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<p>The treatment of ventilator-associated pneumonia (VAP) remains challenging to manage, despite its high prevalence in intensive care units (ICUs). There are differences among hospitals in the prevalence of specific microorganisms that cause VAP. Thus, the initial empirical antibiotic therapy should be based on local epidemiology and general guidelines that suggest medication based on concern for multidrug-resistant bacteria. The objective of this research was to develop a strategy to decrease biofilm formation on endotracheal tube by green fabrication methods as an attempt to decrease incidence of VAP. In this study 100 microbial isolates were collected from suspected VAP cases in intensive care units. According to this study, the most frequent isolates were Klebsiella pneumoniae (36%), followed by Candida spp (17%), Neisseria spp (12%), Pseudomonas aeruginosa (10%) and Methicillin-resistant Staphylococcus aureus (MRSA) (8%). Biofilm formation, a key virulence mechanism in VAP, was detected in 55% of the bacterial isolates analyzed in this study, and all of them were strong biofilm producers. This is clinically significant as biofilm on endotracheal tubes (ETT) can be a direct source of infection in patients receiving mechanical ventilation. Furthermore, we found a 63% multi-drug resistance rate among the isolates. This study proposes a preventive strategy based on eucalyptus-mediated biosynthesis of silver nanoparticles (E-AgNPs) in an ETT. The functionalized ETT displayed nanoscale surface roughness due to embedded E-AgNPs, with EDX spectroscopy confirming silver distribution across and within the coating. Compared to the unmodified ETT, the E-AgNPs-coated tube showed notable antimicrobial properties, suppressing free-floating bacterial growth and preventing microbial attachment. The antimicrobial assessment revealed that the silver nanoparticle-coated ETT segment generated 0.5–0.7 cm inhibition zones when tested against MRSA using the agar diffusion method. To establish a robust defense against VAP, further investigation is required to define the therapeutic silver concentration in biogenic nanoparticle ETT coatings, balancing antimicrobial efficacy with biocompatibility.</p>

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Evaluating the Efficacy of Biogenic Nano-Silver Coatings on Endotracheal Tubes for Mitigating Ventilator-Associated Pneumonia in ICUs

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Esraa Amen,
  • Hala Abu Shady,
  • HebatAllah Youssef

摘要

The treatment of ventilator-associated pneumonia (VAP) remains challenging to manage, despite its high prevalence in intensive care units (ICUs). There are differences among hospitals in the prevalence of specific microorganisms that cause VAP. Thus, the initial empirical antibiotic therapy should be based on local epidemiology and general guidelines that suggest medication based on concern for multidrug-resistant bacteria. The objective of this research was to develop a strategy to decrease biofilm formation on endotracheal tube by green fabrication methods as an attempt to decrease incidence of VAP. In this study 100 microbial isolates were collected from suspected VAP cases in intensive care units. According to this study, the most frequent isolates were Klebsiella pneumoniae (36%), followed by Candida spp (17%), Neisseria spp (12%), Pseudomonas aeruginosa (10%) and Methicillin-resistant Staphylococcus aureus (MRSA) (8%). Biofilm formation, a key virulence mechanism in VAP, was detected in 55% of the bacterial isolates analyzed in this study, and all of them were strong biofilm producers. This is clinically significant as biofilm on endotracheal tubes (ETT) can be a direct source of infection in patients receiving mechanical ventilation. Furthermore, we found a 63% multi-drug resistance rate among the isolates. This study proposes a preventive strategy based on eucalyptus-mediated biosynthesis of silver nanoparticles (E-AgNPs) in an ETT. The functionalized ETT displayed nanoscale surface roughness due to embedded E-AgNPs, with EDX spectroscopy confirming silver distribution across and within the coating. Compared to the unmodified ETT, the E-AgNPs-coated tube showed notable antimicrobial properties, suppressing free-floating bacterial growth and preventing microbial attachment. The antimicrobial assessment revealed that the silver nanoparticle-coated ETT segment generated 0.5–0.7 cm inhibition zones when tested against MRSA using the agar diffusion method. To establish a robust defense against VAP, further investigation is required to define the therapeutic silver concentration in biogenic nanoparticle ETT coatings, balancing antimicrobial efficacy with biocompatibility.