Dual Function Catheter to Prevent Thrombus and Infection

DESCRIPTION (provided by applicant): The objective of this work is to complete development of a novel antibacterial, acute hemodialysis catheter and conduct the preclinical testing required for FDA approval. This product will address 3 major unmet needs for intravenous catheters by: (1) providing dual function coatings that are resistant to both biofilm and thrombus, (2) incorporating antimicrobial technology that will not stimulate the growth of antibiotic resistant bacteria, and (3) improving the durationof antimicrobial activity relative to existing products. The coating is based on a combination of a novel protein resistant block copolymer and an antimicrobial peptide. Coatings will be produced by binding the peptide to surfaces in two modes (via a flexible tether and via entrapment). Recent studies indicate that this is a viable approach based on the peptide's behavior and suggests antimicrobial activity can be maintained when bound to a surface if sufficient solvent accessibility and molecular mobilityare preserved. A layer of the antibacterial peptide prepared in this way should be safe, functional, and long-lasting. A key feature of this technology is that it kills bacteria through a multi-tiered mechanism that is fundamentally different from that ofclinical antibiotics and is unlikely to cause bacteria to develop resistance. During the proposed period of support, the coating composition and application process will be optimized. Coated catheters will be evaluated for coating efficacy against clinically relevant bacteria strains, durability and mechanical properties to ensure that the coating process developed does not alter the necessary mechanical properties of the catheter. Coating components will be produced under Good Manufacturing Practice (GMPs) and a GMP manufacturing process will be developed and implemented for production of the fully coated and assembled catheter. Preclinical testing required for FDA approval of the coated catheters will also be completed. At the end of this development program, the company will be ready to submit a 510k application and plan to begin post approval clinical testing. The results of this work will have a significant impact on the ability to deliver quality care to both acute and end stage renal disease hemodialysis patients and will decrease their risks of morbidity and mortality due to infections. It will also have a significant impact on the ability to control the rapidly growing cost of treating these patient populations by preventing costly catheter related blood stream infections. PUBLIC HEALTH RELEVANCE: Antibacterial coatings are key to the prevention of medical device related infections, which are a cause of high morbidity and mortality, longer hospital stays, and unnecessary treatment costs. This project aims to develop a new antimicrobial coating technology and apply it to produce an antimicrobial hemodialysis catheter that will prevent biofilms without compromising the efficacy of the limited arsenal of clinical antibiotics. This technology is expected to substantially decrease morbidity and mortality for acute and chronic hemodialysis patients as well as help contain their treatment cost by preventing infections. This research program will potentially yield a solution to the fundamental problem ofbiofilm formation on medical devices and will be an important step toward responsible infection control.