Photodynamic therapy as a potential approach for preventing fungal spread associated with the use of endotracheal tubes

Fungal infections related to biofilm formation on medical devices, such as endotracheal tubes (ETTs), pose significant health risks, especially during intubation procedures where fungi like Candida spp. can migrate into the lower respiratory tract. This study explores the use of Photodynamic Therapy (PDT) to prevent fungal cell migration from ETT surfaces to lungs, focusing on the role of curcumin as a photosensitizer. ETTs were coated with varying concentrations of curcumin, and biofilm formation was measured after applying PDT with a 50 J/cm² irradiation dose. The study found that ETTs functionalized with a one-third concentration of CUR reduced biofilm formation by 1.78 Log, significantly lowering microbial load and potentially decreasing hospital-acquired infections. Confocal fluorescence microscopy confirmed that PDT damaged the biofilm's extracellular matrix and caused detachment of dead fungal cells. Moreover, the fluorescence analysis reveals the photodegradation behavior of the photosensitizer within the tube, providing critical insights into its stability and durability, which are essential for evaluating the long-term applicability of these tubes in clinical settings. These results suggest PDT as a promising strategy to reduce fungal infections in high-risk patients, offering potential for future clinical application in preventing device-associated infections.