Bladder irrigation with povidone‐iodine prevent recurrent urinary tract infections in neurogenic bladder patients on clean intermittent catheterization

Moussa, Mohamad; Chakra, Mohamed Abou; Papatsoris, Athanasios; Dellis, Athanasios; Dabboucy, Baraa; Fares, Youssef

doi:10.1002/nau.24607

Cited by 11 publications

(5 citation statements)

References 28 publications

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“…In this study, our prototype theranostic coatings were able to provide both advanced warning of catheter blockage as well as actively increasing the time taken for P. mirabilis to block catheters. While both therapeutic agents tested in our coatings may be administered orally for the treatment of UTIs, localized delivery options have the potential to avoid many of the systemic side effects associated with these drugs and provide a more effective way to combat CAUTIs (Benderev, 1988 ; Zacchè et al ., 2015 ; Wan et al ., 2018 ; Marei et al ., 2021 ; Moussa et al ., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Infection responsive coatings to reduce biofilm formation and encrustation of urinary catheters

Slate,

Clarke,

Kerio

et al. 2023

Journal of Applied Microbiology

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Aims The care of patients undergoing long-term urethral catheterisation is frequently complicated by Proteus mirabilis infection. This organism forms dense, crystalline biofilms which block catheters leading to serious clinical conditions. However, there are currently no truly effective approaches to control this problem. Here we describe the development of a novel theranostic catheter coating, to simultaneously provide early warning of blockage, and actively delay crystalline biofilm formation. Methods and results The coating comprises of a pH sensitive upper layer of poly(methyl methacrylate-co-methacrylic acid; Eudragit S100®) and a hydrogel base layer of poly(vinyl alcohol), which is loaded with therapeutic agents (acetohydroxamic acid or ciprofloxacin hydrochloride) and the fluorescent dye 5(6)-Carboxyfluorescein (CF). The elevation of urinary pH due to P. mirabilis urease activity results in the dissolution of the upper layer and release of cargo agents contained in the base layer. Experiments using in vitro models of P. mirabilis catheter infection demonstrated that coatings significantly delay time taken for catheters to block. Coatings containing both CF dye and ciprofloxacin HCl were able to provide an average of ca. 79 h advanced warning of blockage and extend catheter lifespan ca. 3.40-fold. Conclusions This study has demonstrated the potential for theranostic, infection-responsive coatings to form a promising approach to combat catheter encrustation and actively delay blockage.

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Section: Discussionmentioning

confidence: 99%

Infection responsive coatings to reduce biofilm formation and encrustation of urinary catheters

Slate,

Clarke,

Kerio

et al. 2023

Journal of Applied Microbiology

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“…For example, a retrospective study found that intravesical gentamicin instillation reduced symptomatic UTI episodes, oral antibiotic use, and the proportion of resistant organisms. 78 Another study demonstrated that daily intravesical povidone-iodine bladder irrigation was associated with a significant reduction in symptomatic UTI in patients with neurogenic bladder and recurrent UTI who performed clean intermittent catheterization 79 Randomized clinical trials are needed to confirm these findings and determine whether they are generalizable to those with indwelling catheters.…”

Section: Dovepressmentioning

confidence: 99%

Catheter-Associated Urinary Tract Infections: Current Challenges and Future Prospects

Werneburg¹

2022

RRU

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Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection and cause of secondary bloodstream infections. Despite many advances in diagnosis, prevention and treatment, CAUTI remains a severe healthcare burden, and antibiotic resistance rates are alarmingly high. In this review, current CAUTI management paradigms and challenges are discussed, followed by future prospects as they relate to the diagnosis, prevention, and treatment. Clinical and translational evidence will be evaluated, as will key basic science studies that underlie preventive and therapeutic approaches. Novel diagnostic strategies and treatment decision aids under development will decrease the time to diagnosis and improve antibiotic accuracy and stewardship. These include several classes of biomarkers often coupled with artificial intelligence algorithms, cell-free DNA, and others. New preventive strategies including catheter coatings and materials, vaccination, and bacterial interference are being developed and investigated. The antibiotic pipeline remains insufficient, and new strategies for the identification of new classes of antibiotics, and rational design of small molecule inhibitor alternatives, are under development for CAUTI treatment.

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“…Currently, literature on the use of BWs in the management of recurrent UTIs is sparse. Evidence has demonstrated that bladder instillation without antibiotics has a role in preventing UTIs in catheterized patients [ 15 , 16 ]. Another study showed that BWs with an anti-septic solution are effective for treating catheter-associated UTIs [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Bladder Washout for the Treatment of Recurrent Urinary Tract Infections After Renal Transplantation

Mossack,

Spellman,

Lagalbo

et al. 2024

Cureus

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Background Current literature suggests that anywhere from 2.9-27% of renal transplant recipients (RTR) will develop recurrent urinary tract infections (UTIs) (≥2 UTIs over six months or ≥3 UTIs over 12 months). Recurrent UTIs are of particular importance to RTR given its increased risk for allograft fibrosis and overall patient survival. Alternative solutions are needed for the management of recurrent UTIs, especially given the vulnerability of RTR to UTIs. We hypothesize that bladder washout (BW) reduces the incidence and recurrence of UTIs in RTR. Methods This is a retrospective study evaluating the utility of BW procedures on RTR diagnosed with recurrent UTIs between December 2013 and July 2021 at a single center. Results A total of 106 patients were included in the study with a total of 118 BW performed. 69% of patients were successfully treated with BW, meaning they no longer met the criteria for recurrent UTIs (<1 UTI) in the six-month post-BW period. The mean number of UTIs was 2.76 (range 2-7) before the BW and 1.16 (range 0-5) after the BW. On average, there were 1.60 fewer UTIs in the post-BW period compared to the pre-BW period (p<0.0001). There is no statistically significant difference in success rates stratified by bacterial class (p=1) or antimicrobial resistance class (p=0.6937). Conclusion BW decreased the incidence of UTIs in the six-month post-operative period as nearly 70% of patients did not have UTI recurrence. This data provides evidence that BW may have utility in transplant recipients with recurrent UTIs. We hope this will stimulate further prospective randomized studies in this area.

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Bladder irrigation with povidone‐iodine prevent recurrent urinary tract infections in neurogenic bladder patients on clean intermittent catheterization

Cited by 11 publications

References 28 publications

Infection responsive coatings to reduce biofilm formation and encrustation of urinary catheters

Infection responsive coatings to reduce biofilm formation and encrustation of urinary catheters

Catheter-Associated Urinary Tract Infections: Current Challenges and Future Prospects

Outcomes of Bladder Washout for the Treatment of Recurrent Urinary Tract Infections After Renal Transplantation

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