title: Bactericidal effects of silver plus titanium dioxide-coated endotracheal tubes on Pseudomonas aeruginosa and Staphylococcus aureus.
abstract: OBJECTIVE
  Ventilator-associated pneumonia (VAP) is a nosocomial infection resulting in significant morbidity and mortality. Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) are pathogens associated with VAP. Silver (Ag) coating of endotracheal tubes (ETTs) reduces bacterial colonization, however titanium dioxide (TiO(2)) coating has not been studied.
  
  
  METHODS
  Five types of ETT coatings were applied over silica layer: Ag, solgel TiO(2), solgel TiO(2) with Ag, Degussa P25 TiO(2) (Degussa TiO(2)), and Degussa TiO(2) with Ag. After ETTs were incubated with P. aeruginosa or S. aureus; colonization was determined quantitatively.
  
  
  RESULTS
  Pseudomonas aeruginosa and S. aureus grew for 5 days on standard ETTs. Compared to standard ETTs, P. aeruginosa growth was significantly inhibited by solgel TiO(2) with Ag at 24 hours, and by Degussa TiO(2) with Ag at 24 and 48 hours after inoculation. No significant difference in S. aureus growth was observed between the control and any of the five coatings for 5 days.
  
  
  CONCLUSIONS
  In vitro, solgel TiO(2) with Ag and Degussa TiO(2) with Ag both attenuated P. aeruginosa growth, but demonstrated no effect on S. aureus colonization. Further studies using alternative coating and incorporating UV light exposure are needed to identify their potential utility in reducing VAP.
authors.affiliation: Division of Pediatric Critical Care Medicine, Department of Pediatrics, Rhode Island Hospital, The Warren Alpert Medical School, Brown University, Providence, RI, USA. ktarquinio@lifespan.org
authors.forename: Keiko M
authors.initials: KM
authors.lastname: Tarquinio
authors.forename: Nikhil K
authors.initials: NK
authors.lastname: Kothurkar
authors.forename: Dharendra Y
authors.initials: DY
authors.lastname: Goswami
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Sanders
authors.forename: Arno L
authors.initials: AL
authors.lastname: Zaritsky
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: LeVine
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000737:chemistry; D002470:Cell Survival / Q000187:drug effects; D020099:Coated Materials, Biocompatible / Q000008:administration & dosage*; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008422:Materials Testing; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012834:Silver / Q000008:administration & dosage* / Q000737:chemistry*; D013211:Staphylococcus aureus / Q000187:drug effects*; D014025:Titanium / Q000737:chemistry*
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; C009495:titanium dioxide; D012834:Silver; D014025:Titanium
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