality; Foundation of National Facility for Translational Medicine (Shanghai) [TMSK-2021-122]; Cross Research Fund project of Shanghai Ninth People's Hospital [JYJC201916]; Wu JiePing Medical Foundation [320.6750.2021-06-18]

    Keywords: Chitosan-nano silver; Surface modification; Ventilator-associated pneumonia; Antibacterial; Antifouling

    Background: The endotracheal tube (ETT) is an essential medical device to secure the airway patency in patients undergoing mechanical ventilation or general anesthesia. However, long-term intubation eventually leads to complete occlusion, ETTs potentiate biofilm-related infections, such as ventilator-associated pneumonia. ETTs are mainly composed of medical polyvinyl chloride (PVC), which adheres to microorganisms to form biofilms.Thus, a simple and efficient method was developed to fabricate CS-AgNPs@PAAm-Gelatin nanocomposite coating to achieve dual antibacterial and antifouling effects. Results: The PAAm-Gelatin (PAAm= polyacrylamide) molecular chain gel has an interpenetrating network with a good hydrophilicity and formed strong covalent bonds with PVC-ETTs, wherein silver nanoparticles were used as antibacterial agents. The CS-AgNPs@PAAm-Gelatin coating showed great resistance and antibacterial effects against Staphylococcus aureus and Pseudomonas aeruginosa. Its antifouling ability was tested using cell, protein, and platelet adhesion assays. Additionally, both properties were comprehensively evaluated using an artificial broncho-lung model in vitro and a porcine mechanical ventilation model in vivo. These remarkable results were further confirmed that the CS-AgNPs@PAAm-Gelatin coating exhibited an excellent antibacterial capacity, an excellent stain resistance, and a good biocompatibility. Conclusions: The CS-AgNPs@PAAm-Gelatin nanocomposite coating effectively prevents the occlusion and biofilmrelated infection of PVC-ETTs by enhancing the antibacterial and antifouling properties, and so has great potential for future clinical applications.
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