Strategies to prevent ventilator-associated Pneumonia by modification of endotracheal tubes

Abstract

The introduction of biomaterials and biomedical devices in modern healthcare has led to significant improvements in disease diagnosis and treatment. However, infections of medical devices, such as endotracheal tubes and urinary catheters, are the leading cause of healthcare-acquired infections with endotracheal intubation and catheterization accounting for 18.5% and 43% of all nosocomial lower respiratory tract and urinary tract infections, respectively. An endotracheal tube (ET tube) is a flexible plastic tube that helps deliver air/oxygen from an artificial ventilator into lungs. The ET tubes can, however, lead to ventilator-associated pneumonia (VAP) due to impaired cough reflexes, increased accumulations of tracheal secretions and promoted bacterial colonization. VAP is a common hospital-acquired infections that occurs in 9-27% of all mechanically ventilated patients with a high mortality. Thus, strategies to prevent VAP include modifications of ET tubes to make ET tubes antibacterial were under investigation. Strategies to enhance the antibacterial properties of ET tubes that have been investigated include incorporation of antibiotics directly into ET tubes and direct modification of materials of ET tubes to make the surface superhydrophobic to resist bacterial adherence. However, these methods significantly impair the mechanical properties of materials, making them unsuitable as materials for ET tubes. Thus, the central aim of this research was to modify ET tubes to improve their properties in preventing bacterial adherence to inhibit or delay biofilm formation through surface modification strategies that avoid modification of ET tube bulk properties.

Thesis embargoed until 31st July 2028

Date of Award	Jul 2023
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Queen's University & China Scholarship Council
Supervisor	Colin McCoy (Supervisor) & Matthew Wylie (Supervisor)