Magnesium oxide coatings on thermoplastic polyurethane as a key approach to prevent catheter-associated infections

Central venous catheters (CVCs) are essential healthcare tools, but their use is often complicated by bacterial colonization on the catheter surface, leading to serious infections and life-threatening bloodstream complications. Current strategies, often reliant on antibiotics or antiseptics, are increasingly ineffective due to the rise of antimicrobial resistance. This study aimed to develop a novel antibacterial coating for CVCs by incorporating magnesium oxide (MgO) nanoparticles onto a thermoplastic polyurethane (TPU) film surface containing barium sulfate (BaSO 4 ). The antibacterial efficacy of these coatings was evaluated against Staphylococcus epidermidis , a major pathogen in catheter-associated infections. The results showed that MgO coatings significantly inhibited bacterial growth in a concentration-dependent manner, with 0.50 % and 1.0 % MgO concentrations achieving complete eradication of both planktonic and adherent bacteria. Importantly, the coatings exhibited excellent cytocompatibility with fibroblasts and showed no significant impact on hemolysis or blood clotting. The 0.50 % MgO coating was identified as the optimal formulation, offering the best balance of potent antibacterial activity, cytocompatibility and hemocompatibility. This approach preserves the valuable physical and chemical properties of the TPU material while providing effective antibacterial protection. The straightforward and cost-effective coating process holds significant promise for industrial scale production, paving the way for a new generation of safer and more effective CVCs.