Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents bacterial colonization and biofilm formation onto catheter surfaces.
The aim of the study was to assess the anti-infective properties of NO-charged catheters exposed to low concentration (up to 103 CFU/ml) of microbial cells in-vitro. We assessed NO-charged tracheal tubes using Pseudomonas aeruginosa, dialysis and biliary catheters using Escherichia coli, and urinary catheters using E. coli, Candida albicans or Enterococcus faecalis. Safety and tolerability of NO-charged urinary catheters were evaluated in a phase 1 clinical study in 12 patients. Six patients were catheterized with NO-charged catheters (NO-group), followed by 6 patients catheterized with regular control catheters (CT-group). Comparison of safety parameters between the study groups was performed.
NO-charged tracheal, dialysis biliary and urinary catheters prevented P. aeruginosa, E. coli and C. albicans attachment and colonization onto their surfaces and eradicated corresponding planktonic microbial cells in the surrounding media after 24-48 hours, while E. faecalis colonization onto urinary catheters was reduced by 1 log compared to controls. All patients catheterized with an NO-charged urinary catheter successfully completed the study without experiencing NO-related AE's or serious AE's (SAE's).
These data highlight the potential of NO-based technology as potential platform for preventing catheter-associated HAI's.
PloS one. 2017 Apr 14*** epublish ***
David Margel, Mark Mizrahi, Gili Regev-Shoshani, Mary Ko, Maya Moshe, Rachel Ozalvo, Liat Shavit-Grievink, Jack Baniel, Daniel Kedar, Ofer Yossepowitch, David Lifshitz, Andrei Nadu, David Greenberg, Yossef Av-Gay
Division of Urology, Rabin Medical Center and Tel-Aviv University, Sackler School of Medicine, Petach-Tikva, Israel., ENOX Ltd., Habarzel 38, Tel-Aviv, Israel., Department of Medicine, Division of Infectious Disease, University of British Columbia, British Columbia Province, Vancouver, Canada.