Central line-associated
bloodstream infection (CLABSI) contributes to mortality and cost. While aseptic dressings and
antibiotic-impregnated
catheters prevent some extraluminal
infections, intraluminal
infections remain a source of CLABSIs. In this proof-of-concept study, an electrochemical intravascular
catheter (e-
catheter) prototype capable of electrochemically generating
hypochlorous acid intraluminally using
platinum electrodes polarized at a constant potential of 1.5
electrode potential relative to saturated
silver/
silver chloride reference
electrode measured in volts (VAg/AgCl) was developed. After 24 h of prepolarization at 1.5 VAg/AgCl, their activity was tested against clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, and Escherichia coli derived from
catheter-related infections. e-
catheters generated a mean HOCl concentration of 15.86 ± 4.03 μM and had a mean pH of 6.14 ± 0.79. E-
catheters prevented
infections of all four species, with an average reduction of 8.41 ± 0.61 log10 CFU/ml at 48 h compared to controls. Polarized e-
catheters which generate low amounts of HOCl continuously should be further developed to prevent intraluminal
infection. IMPORTANCE
Catheter-related infections constitute an economic and mortality burden in health care. Several options are available to reduce the risk of
infection, but only a few focus on preventing intraluminal
infection, which occurs in long-term
catheters, most often used for dialysis, prolonged treatment, or
chemotherapy. A prototype of a
catheter called an "e-
catheter" composed of three
electrodes, capable of producing
hypochlorous acid (HOCl) electrochemically in its lumen, was developed. When polarized at 1.5 V,
chloride ions in the
solution are oxidized to continuously produce low amounts of HOCl, which exhibits antibacterial activity in the lumen of the
catheter. Here, this prototype was shown to be able to generate HOCl as well as prevent
infection in a preliminary in vitro
catheter model. This approach is a potential strategy for
catheter infection prevention.