A new-generation quaternized chitosan-functionalized catheter coating with high hydrophilicity and antibacterial properties

Catheter-associated urinary tract infections (CAUTIs), the most prevalent hospital-acquired infections globally, remain unresolved despite the development of antimicrobial catheters incorporating silver or antibiotics. To address this challenge, a quaternized chitosan (HTCC)-functionalized catheter was developed through oxygen plasma activation of polyvinyl chloride (PVC) surfaces, followed by polydopamine (PDA) coating and HTCC grafting. This process improves the hydrophilicity of the PVC surface, which is beneficial for reducing urethral mucosal damage in patients, inhibiting the formation of bacterial biofilms, reducing friction and improving patient comfort. This approach eliminated the need for potentially toxic silver nanoparticles and the issue of antibiotic resistance while enhancing surface hydrophilicity. The modified catheter demonstrated superior antibiofilm and antimicrobial efficacy against key uropathogens, including <i>Staphylococcus aureus</i> and <i>Escherichia coli</i>, compared to commercial PVP-urea coated PVC catheters. With its combined advantages in surface wettability, antimicrobial performance, and biocompatibility, this HTCC-based design presents a promising solution for CAUTI prevention and establishes a new paradigm for medical device coatings.