Catheter-associated urinary tract infections (CAUTIs) are the most common health care-associated infections due to rapid bacterial colonization+ and biofilm formation in urinary catheters. This behavior has been extensively documented in medical devices. However, there is a few literature works on CAUTI providing a model that allows the exhaustive study of biofilm formation in a urinary environment. The development of an effective model would be helpful to identify the factors that promote the biofilm formation and identify strategies to avoid it. In this work, we have developed a model to test biofilm formation on urinary medical device surfaces by simulating environmental and physical conditions using a quartz crystal microbalance with dissipation (QCM-D) module with an uropathogenic strain. Moreover, we used the developed model to study the role of human albumin present in artificial urine at high concentrations because of renal failure or heart-diseases in patients. Despite model limitations using artificial urine, these tests show that human albumin can be considered as a promoter of biofilm formation on hydrophobic surfaces, being a possible risk factor to developing a CAUTI.

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bladder when they are unable to urinate on their own, relieving buildup of unwanted fluid collections, and administering medicines. During patient hospitalization, 17.5 to 23.6% of hospital patients undergo urinary catheterization, which typically leads to catheter-associated infections. [1] Catheter-associated urinary tract infections (CAUTIs) are commonly acquired in healthcare facilities, and arise from periurethral contamination and subsequent migration of uropathogenic bacteria through the urinary catheter to the bladder. [2][3][4] As a result, between 8.4 and 9.9 million of nosocomial CAUTIs occur in the United States annually, being the most common hospital-originated complication in the US, [5][6][7] representing an additional healthcare cost of $451 million dollars/year. [8] To fight against these types of infections and the formation of bacterial biofilms that cause them, a wide range of surface-engineering solutions have been developed for medical devices. Antimicrobial surfaces either make use of biocide release [9] or surface functionalities that kill bacteria on contact. [10] In contrast, antifouling surfaces prevent the initial adhesion of bacteria and the formation of biofilms through physical (surface topography modification) and/or chemical (surface chemistry modification) cues. [11] One of the most common antifouling strategy in medical devices consists in coating the device surface with hydrophilic polymers to hinder hydrophobic interactions to reduce the adhesion of proteins and bacteria. [12] For example, polyethylene glycol (PEG) and its derivatives are arguably the most widespread antifouling polymers in medical applications, [13,14] while zwitterionic polymers are emerging as a promising alternative [15,16] due to their enhanced antifouling and biofouling properties. [17][18][19] These polymers are typically grafted onto the surface of biomaterials to prevent protein and bacteria adhesion via hydration protective layers [20] and steric repulsion through mechanical agitation of their chains. [12,21] These antifouling coating methods have been extensively used in a wide array of applications and materials including micro/ nanoparticles for drug delivery [22][23][24] and metal surfaces for biosensing. [25] Although they work reasonably well in rigid substrates (such as in gold electrodes), [26] these methods present severe limitations in flexible and stretchable materials Despite modern advancements in sterilization and medical practices, bacterial infections remain a significant concern in the implantation of medical devices. There is currently an urgent need for long-lasting and high-stable strategies to avoid the adhesion of bacteria to the wide range of materials present in medical devices. Here, a versatile methodology to create antibiofouling coatings that prevent the adhesion of bacteria to silicone-based materials used in healthcare is reported. These coatings consist of bifunctional ethylene glycol dimethacrylate as an anchor between a zwitterionic polymer (SBMA), which provides ant...