Biofilms, Bacteria and Bladder Catheters A Clinical Study

Ramsay, J. W. A.; Garnham, Andrew; Mulhall, Anne; Crow, Rosemary; Bryan, J.; Eardley, Ian; Vale, Justin; Whitfield, H. N.

doi:10.1111/j.1464-410x.1989.tb06050.x

Cited by 77 publications

(21 citation statements)

References 18 publications

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“…Blockage of urinary catheters is thought to involve the production of bacterial bio®lms which consist of bacterial cells, glycocalyx and crystals. 13,14 This is the subject of our current research.…”

Section: Discussionmentioning

confidence: 99%

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

et al. 1998

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We report on the clinical outcome and satisfaction survey of long-term suprapubic catheterisation in patients with neuropathic bladder dysfunction. Between early 1988 and later 1995, 185 suprapubic catheters were inserted under direct cystoscopic vision. Anticholinergic therapy was given to all patients with signi®cant detrusor hyper-re¯exia; the catheters clamped daily for two hours and changed every six weeks. Ultrasonography and assessment of the serum creatinine were used to assess the upper renal tracts, and the results of the pre-and post-catheter video-cystometrography was used to evaluate bladder morphology, cystometric capacity, maximum detrusor pressure and the presence of vesico-ureteric re¯ux. There were equivalent numbers of males and females. The follow-up ranges from 3 ± 68 months. Following catheterisation, there was a 50% reduction in the average maximum detrusor pressure, bladder morphology improved in 85% of the cases; the bladder capacity and upper renal tracts remained unchanged. Vesico-ureteric re¯ux was abolished in 33% of the cases. Complaints were common consisting of recurrent catheter blockage, persistent urinary leakage and recurrent urinary tract infections. There was a 2.7% incidence of small bowel injury with one fatality. However, the general level of satisfaction was high. It is concluded that suprapubic catheterisation is an e ective and well tolerated method of management in selected patients with neuropathic bladder dysfunction for whom only major surgery would otherwise provide a solution to incontinence. We are encouraged to ®nd preservation of renal function with maintained bladder volumes and reduced maximum detrusor pressures thus justifying the policy of catheter clamping and anti-cholinergic therapy in the presence of signi®cant detrusor hyper-re¯exia. However, even in expert hands this procedure is not without hazards.

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Section: Discussionmentioning

confidence: 99%

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

et al. 1998

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“…Additionally, the catheter also damages the bladder mucosa by triggering inflammatory response and mechanical erosion [30]. Once bacteria gain entry into the urinary tract, low level bacteriuria progresses within 24 to 48 h in the absence of an antimicrobial therapy [31] [32] [33].…”

Section: Pathogenesis Of Catheter-associated Biofilmmentioning

confidence: 99%

Detection of Biofilm Forming Bacterial Communities from Urinary Catheter of Patients with Change in Its Antibiotic Susceptibility Pattern and Triclosan Effect from Different Hospitals of Amravati City Maharashtra, India

Tiwari¹,

Ghnawate²

2017

OJMM

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Purpose: Bacterial biofilm develop on the surfaces of urinary catheter and proceed to cause full blown bacterial infections and sepsis. Urinary catheters, infection rates increase with the duration of catheterization at rates of per day with virtually all of those who undergo long-term catheterization becoming infected. Also antibiotics results in the adaptation and development of resistance leading to treatment failure, prolonged hospitalization, increased costs of care, and increased mortality. Methods: In the present study total 200 used urinary catheters were studied from the different hospitals of Amravati city in 2015-2016. Different bacterial uropathogens were isolated by conventional method and biofilm formation was studied by tissue culture plate (TCP). Antibiotic sensitivity was performed by disc diffusion method. Minimum inhibitory concentration (MIC) and Minimum biofilm eradicating concentration (MBEC) of triclosan was determined by TCP. Results: Out of total samples 93% are contaminated. Around 59% urinary catheters contain mixed consortia. Pseudomonas aeruginosa was found to be the strong biofilm forming and multidrug resistant organism. The most effective drug over seven bacteria isolates were chloramphenicol. Triclosan was used to test against the strong and moderate biofilm forming isolates the MIC of triclosan ranged between 1.5 and 1000 μg/ml and MBEC was between 800 and 3200 μg/ml Conclusions: From the study it was concluded that female are more prone to be infected with catheter associated infection. Pseudomonas aeruginosa was found to be deadly caused of infection, as it is highly resistant to antibiotics. Also triclosan showed effective result on the bacterial uropathogens.

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“…37 Even the urine culture results can be misleading, as numerous studies have shown that urine cultures collected through an "old" indwelling catheter have more species and higher numbers of organisms than urine cultures collected through a newly inserted catheter or through suprapubic bladder aspiration. [38][39][40][41] Although practice guidelines are neutral on this topic, we recommend changing the urinary catheter as part of the therapy for CAUTI. 42 The catheter can be changed before the urine is collected for culture, in which case the microbiology laboratory will be spared workup of spurious species and the patient may be spared unnecessary antibiotics.…”

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confidence: 99%

Role of biofilm in catheter-associated urinary tract infection☆

Trautner

Darouiche

2004

American Journal of Infection Control

366

263

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The predominant form of life for the majority of microorganisms in any hydrated biologic system is a cooperative community termed a "biofilm." A biofilm on an indwelling urinary catheter consists of adherent microorganisms, their extracellular products, and host components deposited on the catheter. The biofilm mode of life conveys a survival advantage to the microorganisms associated with it and, thus, biofilm on urinary catheters results in persistent infections that are resistant to antimicrobial therapy. Because chronic catheterization leads almost inevitably to bacteriuria, routine treatment of asymptomatic bacteriuria in persons who are catheterized is not recommended. When symptoms of a urinary tract infection develop in a person who is catheterized, changing the catheter before collecting urine improves the accuracy of urine culture results. Changing the catheter may also improve the response to antibiotic therapy by removing the biofilm that probably contains the infecting organisms and that can serve as a nidus for reinfection. Currently, no proven effective strategies exist for prevention of catheter-associated urinary tract infection in persons who are chronically catheterized.Health care providers have traditionally envisioned bacteria in their free-floating or planktonic state, and planktonic organisms have been the focus of traditional microbiologic methods of sampling and culture. 1 However, the predominant form of life for the majority of microorganisms in any hydrated biologic system, such as the human body, is a cooperative community termed a "biofilm." 2 A formal definition of biofilm includes 3 components: (1) adherence of the microorganisms, either to a surface or to each other; (2) a change in gene expression resulting in a different phenotype from the planktonic state; and (3) an extracellular matrix composed of host components and secreted bacterial products. 3,4 A functional definition of biofilm also includes the fact that biofilm results in chronic, persistent infections that are difficult to eradicate with antimicrobial therapy. 5 The relevance of biofilm to catheter-associated urinary tract infection (UTI) (CAU-TI) is that a foreign body, such as an indwelling urethral catheter, connecting a normally sterile, hydrated body site to the outside world will inevitably become colonized with microorganisms. 4 Thus, the central character in the story of CAUTI is really the biofilm on the urinary catheter. PATHOGENESIS OF URINARY CATHETER-ASSOCIATED BIOFILMThe pathogenesis of CAUTI is related to the susceptibility of inert catheter material to microbial colonization. On the surface of normal bladder mucosa, binding of bacteria triggers an NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript inflammatory response that results in an influx of neutrophils and sloughing of epithelial cells with bound bacteria. [6][7][8][9] Both processes contribute to clearance of the bacteria from the mucosal surface. In contrast, catheter surfaces have no inherent defense mechani...

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Biofilms, Bacteria and Bladder Catheters A Clinical Study

Cited by 77 publications

References 18 publications

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

Detection of Biofilm Forming Bacterial Communities from Urinary Catheter of Patients with Change in Its Antibiotic Susceptibility Pattern and Triclosan Effect from Different Hospitals of Amravati City Maharashtra, India

Role of biofilm in catheter-associated urinary tract infection☆

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