PROJECT SUMMARY
Central venous catheters are indispensable healthcare devices used for a range of applications from
hemodialysis to critically ill patients. Unfortunately, central venous catheters provide a route for entry of
pathogens into the bloodstream, resulting in central line-associated bloodstream infection (CLABSI). The
pathophysiology of CLABSI comprises two main routes of infection: the extraluminal route for short-term central
venous catheters, where microorganisms enter from the insertion site and colonize the catheter tip; and the
intraluminal route for long-term central venous catheters, where frequent line manipulation introduces
microorganisms into the lumen. While many approaches for CLABSI prevention focus on aseptic techniques to
mitigate extraluminal and, to some extent, intraluminal infections, intraluminal infections remain a major source
of CLABSI. Here, we propose to develop a non-antibiotic approach to prevent CLABSI using controlled
electrochemical reactions occurring in the catheter lumen to generate the biocide hypochlorous acid (HOCl). In
preliminary work, we showed antimicrobial activity of electrochemical HOCl generation on catheter surfaces, and
in a preliminary in vitro catheter model, demonstrated that this strategy may prevent CLABSI. We further showed
that HOCl concentrations and delivery rates are controllable by tuning electrochemical parameters. We term the
devices we propose to develop that will generate intraluminal HOCl as a CLABSI prevention strategy,
electrochemical intravascular catheters (e-catheters). eCatheters will use a novel intraluminal electrochemical
system designed to deliver HOCl at concentrations ‘tuned” to prevent microbial cell growth and biofilm formation
without causing host toxicity. The e-catheters will be controlled by custom-designed micropotentiostats for use
in animals (and, eventually, in humans). The developed devices will be tested against 12 species of bacteria and
yeast in vitro and evaluated in a rabbit model of intravascular catheter-associated infection to assess prevention
of Staphylococcus aureus and Klebsiella pneumoniae CLABSI. The innovative e-catheter strategy provides an
original way to address CLABSI prevention, avoiding conventional antibiotics and therefore selective pressure
on commensal microbiota and emergence of antibiotic resistance.