Patent Publication Number: US-2019168023-A1

Title: Method, system, and devices of safe, antimicrobial light-emitting catheters, tubes, and instruments

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims priority to earlier filed U.S. Provisional Application Ser. No. 62/501,679, filed May 4, 2017, the contents of which are incorporated herein by reference. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present patent document relates generally to catheters, tubes, and instruments and more particularly to antimicrobial light-emitting catheters, tubes, and instruments that are safe to human tissue. 
     2. Description of the Related Art 
     A catheter is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted into various body cavities, ducts, or vessels to treat diseases, provide access for surgical procedures, facilitate drainage of bodily fluids, and allow administration of fluids or gases, among other functions. Through modification of catheter materials or design, it is possible to tailor catheters for vascular, cardiovascular, neurovascular, neurological, renal, urological, oncologic, gastrointestinal, spinal, peripheral intervention, endoscopic, patient-monitoring, surgical, interventional radiology, respiratory, wound management, ophthalmic applications, among others. 
     The process of inserting a catheter is catheterization. Catheters may be flexible or very stiff, depending upon the intended use. 
     A catheter left inside the body, either temporarily or permanently, may be referred to as an indwelling catheter (for example, a peripherally inserted central catheter). A permanently inserted catheter may be referred to as a permcath. 
     Despite the many benefits and necessity of using catheters, use is not without problems, such as the well-documented risk of catheter-related infections. 
     Regarding urinary catheters (also called Foley catheters), urinary tract infections (UTI) associated with these catheters are the leading cause of secondary health care-associated bacteremia. Approximately 20 percent of hospital-acquired bacteremias arise from the urinary tract, and the mortality associated with this condition is about 10 percent. 
     Bacteriuria in patients with indwelling bladder catheters occurs at a rate of approximately 3 to 10 percent per day of catheterization. Of those with bacteriuria, approximately 10 to 25 percent develop UTI. The most important risk factor is the duration of catheterization. Other risk factors include errors in catheter care, such as failure to adhere to antiseptic technique. 
     For intravascular catheters, nosocomial (hospital-acquired) bloodstream infections (BSIs) are an important cause of morbidity and mortality, with an estimated 250,000 cases occurring each year in the United States. Sixty-four percent of the nosocomial BSIs reported were primary BSIs. Most primary BSIs are associated with intravascular catheters, and central venous catheters (CVCs) in particular. Approximately 90 percent of annual catheter-related bloodstream infections in the United States occur with CVCs. Prospective studies have shown that every intravascular device confers a risk of infection to patients, although some (e.g., non-tunneled central venous catheters and pulmonary artery catheters) carry greater risk than others (e.g., peripheral intravenous catheters). For central venous catheters, the site of catheter placement affects the risk of infection, with the subclavian site being associated with less risk than others. Although there is a lower risk of infection, there is a substantially higher risk of pneumonia. 
     Indwelling catheters are a frequent source of infection in many populations who required long-term venous access, including hemodialysis and oncology patients as well as those receiving total parenteral nutrition. In 2008 in the United States, an estimated 37,000 CR-BSIs occurred among patients receiving outpatient hemodialysis. Similarly, tubes and instruments used in healthcare settings are also prone to colonization by microorganisms, which may, in turn, lead to infection of the exposed patient. 
     The risk of catheter-associated infection is multifactorial, dependent on host factors (e.g., chronic illness, immune deficiency, loss of skin integrity) and catheter factors (e.g., catheter type, location of catheter, and duration of placement). The sources of infection from a catheter can be attributable to four major sources: colonization from the skin, intraluminal or hub contamination, secondary seeding from a bloodstream infection (extraluminal), and, rarely, contamination of the infusate. Catheter-based approaches to reduce one or more of the sources of infection merit application—in particular, efforts aimed to reduce microorganisms at the skin and catheter tube. 
     Current strategies for reducing catheter, tubes, and instrument related infections include use of antibiotics and microbial resistant coatings. However, coatings or material modifications do not kill already colonized organisms. Antimicrobial-impregnated catheters, such as with chlorhexidine-silver sulfadiazine, have failed to reduce infection rates. Minocycline-rifampin-coated tubes, instruments and catheters have increased risk of anaphylaxis and emergence of resistant organisms. Experiments with silver-impregnated collagen cuffs have resulted in no bacteremia benefit in trials of tunneled catheters or double or triple lumen catheters. Use of Heparin bonding to reduce thrombosis which may or not be related to infection, have not resulted in specific benefits. Antibiotic locks have increased risk of development of resistant organisms. Further, use of antibiotics, however, is only after the patient has contracted an infection, which is undesirable. The use of antibiotics can cause adverse and systemic effects. Furthermore, the rise of antibiotic resistant strains of bacteria has made treatment of infections more difficult. Antimicrobial coatings for medical devices generally have proven ineffective at preventing infections. Antimicrobial coatings may only be able to prevent or slow bacterial colonization (i.e., bacteriostatic) but are not able to reduce or kill bacteria already colonized on a surface (i.e., bactericidal). 
     New approaches to combating infection without the use of antibiotics are needed to reduce or slow antibiotic resistance. The rising problem of antibiotic resistance has prompted precautions against creating, and if possible eliminate, multidrug resistance in concert with exploring new methods to kill pathogenic microorganisms. The investigation of novel non-antibiotic approaches, which can prevent and protect against infectious diseases should be prioritized. Promising non-antibiotic approaches include light-based technologies. Advantages of light-based antimicrobial therapies lie in their ability to eradicate microbes regardless of antibiotic resistance, and the fundamental improbability of the microbes themselves developing resistance to these light-based therapies due to the rather non-specific nature of the targets and the dynamic modifiability of various light parameters at the first sign of organism tolerance. 
     Although promising, not all light-based antimicrobial approaches may be applicable for integration into devices such as catheters, tubes, and instrument applications. For example, specific wavelengths in the ultraviolet spectrum are known to cause harmful effects to human tissue (e.g., cancer) and can degrade many natural and synthetic polymers. As such, these particular wavelengths would preclude safe use in medical devices that are inserted into the patient. Therefore, certain light-based antimicrobial approaches may be applicable for integration into catheter, tube, and instrument applications to reduce associated infections. 
     Accordingly, there is a need in the art for patient-safe, non-antibiotic, germicidal catheters, tubes, and instruments that kill microorganisms on their surfaces to reduce the risk of infection. 
     SUMMARY OF THE INVENTION 
     The light-emitting antimicrobial catheter solves the problems noted in the prior art by providing a catheter that includes a thin, flexible tube having an optically transparent wall; and a light transmitter configured and arranged to emit light through the tube, which may be ultraviolet C (UVC) irradiation, photodynamic therapy (PDT), violet-blue light therapy, and other light-based therapies. In one embodiment, violet-blue wavelengths (from 400-500 nm) of visible spectrum light that have both antimicrobial effects and are safe to expose to human tissue, such as 405 nm or 415 nm in wavelength, may be used. A patient is catheterized with the catheter and a prophylactic or therapeutic amount of light is administered to the patient, thereby reducing the risk of infections introduced from the catheter itself, or received through the opening in the body that receives the catheter. The antimicrobial light targets sources of infection, in particular at the skin interface and the tube (intraluminal and outer surface). The catheter may be configured for use in any application, including the urinary tract, intravascular, ventricular drains, neuro catheters, epidural catheters, suction catheters, rectal tubes, or any other catheter, tube, and tube-like instruments that may be indwelling or temporary in placement. Light may be administered for any duration sufficient to kill pathogens. Additionally, the emitted light may be pulsed, varied in intensity, applied when or before the catheter device is inserted or used. The variables of intensity, duration, and wavelength may be adjusted as needed or necessary to achieve the maximum antimicrobial or therapeutic effect while minimizing any side effects to the patient. Furthermore, visible spectrum violet-blue light (e.g., 405 nm and 415 nm wavelength) is considered safe to mammalian cells thereby making both safe to the patient and therapeutic in its germicidal efficacy. Although the mechanism of the antimicrobial effect of visible spectrum violet-blue light is still not fully understood, the commonly accepted hypothesis is that violet-blue light excites endogenous intracellular porphyrins, and this photon absorption then leads to energy transfer and ultimately, the production of highly cytotoxic reactive oxygen species. The biocidal effect of violet-blue light represents a photodynamic inactivation mechanism that involves the absorption of photons in the region of 405 nm by endogenous porphyrin molecules within microbial cells. This absorption initiates excitation of the porphyrin molecules, and excited porphyrins interact with oxygen or cell components to produce reactive oxygen species (ROS) causing oxidative damage and microbial cell death. Cell death has been accredited to oxidative damage to the cell membrane; however, it is likely that, due to the non-selective nature of ROS, multi-target damage will be induced in exposed microbial cells. 
     For instance, by way of example and not limitation, some pathogens found to be susceptible to violet-blue antimicrobial visible spectrum light include bacteria, yeast, fungi, spores, and viruses, such as  Clostridium difficile, Clostridium perfringens, Enterococcus, Listeria,    Methicillin -resistant  Staphylococcus aureus  (MRSA),  Propionibacterium acnes, Salmonella enteritidis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mutans, Streptococcus pyogenes,  other  Streptococci  species,  Vancomycin -resistant  Enterococcus, Streptomyces phage  ΦC31 , Bacillus cereus, Bacillus megaterium, Bacillus subtilis, Acinetobacter baumannii, Campylobacter jejuni, Escherichia coli, Fusobacterium nucleatum, Helicobacter pylori, Klebsiella pneumoniae, Mycobacterium, Porphyromonas gingivalis, Prevotella intermedia, Prevotella melaninogenica, Prevotella nigrescens, Proteus vulgaris, Pseudomonas aeruginosa, Shigella sonnei, Aspergillus niger, Candida albicans, Saccharomyces cerevisiae, Enterobacter,  and  Serratia , among others 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       These and other features, aspects, and advantages of the present invention will become better understood with reference to the following description, appended claims, and accompanying drawings where: 
         FIG. 1A  is a perspective view of a first embodiment of an antimicrobial light-emitting catheter configured for urinary tract use; 
         FIG. 1B  is a perspective view of a second embodiment of an antimicrobial light emitting catheter configured for intravascular use; 
         FIG. 1C  is a perspective view of a third embodiment of an antimicrobial light emitting catheter configured for intravascular use; 
         FIG. 2  is a block diagram of light transmitter; 
         FIG. 3A  is a cross-sectional view of a first embodiment of a side embedded light transmitter on the catheter tube; 
         FIG. 3B  is a cross-sectional view of a second embodiment with multiple side embedded light transmitters on the catheter tube; 
         FIG. 3C  is a cross-sectional view of a third embodiment with a wall emitter; 
         FIG. 3D  is a cross-sectional view with a fourth embodiment with an add-on sleeve on the catheter tube; 
         FIG. 3E  is a cross-sectional view with a fourth embodiment with an add-on sleeve on the catheter tube; 
         FIG. 3F  is a partial cross-section view illustrating use of an intravascular catheter inserted in a patient; 
         FIG. 4  is a flow chart of a method of treatment using the antimicrobial catheter as disclose herein; 
         FIG. 5A  is a partial perspective view of an exemplary embodiment of a central venous catheter made in accordance with the present invention; 
         FIG. 5B  is a partial perspective view of another exemplary embodiment of a central venous catheter made in accordance with the present invention; 
         FIG. 5C  is a perspective view illustrating use on a patient of a central venous catheter made in accordance with the present invention; 
         FIG. 5D  is a partial perspective view of an exemplary embodiment of a central venous catheter made in accordance with the present invention with an integral light emitter; 
         FIG. 5E  is a partial perspective view of another exemplary embodiment of a central venous catheter made in accordance with the present invention with an integral light emitter; 
         FIG. 5F  is a perspective view illustrating use on a patient of a central venous catheter made in accordance with the present invention; 
         FIG. 6A  is a partial perspective view of an exemplary embodiment of a long-term hemodialysis catheter made in accordance with the present invention; 
         FIG. 6B  is a perspective view illustrating use on a patient of a long-term hemodialysis catheter made in accordance with the present invention; 
         FIG. 6C  is a partial perspective view of another exemplary embodiment of a long-term hemodialysis catheter made in accordance with the present invention having an integral light emitter; 
         FIG. 6D  is a perspective view illustrating use on a patient of a long-term hemodialysis catheter having an integral light emitter made in accordance with the present invention; 
         FIG. 7A  is a partial perspective view of an exemplary embodiment of a PICC line made in accordance with the present invention; 
         FIG. 7B  is a perspective view illustrating use on a patient of a PICC line made in accordance with the present invention; 
         FIG. 7C  is a partial perspective view of another exemplary embodiment of a PICC line made in accordance with the present invention, having an integral light emitter; 
         FIG. 7D  is a partial perspective view illustrating use on a patient of another embodiment of a PICC line made in accordance with the present invention, having an integral light emitter; 
         FIG. 7E , is a partial perspective view illustrating use on a patient of yet another embodiment of a PICC line made in accordance with the present invention; 
         FIG. 8A  is a perspective view of an exemplary embodiment of an endotracheal tube made in accordance with the present invention, with a removable light emitter attached thereto; 
         FIG. 8B  is a perspective view of an exemplary embodiment of an endotracheal tube made in accordance with the present invention, illustrating a light emitter detached therefrom; 
         FIG. 8C  is a partial perspective view illustrating intubation of a patient with an endotracheal tube made in accordance with the present invention, with the light emitter removed; 
         FIG. 8D  is a partial perspective view illustrating an intubated patient with an endotracheal tube made in accordance with the present invention, with the light emitter attached; 
         FIG. 9A  is a partial perspective view of an exemplary embodiment of a urinary catheter made in accordance with the present invention; 
         FIG. 9B  is an illustration of use of a urinary catheter, generally; 
         FIG. 9C  is a perspective view illustrating use on a patient of a urinary catheter made in accordance with the present invention; 
         FIG. 10A  is a front, side perspective view of an exemplary embodiment of a subdermal port made in accordance with the present invention; 
         FIG. 10B  is a rear, side perspective view of an exemplary embodiment of a subdermal port made in accordance with the present invention; 
         FIG. 10C  is a perspective view illustrating use on a patient of a subdermal port made in accordance with the present invention, with the light emitter activated; 
         FIG. 10D  is a perspective view illustrating use on a patient of a subdermal port made in accordance with the present invention, with the light emitter deactivated; 
         FIG. 11A  is a partial perspective view of an exemplary embodiment of a Peritoneal dialysis catheter made in accordance with the present invention; 
         FIG. 11B  is a partial perspective view illustrating use on a patient of a Peritoneal dialysis catheter made in accordance with the present invention; 
         FIG. 12A  is a partial perspective view of an exemplary embodiment of a peripheral intravenous catheter made in accordance with the present invention; 
         FIG. 12B  is a perspective view illustrating use on a patient of a peripheral intravenous catheter made in accordance with the present invention; 
         FIG. 13A  is a partial perspective view of an exemplary embodiment of a short-term hemodialysis catheter made in accordance with the present invention; 
         FIG. 13B  is a perspective view illustrating use on a patient of a short-term hemodialysis catheter made in accordance with the present invention; 
         FIG. 13C  is a partial perspective view of another exemplary embodiment of a short-term hemodialysis catheter made in accordance with the present invention having an integral light emitter; 
         FIG. 13D  is a perspective view illustrating use on a patient of a short-term hemodialysis catheter having an integral light emitter made in accordance with the present invention; 
         FIG. 14A  is a perspective view illustrating use of a light emitter on medical tubing; 
         FIG. 14B  is a perspective view of medical tubing that could a light emitter could be coupled thereto to create an antimicrobial effect; 
         FIG. 14C  is a perspective view of a medical device having tubing where a light emitter may be attached thereto to create an antimicrobial effect; and 
         FIG. 14D  is a perspective view of a beverage dispensing system with tubing that a light emitter may be attached thereto to create an antimicrobial effect. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     As will be described in greater detail below, the light-emitting, antimicrobial instruments, tubes, and catheters includes a thin, flexible tube having an optically transparent wall; and a light transmitter configured and arranged to emit light through the tube and/or other portions of the instrument, which may be ultraviolet C (UVC) irradiation, photodynamic therapy (PDT), violet-blue light therapy, and other light-based therapies. In one embodiment, antimicrobial light that is safe to expose to human tissue, visible spectrum violet-blue light from 400-500 nm in wavelength, such as 405 nm or 415 nm, for instance, may be used. The instrument, tube, or catheter is used on a patient and a therapeutic amount of light is administered to kill any microbes on the surface of the instrument, tube, or catheter, thereby reducing the risk of infection to the patient. The instrument, tube, or catheter may be configured for use in cardiovascular, neurovascular, neurological, renal, urological, oncologic, gastrointestinal, spinal, peripheral intervention, endoscopic, patient-monitoring, surgical, interventional radiology, respiratory, wound management, ophthalmic or any other health application, and may be indwelling or temporary. Light may be administered for the duration of use or another time period, such as 5, 10, 15, 30 or 60 minutes, for instance. Because the antimicrobial properties of visible spectrum violet-blue light, the risk of bacterial infection through the use of the instrument, tube, or catheter is reduced. 
     Referring to  FIG. 1A  a first embodiment of a light-emitting antimicrobial catheter for use in the urinary tract is illustrated generally at  10 . The catheter  10  includes an optically transparent tube  12  with a tip  14  and a drain  16 . The catheter  10  may include an inflatable balloonl 8  near the tip  14 . An inflation port  20  is provided to inflate the balloon  18 . In some configurations, the catheter  10  may include an irrigation port  22  as well. A light transmitter  24  is connected to the tube  12  and configured to emit light through the optically transparent wall of the catheter  10 . The light transmitter  24  may include a side-emitting optical fiber  26  connected to a light source  28 , a control circuit  30  to control the light source  28 , and a power source  32 , to power the light source  28  and control circuit  30 . In some embodiments, the drain  16 , inflation port  20 , and/or irrigation port  22  may also be made from optically transparent material to transmit light to the patient&#39;s skin underlying the catheter  10 . 
     Referring to  FIG. 1B  a second embodiment of a light-emitting antimicrobial catheter for intravascular use is illustrated generally at  40 . In particular, a peripheral venous catheter is shown. The catheter  40  includes a tip  42  for insertion into a vein of the patient and delivery of a cannula  44  into the vein and wings  46  for handling and securing the catheter  40  with adhesive to the patient&#39;s body. The cannula  44  is an optically transparent tube for delivery for fluids and medication into the vein. The exterior portion of the body of the catheter  40 , including wings  46 , may be optically transparent plastic as well, for delivery of light from the light emitter to the skin of the patient underlying the catheter  40 . The tip  42  is partially withdrawn after insertion of the cannula  44 , leaving the cannula  44  within the vein. A valve  48  may be provided for delivery of medication by syringe to the patient. A port  50  may be included for connection of an infusion line to the catheter  40 . A clamp  52  may be included to shut off the catheter  40 , for example, during change of intravenous fluid drip. A light transmitter  24  is connected to the cannula  44  and configured to emit light through the optically transparent wall. The light transmitter  24  may include a side-emitting optical fiber  26 , connected to a light source  28 , a control circuit  30  to control the light source  28  and a power source  32 , to power the light source  28  and control circuit  30 . 
     Referring to  FIG. 1C  a third embodiment of a light-emitting antimicrobial catheter for intravascular use is illustrated generally at  60 . In particular, a hemodialysis catheter is shown. The catheter  60  includes a tip  42  for insertion into a vein of the patient. The catheter  60  includes a cannula  68  which includes a venous lumen  64  and an arterial lumen  66 , for drawing away and returning blood, respectively, to the patient. The lumens  64 ,  66  and cannula may be formed from an optically transparent material. Each lumen may include its own port  70 . Each lumen may also include a clamp  72  to shut off the respective lumen  64 ,  66 . A light transmitter  24  is connected to the lumen  64 ,  66  and/or cannula  68  and configured to emit light through the optically transparent material. The light transmitter  24  may include a side-emitting optical fiber  26 , connected to a light source  28 , a control circuit  30  to control the light source  28  and a power source  32 , to power the light source  28  and control circuit  30 . 
     Referring to  FIG. 2 , an illustration of an embodiment of a light transmitter  24  is shown generally. The light transmitter  24 , as noted above, includes a light source  28 , such as an LED laser module that may be optically connected to an optical fiber monofilament  26 . The light source  28  is electrically connected to a control circuit  30  to control the functioning of the light source  28 , which will be further described below. Extending from the control circuit  30  is an optional connector  34  electrically connected to the control circuit  32 , for connecting to a power source  32 , such as a battery or DC power supply. The optional connector  34  allows a power source  32  to be easily changed; for instance, a fresh battery provided. The light source  28  may be configured to emit light in antimicrobial light wavelengths. In one embodiment, the light source  28  is configured to emit light in a wavelength of 405 nm or 415 nm. The light source may be configured to emit any wavelength of light, which have been shown to have antimicrobial properties without the adverse risks associated with certain electromagnetic radiation wavelengths. The light transmitter may include an optional housing  25  to enclose and protect the components of the light transmitter  24 . 
     In some embodiments, the control circuit  30  may provide additional functionality besides mere power management and an ON/OFF control  36  for the light source  28 . For instance, the control circuit  30  may include a timer function  37  for automatic shutoff after a preselected amount of time, such as 5, 10, 15, 30 or 60 minutes or longer. Alternatively, or in addition to, the preselected amount of time may be user settable to any desired time period. The control circuit  30  may also include an intensity function  38  to control the brightness or intensity of the emitted light from the light source  28 . In some embodiments, the control circuit  30  may also include a wavelength function  39  to select the wavelength of emitted light to a desired wavelength form the light source  28 . In some embodiments, the control circuit  30  may include a function to pulse the light source  28  at predetermined intervals and/or patterns. In some embodiments, the control circuit  30  may include a display  41  to show information regarding the timer, intensity and/or wavelength. The control circuit  30  may be integrated with the light source  28 . 
     Referring to  FIGS. 3A-3D , the light transmitter  24  may be connected to the optically transparent tube or cannula of the catheter in a variety of configurations, described in greater detail below. As mentioned above, the light transmitter may include a side-emitting optical fiber  26 , which may be a monofilament. These images are not to scale, but illustrated to accentuate the respective structures for better understanding. 
     Referring to  FIG. 3A , a cross-sectional view of a first embodiment where an optical fiber  26  is embedded on the wall of the catheter tube  12 . In this configuration, the optical fiber  26  is integrally formed with the catheter tube  12 ,  44  such that light emitted from the optical fiber  26  transmits through the catheter tube  12 ,  44 . 
     Referring to  FIG. 3B , a cross-sectional view of a second embodiment with multiple side embedded optical fibers  26  on the catheter tube  12 ,  44 . In particular, two or more fiber optic monofilaments  26  may be integrally formed in the catheter tube  12 ,  44 , thus ensuring uniform exposure of light from the light source  28  from all directions. 
     Referring to  FIG. 3C , a cross-sectional view of a third embodiment with a wall emitter, where the light source  28  is optically connected to the catheter tube and configured to emit light directly through the catheter tube  12 ,  44  without need for a separate waveguide, such as an optical fiber. 
     Referring to  FIG. 3D , a cross-sectional view of a fourth embodiment where an optical fiber  26  is embedded within the wall of the catheter tube  12 . In this configuration, the optical fiber  26  is integrally formed with the catheter tube  12 ,  44  such that light emitted from the optical fiber  26  transmits through the catheter tube  12 ,  44 . 
     The fiber optic  26  may be a plastic optical fiber or polymer optical fiber, such as PMMA (acrylic) and/or polystyrene. The fiber optic  26  may also be made from glass, such as silica, fluorozirconate, fluoroaluminate, outher fluoride glasses, chalcogenide glass, phosphate glass, and sapphire. Optical fiber produced by Corning, such as Corning&#39;s Fibrance® light-diffusing fiber may be used. electroluminescent wire (a copper wire coated with phosphor) may also be used as fiber optic  26 . Other light transmitting fiber may be used, provided they are safe for the patient, adaptable for catheter, tubes and instruments inserted into the body, and capable of delivery adequate antimicrobial light. 
     Referring to  FIG. 3E , a cross-sectional view with a fourth embodiment with an add-on sleeve  54  on the catheter tube  12 , 44 . In the fourth embodiment, the sleeve  54  may be used as an add-on or retrofit to add light emitting functionality to prior art catheters. Such retrofitted catheters need not be optically clear; the add-on sleeve encircles the tube to coat the surface of the tube with bactericidal light. In this embodiment, the sleeve  54  is a tubular or condom-like sheath structure with a resilient wall that is optically transparent and capable of side-emitting light. A side-emitting optical fiber monofilament  26  is embedded in the wall of the sleeve  54  and configured to emit light through the sleeve  54 . The portion of the wall  56  that the optical fiber monofilament  26  is embedded may be thickened to encase the optical fiber  26 . 
     Referring to  FIG. 3E , in some embodiments, the catheter may include an interior portion  76 , which is placed inside the patient&#39;s body, and an exterior portion  78 , which is placed on an exterior portion of the patient&#39;s body. The light emitter may include a fiber monofilament  26  that is configured to emit light through the cannula  44  on the interior portion  76  of the catheter and also through the exterior portion  78  of the catheter and, consequently, onto the skin of patient. The light emitted onto the skin of the patient reduces the risk of infection on the skin at or nor the site of the catherization, as in  FIG. 3F . The risk of catheter-associated infection is multifactorial, dependent on host factors (e.g., chronic illness, immune deficiency, loss of skin integrity) and catheter factors (e.g., catheter type, location of catheter, and duration of placement). The sources of infection from a catheter can be attributable to four major sources: 1) colonization from the skin  80   a,  2) intraluminal or hub contamination  80   b,  3) secondary seeding from a bloodstream infection (extraluminal)  80   c , and, rarely, 4) contamination of the infusate  80   d . Catheter-based efforts to reduce one or more of the sources of infection merit application. 
     Referring to  FIG. 4 , a flowchart illustrating a method of treatment is shown generally at  100 . In a first step  102 , a catheter with a tube having an optically transparent wall and a light transmitter configured to emit light through the tube is providence. In a second step  104 , a patient is catheterized with the catheter. In a third step  106 , a therapeutic amount of light is administered with the light transmitter to the patient. The duration of exposure of light could be for the duration the catheter is inserted for the procedure in question or for other time periods, such as five minutes, ten minutes, thirty minutes, one hour or longer. An optional fourth step may include removal of the catheter from the patient. The method may include a step of adjusting a parameter of the light emitter, including adjusting intensity, radiant exposure, dwell time, wavelength, and pulse frequency of the light emitter. 
     It should be understood that the light-emitting antimicrobial catheter described herein may be used in any number of catheters, tubes, instruments, drains, ports, and devices, such as, arterial lines, balloon catheters, central venous catheters, dialysis catheters, embryo transfer catheter, Electrophysiology study, Fogarty embolectomy catheter, Foley catheters, Groshong line, Hickman line, insulin port, intrauterine pressure catheter, Murphy drip, peripheral venous catheter, peripherally inserted central catheter, peripheral catheters, pulmonary artery catheter, Quinton catheter, Swan-Ganz catheters, Stadium buddy, Suprapubic cystostomy, umbilical line catheters, midline catheters, ureteric balloon catheter, bowel management systems, gastric management systems, cardiac monitoring, intra-abdominal pressure monitoring systems, pacing electrodes, medical tubing, hemodialysis catheters, catheter repair systems, inflation devices, temperature-sensing systems, angioplasty, balloon PTA catheters, nontunneled central catheters, tunneled central catheters, peripherally inserted central catheters, implantable ports, Broviac catheter, Groshong line, Huber needle, balloon dilation catheters, carotid shunts, tunnelers, central venous catheter replacement connectors, introducers, micro introducers, recanalization catheters, guidewires, chronic total occlusion systems, enteral feeding systems, gastrostomy devices, percutaneous endoscopic gastrostomy feeding device, jejunal feeding devices, Seldinger needles, puncture needles, gastric decompression tube, stoma measuring systems, left ventricular assist device driveline, hemodialysis catheters, intraperitoneal dialysis catheters, ports, implantable ports, dual lumen ports, peritoneal ports, procedural devices, stent grafts, support catheters, channel drains, round drains, flat drains, gravity drains, PVC drains, sump drains, passive drains, active drains, crossing support catheters, surgical grafts, grafts, tip confirmation systems, valvuloplasty systems, valvuloplasty catheters, intracranial catheters, epidural catheters, subcutaneous administration, valvuloplasty perfusion catheters, vascular probes, vena cava filters, vena cava filter retrieval systems, vascular stents, biliary stents, subarachnoid space catheters, expandable biliary stents, endovascular stent graft, grafts, vascular stents, revision grafts, vascular access grafts, vascular grafts, bypass grafts, biopsy systems, breast biopsy systems, biopsy probes, biopsy tubing, ultra sound procedure systems, stereotactic procedure systems, MRI procedures systems, CT procedure systems, drivers, probes, introducers, vacuum-assisted procedure systems, coaxial cannulas, tissue marker systems, localization systems, localization devices, localization wires, needles, guide wires, sheaths, catheters, cannulas, core biopsy instruments, needles, coaxial biopsy needles, drainage catheters, aspiration needles, biopsy needles, PTFE products, breast localization wire, breast tissue markers, laparoscopic instruments, access needles, needles, obturators, guide wires, radial approach accessories, sheath introducers, angiography systems, diagnostic cardiology catheters, diagnostic guide wires, fluid management systems, nephrostomy tube, drains, venous catheter, balloon septostomy, balloon angioplasty, tubing, fluid administration systems, high pressure tubing, pressure monitoring tubing, guidewire accessories, manifolds, stopcocks, adapters, syringes, transducers, aspiration catheters, guiding catheters, hemostasis valves, hemostasis accessories, inflation devices, pericardiocentesis catheters, steerable microcatheters, stent positioning system, compression devices, cardiac rhythm management devices, introducers, electrophysiology devices, pressure monitoring devices, infection control solutions, pens, safety management devices, waste management devices, transradial access, adapters, introducers, dilators, needles, peritoneal dialysis devices, peritoneal dialysis catheters, hemodialysis instruments, hemodialysis devices, hemodialysis catheters, chronic dialysis catheters, tunneled dialysis catheter, curved needles, catheter extractors, hemodialysis access graft, inside-out access catheters, diagnostic guide wires, diagnostic peripheral catheters, angiography devices, fluid management devices, tubing, medical tubing, non-medical tubing, guide wire accessories, hydrophilic guide wires, syringes, balloon catheters, inflation devices, snares, support catheters, therapeutic infusion systems, infusion pumps, infusion pump accessories, infusion pump tubing, fluid dispensing systems, infusion catheters, drainage systems, valve adapters, drainage tubing, connecting tubes, drainage catheters, paracentesis systems, paracentesis devices, thoracentesis devices, thoracentesis systems, hemostasis devices, hemostasis instruments, hemostasis systems, valves, connectors, adaptors, syringes, bags, waste bags, embolotherapy instruments, tumor ablation systems, vertebral compression fracture systems, vertebral augmentation system, vertebroplasty, straight balloons, steerable balloons, steerable needles, access instruments, bone cement systems, percutaneous instruments, percutaneous access, percutaneous drainage, retrieval devices, ureteral catheters, straight catheters, pigtailed catheters, cobra-shaped catheters, Shepherd catheters, hydrophobic catheters, intermittent catheters, pediatric catheters, Judkins left catheters, Judkins right catheters, Judkins left short tip catheters, Judkins right short tip catheters, Amplatz left catheters, Amplatz right catheters, left coronary bypass catheters, right coronary bypass catheters, cardiac pigtail catheters, multipurpose catheters, diagnostic catheters, angiography catheters, guiding catheters, angioplasty catheters, balloon catheters, PTCA wire, butterfly catheters, ureteral stents, stents, kidney stone management system accessories, patient-monitoring systems, patient-monitoring cables, patient-monitoring accessories, tumor ablation systems, image-guided procedures, external catheters, external catheter accessories, endotracheal tubes, Jackson-Pratt drain, Blake drain, Penrose drain, negative pressure wound therapy drains, redivac drain, pigtail drain, Davol drain, chest tube, wound manager, surgical drains, rubber drain, Kehr&#39;s t-tube, trocars, close wound drainage systems, open wound drainage systems, extruded tubing, polyimide tubing, heat shrink tubing, reinforced tubing, PTFE liner tubing, balloon catheters, reinforced shaft catheters, open suction catheter systems, nasogastric tubes, wound drains, wound evacuators, skin care, wound care, irrigation systems, Foley catheter stabilization, intermittent catheters, special Foley catheters, Foley catheters, urinary incontinence systems, kidney stone laser fibers, kidney stone access sheaths, kidney stone dilation systems, guidewires, steerable guidewires, reshapable guide wires, microcatheters, steerable microcatheters, intraventricular catheters, tracheobronchial stents, delivery systems, over-the-wire visualization systems, direct visualization systems, pulmonary balloon dilator, sizing devices, stent sizing device, brochoalveolar lavage instruments, endoscopic instruments, endoscopic devices, endoscopic accessories, retrieval devices, esophageal stent, cholangiography devices, balloon dilators, probes, negative pressure syringes, sizing devices, inflation devices, irrigation devices, surgical instruments, procedural instruments, endoscopic devices, laparoscopic devices, minimally invasive surgery instruments, suction devices, urinary catheterization, and intraperitoneal catheters, endotracheal tubes, ventilator tubing, gastrostomy tubes, nasogastric tubes, Levin tube, SUMP or SALEM tubes, Moss tube, Sengstaken-Blakemore tubes, Minnesota tube, Nutrifl ex tube, orogastric tubes, surgical tubes, medical tubes, drainage tubes placed for drainage of fluids/pus/gases, cannulas, among others. 
     For instance,  FIGS. 5A through 12C  illustrate various embodiment of other catheters and fluid delivery systems for patients. 
     Referring to  FIG. 5A , an exemplary embodiment of a central venous catheter made in accordance with the present invention is illustrated generally at  500 . The catheter  500  includes a wall  504  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  504 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIG. 5B , another exemplary embodiment of a central venous catheter made in accordance with the present invention is illustrated generally at  506 . The catheter  500  includes a wall  504  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  504 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 5C , illustrates use on a patient  501  of a central venous catheter  500 ,  506  made in accordance with the present invention, illustrating the wall  504  of the catheter  500 ,  506  transmitting light from the light emitter  24  to an exterior portion of the patient&#39;s  501  skin and into the patient&#39;s  501  body. 
     Referring to  FIG. 5D , an exemplary embodiment of a central venous catheter made in accordance with the present invention is illustrated generally at  510 . The catheter  510  includes a wall  504  and a hub  508  comprising an optically transparent material. The hub  508  includes an integral light emitter  24  configured to emit light through the wall  504  and hub  508 . 
     Referring to  FIG. 5E , another exemplary embodiment of a central venous catheter made in accordance with the present invention is illustrated generally at  512 . The catheter  512  includes a wall  504  and a hub  508  comprising an optically transparent material. The hub  508  includes an integral light emitter  24  configured to emit light through the wall  504  and hub  508 . 
     Referring to  FIG. 5F , illustrates use on a patient  501  of a central venous catheter  510 ,  512  made in accordance with the present invention, showing the skin around the hub  508  of the catheter  510 ,  512 , receiving exposure to additional light from the integral light emitter  24 , in addition to light transmitted through the wall  504  to an exterior portion of the patient&#39;s  501  skin and into the patient&#39;s  501  body. 
     Referring to  FIGS. 6A and 6B , an exemplary embodiment of a hemodialysis catheter made in accordance with the present invention is illustrated generally at  600  and in use on a patient  601 . The catheter  600  includes a wall  604  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  604 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 6C and 6D , another exemplary embodiment of a hemodialysis catheter made in accordance with the present invention is illustrated generally at  606  and in use on a patient  601 . The catheter  606  includes a wall  604  and a hub  608  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  604  and hub  608 . 
     Referring to  FIGS. 7A and 7B , an exemplary embodiment of a peripherally inserted central catheter (PICC) line made in accordance with the present invention is illustrated generally at  700  and in use on a patient  701 . A medical professional  703  may administer medications through a port  706 ,  708  of the PICC line  700 . The ports may be selectively closed with clamps  710 ,  712 . The PICC line  700  includes a wall  704  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  704 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 7C and 7D , another exemplary embodiment of a PICC line made in accordance with the present invention is illustrated generally at  714  and in use on a patient  701 . A medical professional  703  may administer medications through a port  706 ,  708  of the PICC line  700 . The ports may be selectively closed with clamps  710 ,  712 . The PICC line  700  includes a wall  704  and a hub  716  comprising an optically transparent material and a light emitter  24 , integrated with the hub  716 , configured to emit light through the wall  704  and hub  716 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIG. 7E , yet another alternative embodiment of a PICC line is illustrated at  718  being used on a patient  701 . 
     Referring to  FIGS. 8A-8D , an exemplary embodiment of a endotracheal tube made in accordance with the present invention is illustrated generally at  800  and in use on a patient  801  by a medical professional  803 . The endotracheal tube  800  includes a port  804  for delivery of fluids and nutrition to the patient and inflation tube port  806  for inflating an inflation cuff  808  at a distal end of the tube  800 . The tube  800  includes a wall  810  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  804 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . During intubation, the light emitter  24  may be removed from the tube  800  to provide a better view for the medical professional  803  (best seen in  FIG. 8C ). Once intubated, the light emitter  24  may be re-attached to the tube  800  (best seen in  FIG. 8D ). The light emitter  24  may couple to the tube  800  via a clip  812  attached to the tube  800 . The clip  812  may comprise a resilient material, allowing mating formations of the clip  812  to clasp the housing  25  of the light emitter  24 . 
     Referring to  FIGS. 9A-9C , an exemplary embodiment of a urinary catheter made in accordance with the present invention is illustrated at  900  and in use on a patient  901 . The catheter  900  includes an optically transparent tube  12  with a tip  14  and a drain  16 . The catheter  10  may include an inflatable balloonl 8  near the tip  14 . An inflation port  20  is provided to inflate the balloon  18 . In some configurations, the catheter  10  may include an irrigation port  22  as well. A light transmitter  24  is connected to the tube  12  and configured to emit light through the optically transparent wall of the catheter  10 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 10A-10D , an exemplary embodiment of a subdermal port made in accordance with the present invention is illustrated at  1000  and in use on a patient  1001 . The port  1000  includes a body  1002  with a septum  1004  and a catheter  1006 . A light transmitter  24  may be incorporated into the body  1002  of the port  1000 . The port  1000  may comprise an optically transparent material configured to transmit light emitted from the light transmitter  24 . The light transmitter  24  may include a control circuit  30  where the on/off  36 , timer function  37 , intensity function  38  and/or wavelength function  39  are controlled wirelessly, magnetically, and/or sonically. 
     Referring to  FIGS. 11A-11B , an exemplary embodiment of a Peritoneal dialysis catheter made in accordance with the present invention is illustrated generally at  1100  and in use on a patient  1101 . The catheter  1100  includes a wall  1104  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  1104 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 12A-12B , an exemplary embodiment of a peripheral intravenous catheter made in accordance with the present invention is illustrated generally at  1200  and in use on a patient  1201 . The catheter  1200  includes a wall  1204  and exterior portion  1206  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  1204  and exterior portion  1206 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 13A and 13B , an exemplary embodiment of a hemodialysis catheter made in accordance with the present invention is illustrated generally at  1300  and in use on a patient  1301 . The catheter  1300  includes a wall  1304  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  1304 . The light emitter  24  may include a display  41  for viewing the function settings  37 ,  38 ,  39  of the control circuit  30  of the light emitter  24 . 
     Referring to  FIGS. 13C and 13D , another exemplary embodiment of a short-term hemodialysis catheter made in accordance with the present invention is illustrated generally at  1306  and in use on a patient  1301 . The catheter  1306  includes a wall  1304  and a hub  1308  comprising an optically transparent material and a light emitter  24  configured to emit light through the wall  1304  and hub  1308 . 
     Referring to  FIGS. 14A-14D , another exemplary embodiment of use of a light emitter coupled to tubing  1402  with an optically transparent wall is illustrated generally at  1400 . The light emitter  24  may be coupled to any tubing  1402  with an optically transparent wall where an anitmicrobral effect is desired. As illustrated in  FIGS. 14B and 14C , various external; tubing  1402  for delivery of fluids and gasses may be adapted as described herein. As illustrated in  FIG. 14D , achieving an antimicrobial effect in tubing  1402  in the food service industry is also desirable, such as, for instance, a beverage dispensing system  1404 . 
     In addition to medical applications, light-emitting antimicrobial tubing may have applications in other industries where control or prevention of microbial and fungal growth has applications, such as; energy production and delivery; material and chemical production; industrial machinery and equipment; automobile components; consumer durables and apparel; consumer staples, such as, food, beverages and tobacco retailing, and household products; pharmaceutical, biotechnology and life sciences; 
     Therefore, it can be seen that the present invention provides a unique solution to the problem of catheter-associated infections, by providing a catheter with an optically transparent wall and a light transmitter configured to emit any antimicrobial light, such as visible spectrum violet-blue 405 nm or 415 nm light, through the optically transparent wall. Because of the antimicrobial properties of violet-blue light, the risk of bacterial infection through the use of the catheter is reduced. 
     It would be appreciated by those skilled in the art that various changes and modifications can be made to the illustrated embodiments without departing from the spirit of the present invention. All such modifications and changes are intended to be within the scope of the present invention except as limited by the scope of the appended claims.