Single Step Surface Modification of NonFluorinated Polymers for Infection Control

描述（由申请人提供）：在美国重症监护病房，导管相关血流感染（CR-BSI）的平均发生率为5/1000导管日，导致每年发生80，000次CR-BSI。CR-BSI的大多数情况是由微生物引起的，所述微生物来源于患者的皮肤并沿着导管的外表面迁移（即，腔外）或从污染的导管毂或管中排出并沿内表面沿着迁移（即，管腔内）。因此，成功的预防策略必须减少插入部位、座和管路的定植，最大限度地减少微生物从皮肤腔外或从座和管路腔内传播，和/或抑制到达导管内段的病原体的粘附和生长。最终目标是开发一种同时解决所有这三种策略的表面处理方法。该第一阶段项目的目标是引入一种独特的加工方法，以证明单步抗菌表面改性的可行性，该方法（1）可应用于各种塑料的表面，包括导管、集线器和医用管材中常用的聚合物;（2）可在复杂几何形状的内外表面上形成;（3）将通过非特异性氧化破坏和通过带负电荷的细菌细胞壁的静电排斥来抑制细菌粘附;（4）将有效对抗细菌、真菌和孢子;（5）并且将不促进增加的抗生素抗性。 公共卫生相关性：这项技术提供了一个巨大的机会，以提高临时和永久性医疗植入装置的成功率，否则可能会导致危及生命的感染并发症。有效的感染控制技术，如所提出的技术，将有助于减轻与美国每年200万医院感染相关的估计每年55亿美元的成本。

DESCRIPTION (provided by applicant): Catheter-related bloodstream infections (CR-BSI) occur at an average rate of 5 per 1,000 catheter days in intensive-care units in the United States, resulting in 80,000 episodes of CR-BSI per year. Most cases of CR- BSIs are caused by microorganisms that originate either from the skin of the patient and migrate along the external surface of the catheter (i.e., extraluminally), or from a contaminated catheter hub or tube and migrate along the internal surfaces (i.e., intraluminally). Therefore, successful prevention strategies must reduce colonization of the insertion site, hubs and tubing, minimize microbial spread extraluminally from the skin or intraluminally from the hubs and tubing, and/or inhibit adherence and growth of pathogens that reach the internal segment of the catheter. The ultimate objective is to develop a surface treatment that will simultaneously address all three of these strategies. The goal of this Phase I project is to introduce a unique processing method to demonstrate the feasibility of a single step antimicrobial surface modification that (1) can be applied to the surface of a variety of plastics, including polymers commonly used in catheters, hubs, and medical tubing; (2) can be formed on both the inner and outer surfaces of complex geometries; (3) will inhibit bacterial adhesion by nonspecific oxidative destruction and by electrostatic repulsion of negatively charged bacterial cell walls; (4) will be effective against bacteria, fungi, and spores; (5) and will not promote increased antibiotic resistance. PUBLIC HEALTH RELEVANCE: This technology provides a tremendous opportunity to improve the success rate of temporary and permanent medical implant devices that may otherwise cause life-threatening infection complications. Effective infection control technologies such as the one proposed will help alleviate the estimated $5.5 billion per year cost associated with the two million nosocomial infections acquired every year in the US.