Smart Composites for Minimising Bacterial Biofilm Formation

细菌污染是医院环境中一直存在的危害，虽然非常小心地将风险降至最低，但它仍然是一种非常常见的现象，可能会对患者的健康产生重大影响。还将出现广泛的财务问题--住院时间延长、治疗费用和工作日损失。如果由于进入管线而使进入患者组织、血液供应、消化或泌尿系统变得容易，则情况会恶化。这些有许多形式，但核心功能是相同的，而不管它们的应用，从而促进流体的直接输送，如血液，营养补充剂，药物等，虽然在现代医疗保健的宝贵援助，但它们的使用充满了困难，因为它们不幸地也打开了直接输送细菌的途径，并且总是细菌感染的主要来源之一。考虑到目前对家庭保健举措的重视，这可能会引起越来越多的关注。考虑到与控制临床环境中的细菌污染相关的问题，可以预期，在家庭的不太严格的范围内，感染的可能性要大得多。抗生素的应用是正常的临床资源，但这是一个开始遭受收益递减。一旦细菌附着在入路管路的表面，它们往往会渗出一层保护性屏障，这可以最大限度地减少抗生素的影响，并可能导致耐药性的产生，反复再感染，需要过早取出管路。与通路相关的感染是一个长期以来一直在寻求解决方案的问题，尽管已经对制造这种管路所用的材料进行了许多技术改进以使细菌污染最小化，但它们的作用往往是延迟而不是防止细菌定植。迫切需要重新思考和追求新技术，以最大限度地减少与外来细菌侵入相关的风险。拟议的项目旨在开发一个新的基础，以解决生物膜的形成和防止线的定殖。这种方法是基于将许多不同的成分结合在一起，这些成分可以被塑造成一种智能材料，当被利用时，可以将生物液体中的氧气转化为能够杀死微生物的更具反应性的形式（超氧化物，过氧化物和羟基自由基）。该装置最初将是探针的形式，该探针将驻留在管线内并沿着管线的长度延伸，并且将保持内表面没有细菌。然而，它可以转换成许多其他格式-例如用于智能绷带。然而，主要的基本原理是，该装置的下面的表面将以这样的方式进行工程设计，即可以控制羟基自由基的量，以便提供抗菌作用，但不诱导血栓溶解作用，从而不影响患者的正常组织。其关键是在探针表面上的微位点处定期产生羟基自由基，所述羟基自由基在界面处提供离散云，但其迅速扩散并在到达正常组织之前被中和。该系统的一个关键优势是它不会导致抗菌素耐药性，可以在临床范围内连续使用，并且不需要患者接受更强效的全身性抗生素。

Bacterial contamination is an ever present hazard within hospital environments and while great care is taken to minimise the risk, it is nevertheless an all too common phenomena that can significantly impact on the wellbeing of the patient. There will also be wide ranging financial issues - in terms of the increased length of hospitalisation, cost of treatment and working days lost. The situation is exacerbated where access to the patient's tissues, blood supply, digestive or urinary system has been eased as a consequence of access lines. These take many forms but the core function is the same irrespective of application whereby they facilitate the direct delivery of fluids such as blood, nutritional supplements, drugs etc. Although an invaluable aid in modern healthcare, their use is however fraught with difficulty as they unfortunately also open a pathway for the direct delivery of bacteria and are invariably one of the major sources of bacterial infection. This is likely to be of increasing concern given the emphasis that is now being placed on healthcare at home initiatives. Given the problems associated with controlling bacterial contamination within a clinical environment, it could be anticipated that infection is much more probable within the less rigorous confines of the domestic home. The application of antibiotics is the normal clinical recourse but it is one that is beginning to suffer from diminishing returns. Once the bacteria have attached to the surface of the access line they tend to exude a protective barrier that can minimise the effects of the antibiotic and can led to the development of resistance with repeated re-infection necessitating the premature removal of the line. The access related infection is a problem that has long been seeking a solution and while many technological advancement have been made to the materials used in the fabrication of such lines to minimise bacterial contamination, their action tends to be one of delaying rather than preventing bacterial colonisation. There is an urgent need for a rethink and the pursuit of new technologies that can minimise the risk associated with adventitious bacterial ingressThe proposed project seeks to develop a new foundation from which to tackle the formation of the biofilm and prevent colonisation of the lines. The approach is based on bringing together a number of distinct components that can be fashioned in to a smart material that when harnessed can convert oxygen within the biological fluid into more reactive forms(superoxide, peroxide and hydroxyl radical) capable of killing the microbes. The device would initially be in the form of a probe that would reside within and extend along the length of the line and which would keep the internal surface free of bacteria. It could however be transferrable into a number of other formats - such as for smart bandages. The main rationale however is that the underlying surface of the device would be engineered in such way that the amount of hydroxyl radicals could be controlled so as to provide the antibacterial action but not induce a thrombolytic action and thereby not affect the normal tissues of the patient. Key to this is the periodic generation of the hydroxyl radical at microsites on the probe surface that provide discrete clouds at the interface but which diffuse rapidly and are neutralised before reaching the normal tissues. A key advantage of the system is that it does not contribute to antimicrobial resistance, can be used continuously and across the clinical spectrum and does not require the patient to be subject to ever more potent systemic antibiotics.