University of Nottingham
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Preventing infections - Antimicrobial devices and coatings

bacteria

The emergence and spread of microbes resistant to antibiotics is one of the greatest global threats to health. Surgical devices and implantable devices often introduce infections to the body and we are exploring different ways to prevent these, making the devices antimicrobial, with commercial success.

Antimicrobial coatings

Camstent catheter close up

Our patented class of materials are resistant to bacterial attachment. Used as a medical device coating, the materials don't work via a killing mechanism, rather they resist bacterial attachment. This has the advantage that that biofilm colonisation is prevented, potentially preventing infection in patients, and that the coating should therefore not contribute to bacterial resistance.

Camstent urinary catheters

This technology, developed by Professor Alexander Morgan, Professor Derek Irvine Professor Paul Williams, has been commercialised for urinary catheters in collaboration with Camstent.  Urinary catheters represent one of the highest causes of hospital acquired infections, costing billions of pounds each year worldwide, and which can be extremely dangerous for patients.

The Bactigon(R) catheters were awarded their CE marking in 2017 and are now undergoing clinical trials in 6 UK hospitals.

Camstent's collaboration with the University of Nottingham was shortlisted for the Times Higher Education (THE) awards 2018 in the category "Most Innovative Contribution to Business-University Collaboration"

Current developments

We are now developing new polymers:

  • With pro and anti inflammatory immune response
  • To reduce infection rates for endotracheal tubes
  • To reduce infection rates in external fixtures
  • To reduce infection rates with venous catheters

Key papers and licensing opportunities

More information about this technology can be found in

Combinatorial discovery of polymers resistant to bacterial attachment Nature Bio-technology. Vol 30, No. 9, Sept 2012.

Discovery of Novel Materials with Broad Resistance to Bacterial Attachment Using Combinatorial Polymer Microarrays. Advanced Materials. 2013, 25, 2542-2547.

Licence and commercial collaboration or investment opportunities are available for this technology.

 

 

Experts

Professor Morgan Alexander, Professor Derek Irvine, Professor Paul WilliamsProfessor Amir Ghaemmaghami

 

Antimicrobial devices

 Codman catheter Roger Bayston

We have also had great success in making the devices themselves antimicrobial. By impregnating the device materials with antimicrobials the antimicrobials continually migrate to the surface of the device, replacing surface-coated materials that may be washed or worn away in use and allowing the antimicrobial capability to last for up to 100 days - vital for in-dwelling devices.

Codman hydrocephalus shunts

Hydrocephalus (a condition causing fluid on the brain not being able to escape) raises pressure inside the head and can cause brain damage if the condition is not promptly treated. Normally a piece of equipment known as a shunt- a thin tube with a valve that is surgically implanted in the brain - is used to drain away the excess fluid to another part of the body. Unfortunately shunt treatment has a very high infection rate, which can lead to life-threatening illness and further brain damage.

Reducing infection worldwide since 2003

Helping to revolutionise the treatment of this life-threatening medical condition, the technology, developed by Professor Roger Bayston, was commercialised in 2003, as Bactiseal(R)catheters in partnership with neurosurgical device manufacturer, Codman, part of the Johnson & Johnson family of companies (now Integra Life Sciences). The FDA-approved shunts are now widely used across 66
countries, reducing infection rates from 24.5% to 4.4% for over 1,000,000
patients (>170,000 since 2016).

A recent UK NIHR-funded randomised controlled trial (BASICS trial) has just reported a very significant reduction in brain infections using our shunt, compared to silver-coated ones that made no difference. Our newest neurosurgical device is designed to prevent serious infections due to gram negative bacteria that Bactiseal is unable to prevent

Long-term urinary catheters and other devices

Further development of the technology is continuing, with applications in other devices and catheters at various stages of development, including long-term urinary catheters, peritoneal dialysis catheters, pins to mend broken bones and bone cement 

The technology shows particular promise in improving the infection rates associated with

Using  a similar technology platform and a tailored formulation our catheter retains activity against highly antibiotic – resistant bacteria for up to 12 weeks (the time when longterm catheters are usually changed). We have had very promising results from the first 30 patients trialling the technology. People with spinal cord injury, multiple sclerosis, stroke, dementia and other conditions are likely to benefit. After a i4i NIHR grant, we are now working towards a multicentre randomised controlled trial.

Fractures are often stabilised from the outside using a cage to which the broken bones are fixed with pins of wires inserted through the skin. We have developed a device that fits around the pins to reduce the infections around them, that can result in osteomyelitis (bone infection).

  • Optimisation of antimicrobial bone cement

Bone cement polymer is often used as a vehicle for antibiotics that need to be administered in high doses locally, to where the infection is. This can give rise to a peculiar form of resistance (paradoxical resistance) discovered by us that usually goes undetected. We are investigating ways in which this resistance occurs and working out ways to prevent it. This will allow companies to optimise their antibiotic bone cements and will save patients from debilitating and dangerous bone infections. 

 

 

Key papers

Roger Bayston, Leanne E. Fisher, Klaus Weber. An antimicrobial modified silicone peritoneal catheter with activity against both Gram positive and Gram negative bacteria Biomaterials 30 (2009) 3167–3173.

Bayston, R. (2017) 7.30 Cerebrospinal Fluid Shunts. In: Ducheyne, P., Grainger, D.W., Healy, K.E., Hutmacher, D.W., and Kirkpatrick, C.J. (eds.), Comprehensive Biomaterials II, vol. 7, pp. 612–627. Oxford: Elsevier.

Leanne E. Fisher, Andrew L. Hook, Waheed Ashraf, Anfal Yousef,  David A. Barrett, David J. Scurr , Xinyong Chen, Emily F. Smith, Michael Fay, Christopher D.J. Parmenter, Richard Parkinson, Roger Bayston. Biomaterial modification of urinary catheters with antimicrobials to give long-term broadspectrum antibiofilm activity. Journal of Controlled Release 202 (2015) 57–64.

Katherine Belfield, Helen Betts, Richard Parkinson, Roger Bayston. A tolerability and patient acceptability pilot study of a novel antimicrobial urinary catheter for long-term use. Neurourology and Urodynamics. 2018;1–8. DOI: 10.1002/nau.23858

 

Experts

Professor Roger Bayston, Professor of Surgical Infection, Dr Katherine Belfield, Researcher in Surgical Infection

 

Antimicrobial gloves

Surgeon wearing gloves - photo credit: www.freepik.com/free-photo/surgeon-wearing-gloves_1198266.htm - Designed by Freepik

In conjunction with medical glove makers Hartalega Malaysia and antimicrobial research and development company Chemical Intelligence UK, we have developed a new type of medical examination glove that has built in antimicrobial technology proven to prevent the spread of infection

The new gloves are the first non-leaching antimicrobial medical gloves in the world.

Read more about the technology in Hartalega's product brochure

Experts: Emeritus Professor Richard James, Professor Roger Finch, Dr Paul Wright and Tim Self

Experts

Morgan Alexander

Professor of Biomedical Surfaces, School of Pharmacy

Roger Bayston

Professor of Surgical Infection, School of Medicine

Amir Ghaemmaghami

Professor of Immunology and Immuno-bioengineering, School of Life Sciences

Derek Irvine

Professor of Materials Chemistry, Faculty of Engineering

Richard James

Emeritis Professor of Microbiology, School of Life Sciences

Tim Self

Head of SLIM - School of Life Sciences Imaging Facility

Paul Williams

Professor of Molecular Microbiology, Centre for Biomolecular Sciences

Case studies

Codman antimicrobial hydrocephalus shunts reduce infections worldwide

Camstent antimicrobial urinary catheters get CE marking

Antimicrobial medical gloves prevent the spread of infections 

Related Research Centres, Institutes and Groups

Biomaterials Related Infection Group

EPSRC Biomaterials Discovery Programme