Center for Biofilm Engineering

Abstract:  

"Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: A clinical trial" 

OBJECTIVE: Coated medical devices have been shown to reduce catheter-related infections. We coated endotracheal tubes (ETT) with silver sulfadiazine (SSD), and tested them in a clinical study to assess the feasibility, safety, and efficacy of preventing bacterial colonization. DESIGN: A prospective, randomized clinical trial, phase I-II. SETTING: Academic intensive care unit (ICU). PARTICIPANTS: Forty-six adult patients expected to need 12-24[Symbol: see text]h of intubation were randomized into two groups. INTERVENTIONS: Patients were randomized to be intubated with a standard non-coated ETT (St-ETT, n[Symbol: see text]=[Symbol: see text]23; control group), or with a SSD-coated ETT (SSD-ETT, n[Symbol: see text]=[Symbol: see text]23).

MEASUREMENTS AND RESULTS: Coating with SSD prevented bacterial colonization of the ETT (frequency of colonization: SSD-ETT 0/23, St-ETT 8/23; p[Symbol: see text]<[Symbol: see text]0.01). No organized bacterial biofilm could be identified on the lumen of any ETT; however, SSD was associated with a thinner mucus layer (in the SSD-ETT secretion deposits ranged from 0 to 200[Symbol: see text]mum; in the St-ETT deposits ranged between 50 and 700[Symbol: see text]mum). No difference was observed between the two groups in the tracheobronchial brush samples (frequency of colonization: SSD-ETT 0/23, St-ETT 2/23; p[Symbol: see text]=[Symbol: see text]0.48). No adverse reactions were observed with the implementation of the novel device.

CONCLUSION: SSD-ETT can be safely used in preventing bacterial colonization and narrowing of the ETT in patients intubated for up to 24[Symbol: see text]h (mean intubation time 16[Symbol: see text]h).


 

Berra L., T. Kolobow, P. Laquerriere, B. Pitts, S. Bramati, J. Pohlmann, C. Marelli, M. Panzeri, P. Brambillasca, F. Villa, A. Baccarelli, S. Bouthors, H.T. Stelfox, L.M. Bigatello, J. Moss, A. Pesenti, “Internally coated endotracheal tubes with silver sulfadiazine in polyurethane to prevent bacterial colonization: A clinical trial," Intensive Care Med. 2008 Apr 17 [Epub ahead of print]