Fleet, Georgia S.K.;
(2023)
Ventilator associated pneumonia: the development of an antimicrobial endotracheal tube and clinical study to understand the infection.
Doctoral thesis (Eng.D), UCL (University College London).
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Georgia Fleet Thesis - Antimicrobial Endotracheal Tubes 26Jun23 .pdf - Accepted Version Download (11MB) | Preview |
Abstract
This thesis describes the development of light activated antimicrobial materials for use in medical devices, as a way to reduce the need for antibiotics in hospitals and consequently slow down the progression of the antimicrobial resistance crisis. As well, to help combat common hospital acquired infections such as ventilator associated pneumonia (VAP), which is the largest cause of death in critical care units (Prof D. Walker, University College Hospital London, 2019). An antimicrobial endotracheal tube was developed to reduce the mortality caused by VAP, as VAP is caused by bacterial biofilms growing on the endotracheal tube. An antimicrobial endotracheal tube was developed here both by using swell encapsulation methods and alternatively by a photocured 3D printing method. Both endotracheal tubes utilise a mix of photosensitizer dye combined with nanoparticles (gold nanoclusters for the swell encapsulated or zinc oxide nanoparticles for the 3D printed) which are then incorporated into polymers by the chosen method. The antimicrobial activity was tested against clinically relevant isolates of P. aeruginosa, E. coli and MRSA cultured directly from extubated endotracheal tubes. The antimicrobial activity was tested in the dark as well as with laser light and white light activation. Within 15 minutes of laser light exposure and 3 hours of white light exposure all isolates were eliminated for both swell encapsulated and 3D printed endotracheal tubes. As well, both antimicrobial endotracheal tubes were able to inactivate infectivity of SARS-CoV-2 within 15 minutes in the dark with no light activation required. To our knowledge this is the most active broad-spectrum material of this kind developed to date; and has a wide range of potential applications due to its powerful antimicrobial properties. An ongoing clinical study has supported this work by analysing extubated endotracheal tubes from patients who were intubated for 5 or more days and provides insights into the types of organisms growing on endotracheal tubes as well as a potential rapid diagnostic technique by using NMR analysis.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Eng.D |
| Title: | Ventilator associated pneumonia: the development of an antimicrobial endotracheal tube and clinical study to understand the infection |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Chemistry |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10173682 |
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