Prevention of ventilation-associated pneumonia applying a functionalized endotracheal tube and photodynamic therapy: a proof of principle with an artificial intubation model

Abstract

Abstract Background Biofilm in medical devices occurs with bacterial adherence through virulence factors by a favorable environment for their proliferation. The transfer of microbial cells from biofilm in endotracheal tube to lungs increases the chances of developing severe infections. This study aimed to optimize antimicrobial photodynamic therapy (PDT) by applying a curcumin-functionalized endotracheal tube in an artificial respiratory system avoiding bacterial and their dispersion in the respiratory system, adding a mechanical ventilator. Methods This model was built containing three components representing oropharynx, trachea, and lungs. ET-curc was inserted into the system's trachea followed by biofilm formation. Results Microbial migration from Staphylococcus aureus and Methicillin-resistant S. aureus (MRSA) biofilms to the left and right lungs were evaluated with and without mechanical ventilation. PDT was applied to ET-curc using a laser (450nm) and resulted in a total bacterial inactivation, avoiding microbial flow relationships from the upper to the lower air system. The effects indicated high effectiveness in bacterial biofilm inactivation and, consequently, in the prevention of their colonization in lungs. Conclusion The results indicated that PDT can be an excellent alternative to prevent the spread of infectious lung diseases by multidrug-resistant microorganisms in patients under mechanical ventilation and provide conditions for starting animal model experiments.