Antimicrobial polyurethanes for intravascular medical devices

Sapienza Univeristy of Rome, Piazzale Aldo More, Rome, Italy Corresponding author iolanda.francolini uniroma1. it 

Since the eradication of these infections with antimicrobial agents is more difficult and often such infections cause the devices to malfunction, leading to their removal, new approaches are needed to prevent bacterial colonization. 

The last method of prevention represents one of the most promising strategies developed in recent years since the antimicrobial agent adsorbed on the catheters is released directly at the infection site. Recently, inhinsicaUy antimicrobial polymers have emerged as promising candidates to address biofilm-based medical device-related infections. 

Catheter material can play an important role in the prevention of catheter-related infections (CR-Is). Indeed, more infectious complications have been associated with the use of polyvinyl chloride (PVC) or polyethylene catheters compared to catheters made of Teflon or polyurethane (PU). 

This chapter will be focused on antimicrobial PUs for intravascular applications. First, a classification of the types of PU intravascular devices and their impact in the medical held will be inhoduced. Then, a survey of infections associated with intravascular devices in terms of incidence, etiology, and pathogenesis will be presented. Next, management of device-related infections and the role of modified PUs in preventing intravascular device-related infections will be discussed. Finally, the future direction of novel antimicrobial polymers as biomaterials for the development of devices preventing biofilm-based infections will be described. 

---