Effect of silver nanocoatings on catheters for haemodialysis in terms of cell viability, proliferation, morphology and antibacterial activity.

The onset of infections associated to bacterial proliferation and biofilm formation on indwelling medical devices represents the major risk of morbidity and mortality among patients. In order to contain the risk of infections in clinical practice, there is a growing interest nowadays in silver-based products due to the strong antimicrobial efficacy of silver against a broad spectrum of microorganisms. In this work, temporary catheters for haemodialysis were coated with silver nano-particles through the in situ photo-reduction of a silver salt in alcoholic solution. A homogeneous distribution of silver particles firmly bonded to the substrate was obtained through the adopted technique. An optimisation study was required to define the amount of silver, in order to obtain good efficacy against Gram-positive and Gram-negative bacteria and no cytotoxic effect. At this purpose, three concentrations of silver, 0.1, 0.25 and 0.5 wt%, have been deposited and tested with respect to bacterial reduction percentage and cellular response. Particularly, bacterial enumeration on Escherichia coli and Staphylococcus aureus, and BrdU incorporation, TUNEL assay and Actin staining on a selected primary cell population were performed on catheters treated with the different silver solutions. The silver percentages tested demonstrated strong antibacterial properties together with a good cellular response, thus indicating that the developed product could be proposed in clinical practice and that the lower percentage tested can be preferred with evident advantages in terms of costs.