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Introduction. Catheter-associated urinary tract infection (CAUTI) is a common nosocomial infection treated with antibiotics, but biofilm and antibiotic resistance have led researchers to seek preventive strategies rather than treatment.
Gap statement. No preventive strategy for CAUTI has been developed to date.
Aim. We studied the anti-biofilm potentials of three non-antibiotics to develop a strategy for CAUTI prevention.
Methodology. Isolates were collected from urine specimens of catheterized inpatients; one of them was identified as Proteus vulgaris (Pv).
Results. Pv swarmed exhibiting a unique bull’s-eye pattern on the surface of 1.25% solidified agar, but it was not well-swarmer with distinguished swarming rafts on the surface of traditional media used for swarming (1.5%). EDTA, aspirin and d-mannose significantly inhibited the biofilm-forming ability of Pv on the surface of the urinary catheter device. EDTA was the strongest followed by aspirin and d-mannose. The concentrations of drugs for 50% inhibition of biofilm (BIC50) were estimated at ~0.2, 0.4 and 0.95 mM for EDTA, aspirin and d-mannose, respectively. All drugs hindered Pv cells from attaching to the catheter surface at the initiation stage of biofilm. The functional groups, –COOH for EDTA and aspirin, interfered with the cell adhesion process of Pv through pili-to-surface interaction.
Conclusion. The inner surface of a urine drainage bag coated with EDTA, and the oral administration of aspirin and d-mannose at their therapeutic doses would be an excellent preventive strategy for CAUTI.
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