Incorporation of Ceragenins into Medical Adhesives and Adhesive Scar Tape to Prevent Microbial Colonization Common in Healthcare-Associated Infections

Abstract

Background/Objectives: Healthcare-associated infections involving surgical sites, skin trauma, and devices penetrating the skin are a frequent source of increased expense, hospitalization periods, and adverse outcomes. Medical adhesives are often employed to help protect compromised skin from infection and to secure medical devices, but adhesives can become contaminated by pathogens, exposing wounds, surgical sites, and medical devices to colonization. We aimed to incorporate ceragenins, a class of antimicrobial agents, into silicone- and polyacrylate-based adhesives with the goal of reducing adhesive contamination and subsequent infections. Methods: Three adhesives were developed and evaluated for the release of ceragenins, antimicrobial efficacy, adhesive strength, and dermal irritation. Results: Elution profiles over two weeks showed a high initial release followed by steady, long-term release. Standard microbial challenges of the adhesives by methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, or Candida albicans demonstrated microbial reduction for 6 to 68 days. Lap shear adhesive strength was not reduced for polyacrylate adhesives containing ceragenins, and no dermal irritation was observed in an in vivo model. Conclusions: Ceragenin-containing adhesive materials appear well suited for prevention of bacterial and fungal infections associated with medical devices and bandages.

Keywords: Candida albicans; Pseudomonas aeruginosa; ceragenins; healthcare-associated infections; methicillin-resistant Staphylococcus aureus; polyacrylate adhesives; scar tape.

Figure 1

Characterization of ceragenin-containing adhesives. Polyacrylate adhesives containing CSA-44 (POLYA44), polyacrylate adhesive containing CSA-131 (POLYA131), and scar tape containing CSA-131 (SCART131). (a) 3-day rolling average of daily elution of CSA-131 and CSA-44 from medical adhesives. (b) Total extraction of CSA-44 and CSA-131 from medical adhesives. (c,d) SEM imaging of POLYA131 (c) and POLYA44 (d) with measurements of adhesive thickness. Release paper is visible above the adhesive, and the substrate pad is visible below.

Figure 2

Antimicrobial efficacy of adhesives and scar tape infused with CSA-44 or CSA-131. Daily growth of (a–c) MRSA, (d–f) P. aeruginosa, and (g–i) C. albicans in the presence of POLYA44, POLYA131, or SCART131. The unaltered adhesive on the same substrate (POLYAC) or uninfused scar tape (SCARTC) were used as controls. Tests were run in triplicate, with error bars indicating the standard deviation. * p < 0.05 according to Student’s t test. Limit of detection (2 logs CFU/mL) indicated by a horizontal line.

Figure 3

Surface-disinfecting properties of adhesives. Quantification of (a,d) MRSA, (b,e) P. aeruginosa, and (c,f) C. albicans on adhesive materials and on agar beneath adhesive materials applied to agar lawns of microorganisms. (a–c) Performance of control (POLYAC) with POLYA44 or POLYA131. (d–f) Scar tape control (SCARTC) compared with scar tape impregnated with CSA-131 (SCART131). Tests were run in triplicate, with error bars indicating the standard deviation. * p < 0.05 according to Student’s t test. Limit of detection (2 logs CFU/cm²) indicated by a horizontal line.

Figure 4

Impact of ceragenins on shear adhesive strength. (a) Schematic illustration of the lap shear test. (b) Shear strength measurements of polyacrylate adhesive controls (PACs), POLYA44 or POLYA131. Error bars represent the standard deviation. * p < 0.05.