A reservoir for pathogens: modifying nasogastric tube surface topography to produce anti-adherence properties

Abstract

Nasogastric tubes (NGTs) are essential medical devices widely employed in both acute and chronic care settings. Yet, their prolonged use is frequently associated with microbial colonisation and infection, contributing to patient mortality and increasing healthcare costs. This study explored novel surface modification of NGTs as a means to mitigate infection, improving patient outcomes. The investigation evaluated the anti-adherence potential of zwitterionic compounds—dimethylsulfoniopropionate (DMSP) and glycine betaine—as well as the antimicrobial properties of copper sulphate (CuSO₄). Fabricated NGT‐mimicking samples were coated with these zwitterions and compared to copper sulphate (CuSO₄)–treated discs as an antimicrobial reference. While neither zwitterion produced measurable anti-adhesive effects under current experimental conditions, copper discs yielded clear antimicrobial activity against Staphylococcus aureus, Escherichia coli and Enterococcus faecalis. Future research should focus on optimising zwitterion formulation, concentration, and coating technique, and evaluating dual-action approaches integrating anti-adhesive zwitterions with selective antimicrobial agents such as endolysins. From both clinical and economic perspectives, this interdisciplinary innovation may yield far-reaching impacts by improving patient care whilst alleviating the burden of infection-related complications.