Ceragenin nanogel coating prevents biofilms formation on urinary catheters

Catheter-associated urinary tract infections (CAUTIs) account for 40% of hospital-acquired infections, increasing health risks, patient discomfort, morbidity, and hospitalisation time. Bacterial colonisation may occur both during catheter insertion and prolonged catheterization by microorganisms in the urinary tract, consequently, increasing the bacteriuria risk due to biofilm formation. Nanogels, a class of soft nanocarriers, offer remarkable versatility for developing functional coatings on indwelling medical devices that can efficiently prevent biofilm formation. In this study, we designed an antibacterial and antibiofilm coating by leveraging the ultrasound-assisted assembly and nanogel self-organization on silicone catheters. The nanogel comprising biocompatible gum arabic and poly(diallyldimethylammonium chloride) was used to encapsulate a synthetic broad-spectrum antimicrobial peptide mimetic ceragenin (CSA-131). A coating from this bioactive nanogel was sonochemically built on the catheters without any prior surface modification. In vitro and in vivo assays showed that the coating provided antimicrobial and antibiofilm activity for up to 7 days of catheterization, next to catheter lubricity. Cytotoxicity assessment confirmed the absence of toxic effects, underscoring the biocompatibility of the coating formulation. These findings highlighted the potential of nanogels, combined with ultrasound technology, as an innovative approach for durable antimicrobial and antibiofilm functionalization of urinary catheters, particularly susceptible to colonisation by microorganisms upon catheterization.