Development of superhydrophobic poly(vinyl chloride) materials with enhanced antibacterial properties for the prevention of ventilator-associated pneumonia

• Superhydrophobic endotracheal tube surfaces where created to prevent bacterial adherence. • Silver coatings modified with hydrophobic thiols achieved water contact angles > 158°. • Surfaces displayed resistance to protein adsorption and bacterial adherence. • Passive anti-adherent surfaces show potential to reduce VAP risk. The evolution of medical devices has transformed modern healthcare. However, these devices are prone to bacterial adherence which may result in formation of biofilms. Ventilator-associated pneumonia (VAP) is associated with a high mortality rate and can be caused by biofilm formation on the surface of endotracheal tubes (ETT). Strategies to modify ETT to prevent bacterial adherence are needed to reduce the risk of VAP development. This study describes a strategy to develop superhydrophobic coatings on PVC, commonly used for ETT manufacture, to prevent adherence of clinically relevant bacteria. A superhydrophobic surface was fabricated by deposition of an adherent silver film and complexation of hydrophobic thiols, namely 1H, 1H, 2H, 2H-perfluorodecanethiol and 1-octadecanethiol on the silver surface. Superhydrophobic surfaces possessed water contact angles greater than 158° and demonstrated enhanced resistance to protein adsorption compared to unmodified PVC. Additionally, their high resistance to aqueous wetting enhanced anti-adherent properties against two common VAP pathogens (methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa ) within 24 h. The superhydrophobic PVC surfaces displayed good in vitro cytocompatibility with no significant difference compared to untreated PVC. These results indicate superhydrophobic PVC coatings may be a promising strategy to optimise ETT for the prevention of VAP.