1887

Abstract

The crystalline bacterial biofilms that encrust Foley catheters compromise the care of many elderly and disabled patients. The aim of this study was to examine whether the biocide triclosan can prevent encrustation by the mixed flora of uropathogens that commonly infect patients undergoing long-term catheterization. Models of the catheterized bladder were inoculated with communities of organisms isolated from patients who were experiencing catheter blockage. The catheter retention balloons were inflated with water or triclosan (3 g triclosan l in 0.1 M sodium carbonate) and urine was supplied to the models for up to 7 days. The effect of triclosan was recorded on the viable cell populations, the pH of the residual urine and the times that catheters took to block. The extent of encrustation of the catheters was visualized by scanning electron microscopy. In models inoculated with communities containing , triclosan prevented the rise in urinary pH that drives crystalline biofilm formation and catheter blockage. The biocide had no effect on populations of and , but , and were eliminated from the residual urine and the catheters drained freely for the 7-day experimental period. In models inoculated with a mixed community containing , catheters inflated with triclosan continued to block rapidly. Although and were eliminated from the residual urine, there was no effect on the viability of . The results indicate that the triclosan strategy should be limited to the treatment of patients who are infected with

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2008-09-01
2019-11-19
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References

  1. Bhargava, H. N. & Leonard, P. A. ( 1996; ). Triclosan: applications and safety. Am J Infect Control 24, 209–218.[CrossRef]
    [Google Scholar]
  2. Clayton, C. L., Chawla, J. C. & Stickler, D. J. ( 1982; ). Some observations on urinary tract infections in patients undergoing long-term bladder catheterization. J Hosp Infect 3, 39–47.[CrossRef]
    [Google Scholar]
  3. Ganderton, L., Chawla, J., Winters, C., Wimpenny, J. & Stickler, D. ( 1992; ). Scanning electron microscopy of bacterial biofilms on indwelling bladder catheters. Eur J Clin Microbiol Infect Dis 11, 789–796.[CrossRef]
    [Google Scholar]
  4. Jones, G. L., Russell, A. D., Caliskan, Z. & Stickler, D. J. ( 2005; ). A strategy for the control of catheter blockage by crystalline Proteus mirabilis biofilm using the antibacterial agent triclosan. Eur Urol 48, 838–845.[CrossRef]
    [Google Scholar]
  5. Jones, G. L., Muller, C. T., O'Reilly, M. & Stickler, D. J. ( 2006; ). Effect of triclosan on the development of bacterial biofilms by urinary tract pathogens on urinary catheters. J Antimicrob Chemother 57, 266–272.[CrossRef]
    [Google Scholar]
  6. Kohler-Ockmore, J. & Feneley, R. C. L. ( 1996; ). Long-term catheterization of the bladder: prevalence and morbidity. Br J Urol 77, 347–351.[CrossRef]
    [Google Scholar]
  7. Kunin, C. M. ( 1989; ). Blockage of urinary catheters: role of microorganisms and constituents of the urine on formation of encrustations. J Clin Epidemiol 42, 835–842.[CrossRef]
    [Google Scholar]
  8. Kunin, C. M. ( 1997; ). The care of the urinary catheter. In Urinary Tract Infections: Detection, Prevention and Management, 5th edn, pp. 226–278. Baltimore: Williams and Wilkins.
  9. Macleod, S. M. & Stickler, D. J. ( 2007; ). Species interactions in mixed-community crystalline biofilms on urinary catheters. J Med Microbiol 56, 1549–1557.[CrossRef]
    [Google Scholar]
  10. Mobley, H. L. & Warren, J. W. ( 1987; ). Urease-positive bacteriuria and obstruction of long-term urinary catheters. J Clin Microbiol 25, 2216–2217.
    [Google Scholar]
  11. Morris, N. S., Stickler, D. J. & McLean, R. J. ( 1999; ). The development of bacterial biofilms on indwelling urethral catheters. World J Urol 17, 345–350.[CrossRef]
    [Google Scholar]
  12. Ohkawa, M., Sugata, T., Sawaki, M., Nakashima, T., Fuse, H. & Hisazumi, H. ( 1990; ). Bacterial and crystal adherence to the surfaces of indwelling urethral catheters. J Urol 143, 717–721.
    [Google Scholar]
  13. Stickler, D. J. & Jones, G. L. ( 2008; ). Reduced susceptibility of Proteus mirabilis to triclosan. Antimicrob Agents Chemother 52, 991–994.[CrossRef]
    [Google Scholar]
  14. Stickler, D., Ganderton, L., King, J., Nettleton, J. & Winters, C. ( 1993; ). Proteus mirabilis biofilms and the encrustation of urethral catheters. Urol Res 21, 407–411.[CrossRef]
    [Google Scholar]
  15. Stickler, D., Morris, N., Moreno, M. C. & Sabbuba, N. ( 1998; ). Studies on the formation of crystalline bacterial biofilms on urethral catheters. Eur J Clin Microbiol Infect Dis 17, 649–652.[CrossRef]
    [Google Scholar]
  16. Stickler, D. J., Morris, N. S. & Winters, C. ( 1999; ). Simple physical model to study formation and physiology of biofilms on urethral catheters. Methods Enzymol 310, 494–501.
    [Google Scholar]
  17. Stickler, D. J., Jones, G. L. & Russell, A. D. ( 2003; ). Control of encrustation and blockage of Foley catheters. Lancet 361, 1435–1437.[CrossRef]
    [Google Scholar]
  18. Warren, J. W., Tenney, J. H., Hoopes, J. M., Muncie, H. L. & Anthony, W. C. ( 1982; ). A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J Infect Dis 146, 719–723.[CrossRef]
    [Google Scholar]
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