“…Furthermore, in the presence of urease-producing bacteria forming salt crystals on the surface, the catheter can be easily roughened to further increase friction, if not treated timely, causing massive obstruction (i.e., encrustation), antibiotic resistance of bacteria, and severe bacterial infection (Wang et al, 2015). To solve this problem, several antibacterial coating strategies have been developed including passive anti-adhesion to repel bacterial adhesion [e.g., poly(N-hydroxyethylacrylamide), and zwitterionic polymers], and active biocidal coating that can directly kill the bacteria on the surface (e.g., chitosan, N-halamine polymer, and other polymers with strong positive charges) combined with antibiotic agents to maximize the efficacy (e.g., silver; Dallas et al, 2011;Zhao et al, 2013;Ng et al, 2014;GhavamiNejad et al, 2016;Li et al, 2017;Yong et al, 2019). Along with the absence of surface functional groups in the elastomers used for urethral catheters, surface modification requires material-specific complexes and toxic chemical reactions producing coatings that lack appropriate mechanical stability for long-term use in a dynamic environment in vivo, hampering the translation into clinic (Voccia et al, 2006;Such et al, 2010).…”