A Dynamically Degradable Surface: Can We ‘Fool’ Bacteria to Delay Biofouling in Urinary Stents?

Abstract

Human body has evolved multiple strategies such as the development of a complex immune system and procurement of commensal microorganisms to deal with detrimental invasion by microbes. Despite this, biofilms pose an extremely difficult mechanism for humans to cope with infections caused by both pathogenic and opportunistically pathogenic microorganisms. Biofilms on urinary stents can lead to patient-discomfort, urinary tract infection and bacteriuria, antimicrobial resistance, stent fouling (encrustation) and obstruction. Currently, biofilm prevention and treatment in ureteral stents are carried out using a ‘static’ coating of the stent with heparin or a pH control-buffer. They increase patency but still becomes colonised by bacteria leading to biofilms. In this chapter we outline a patent-pending first-principle design strategy for a stent-coating stents that has the potential of increasing the patency by manifold and, at will. This strategy involves delaying biofouling with a ‘dynamically degradable surface’ and will be described in this chapter.