Elliot Sherren

Background/Objectives: Healthcare-associated infections involving surgical sites, skin trauma, and devices penetrating the skin are a frequent source of increased expense, hospitalization periods, and adverse outcomes. Medical adhesives are often employed to help protect compromised skin from infection and to secure medical devices, but adhesives can become contaminated by pathogens, exposing wounds, surgical sites, and medical devices to colonization. We aimed to incorporate ceragenins, a class of antimicrobial agents, into silicone- and polyacrylate-based adhesives with the goal of reducing adhesive contamination and subsequent infections. Methods: Three adhesives were developed and evaluated for the release of ceragenins, antimicrobial efficacy, adhesive strength, and dermal irritation. Results: Elution profiles over two weeks showed a high initial release followed by steady, long-term release. Standard microbial challenges of the adhesives by methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, or Candida albicans demonstrated microbial reduction for 6 to 68 days. Lap shear adhesive strength was not reduced for polyacrylate adhesives containing ceragenins, and no dermal irritation was observed in an in vivo model. Conclusions: Ceragenin-containing adhesive materials appear well suited for prevention of bacterial and fungal infections associated with medical devices and bandages.

Healthcare-acquired infections and multi-drug resistance in pathogens pose a major crisis for the healthcare industry. Novel antibiotics which are effective against resistant strains and unlikely to elicit strong resistance are sought after in these settings. We have previously developed synthetic mimics of ubiquitous antimicrobial peptides and have worked to apply a lead compound, CSA-131, to the crisis. We aimed to generate a system of CSA-131-containing coatings for medical devices that can be adjusted to match elution and compound load for various environments and establish their efficacy in preventing the growth of common pathogens in and around these devices. Peripherally inserted central catheter (PICC) lines were selected for our substrate in this work, and a polyurethane-based system was used to establish coatings for evaluation. Microbial challenges by methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans were performed and SEM was used to evaluate coating structure and colonization. The results indicate that selected coatings show activity against selected planktonic pathogens that extend between 16 and 33 days, with similar periods of biofilm prevention.