The development of bacterial biofilms on indwelling urethral catheters

Morris, Nicola; Stickler, D.J.; McLean, Robert

doi:10.1007/s003450050159

Cited by 181 publications

(133 citation statements)

References 45 publications

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“…Most complications with a LTC are encrustation-related catheter blockage, and 50% of catheter users are troubled with this problem [2,[6][7][8]. All available types of indwelling catheters are susceptible to encrustation [9], in addition to catheterassociated infections and urosepsis [10]. Data from the BioMed Catheter Clinic has introduced the idea of managing such patients with blocked or/and encrusted catheters in a dedicated clinic, equipped with facilities such as flexible cystoscope, enabling patients to be treated in an environment that meets their needs and potentially reduces the risk of catheter problems at a later date and more complex bladder stone removal [4].…”

Section: Discussionmentioning

confidence: 99%

Impact of the lack of community urinary catheter care services on the Emergency Department

et al. 2016

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ObjectivesTo conduct an audit of patients presenting with long-term urinary catheter (LTC)-associated problems to our Emergency Department (ED) and to assess the availability of community nursing support for their LTC. We also estimated the cost implication to the health service and the potential solutions to this issue, as although catheter care is provided by community nurses, LTC problems are common presentations to the ED and are often significant burdens to the services. Patients and MethodsA study was carried out of all patients presenting to the ED with a urinary catheter problem, specifically studying LTCs and the reason for presentation, district nurses' involvement, and the intervention received. ResultsIn all, 78 patients with a urinary catheter problem presented to the ED over a 69-day period, of whom 59 (68%) had a LTC. In all, 33 patients (42%) attended during normal working hours between 0900 and 1700 h. The mean (range) age was 74 (42-93) years and the duration the LTC had been in situ was 11 (1-120) months. The most common reasons for attendance were blocked catheter (37 patients, 47%) and catheter-bypass (18, 23%). Only 28 patients (36%) were known to district nursing services, and 14% were referred by a district nurse. Most of the remaining patients self-referred to the ED. No patient had any documented contact with their general practitioner. In addition, 64 patients (82%) had their catheter issues addressed adequately by ED nurses or doctors, without any urology involvement. ConclusionsThe high morbidity of LTCs causes a considerable demand on ED services, and has heavy cost implications to the health system. Most patients had minimal community nurse support, and their catheter problems were easily dealt with by ED nurses and doctors.

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Section: Discussionmentioning

confidence: 99%

Impact of the lack of community urinary catheter care services on the Emergency Department

et al. 2016

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“…Enteroinvasive and enteropathogenic isolates, on the other hand, express little or no curli at either temperature (4). Recently it has been realized that the majority of human bacterial infections are biofilm related (6,24). Anderson et al (1) reported that E. coli formed the intracellular biofilmlike pods in urinary tract infections of mice.…”

Section: Discussionmentioning

confidence: 99%

Curli Fibers Are Required for Development of Biofilm Architecture in Escherichia coli K‐12 and Enhance Bacterial Adherence to Human Uroepithelial Cells

Kikuchi

Mizunoe

Takade

et al. 2005

Microbiology and Immunology

158

120

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Sessile bacteria show phenotypical, biochemical, and morphological differences from their planktonic counterparts. Curli, extracellular structures important for biofilm formation, are only produced at temperatures below 30 C in Escherichia coli K-12 strains. In this report, we show that E. coli K-12 can produce curli at 37 C when grown as a biofilm community. The curli-expressing strain formed more biofilms on polyurethane sheets than the curli-deficient strain under growth temperatures of both 25 C and 37 C. Curli are required for the formation of a three-dimensional mature biofilm, with characteristic water channels and pillars of bacteria. Observations by electron microscopy revealed the presence at the surfaces of the curli-deficient mutant in biofilm of flagella and type I pili. A wild-type curli-expressing E. coli strain significantly adhered to several lines of human uroepithelial cells, more so than an isogenic curlideficient strain. The finding that curli are expressed at 37 C in biofilm and enhance bacterial adherence to mammalian host cells suggests an important role for curli in pathogenesis.

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“…Crystal formation occurs due to the urease-catalysed hydrolysis of urea into ammonia, leading to an increase in the local pH and the precipitation of calcium, magnesium and phosphate ions (Morris et al, 1999). The pathogenesis of P. mirabilis UTIs is not at present understood fully.…”

Section: Introductionmentioning

confidence: 99%

The high-affinity phosphate transporter Pst in Proteus mirabilis HI4320 and its importance in biofilm formation

et al. 2009

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Proteus mirabilis causes urinary tract infections (UTIs) in individuals requiring long-term indwelling catheterization. The pathogenesis of this uropathogen is mediated by a number of virulence factors and the formation of crystalline biofilms. In addition, micro-organisms have evolved complex systems for the acquisition of nutrients, including the phosphate-specific transport system, which has been shown to be important in biofilm formation and pathogenesis. A functional Pst system is important during UTIs caused by P. mirabilis HI4320, since transposon mutants in the PstS periplasmic binding protein and the PstA permease protein were attenuated in the CBA mouse model of UTI. These mutants displayed a defect in biofilm formation when grown in human urine. This study focuses on a comparison of the proteomes during biofilm and planktonic growth in phosphate-rich medium and human urine, and microscopic investigations of biofilms formed by the pst mutants. Our data suggest that (i) the Dpst mutants, and particularly the DpstS mutant, are defective in biofilm formation, and (ii) the proteomes of these mutants differ significantly from that of the wild-type. Therefore, since the Pst system of P. mirabilis HI4320 negatively regulates biofilm formation, this system is important for the pathogenesis of these organisms during complicated UTIs. INTRODUCTIONProteus mirabilis -a member of the family Enterobacteriaceae -is the most common aetiological agent responsible for complicated urinary tract infections (UTIs) (Mobley, 1996). Subpopulations at higher risk for infection by this pathogen include those with long-term indwelling catheterization as well as those with structural and functional abnormalities within the urinary tract (Mobley, 1996). Clinical syndromes associated with P. mirabilis include cystitis and pyelonephritis, with possible complications from stone formation and bacteraemia (Mobley, 1996). These micro-organisms survive in the urinary tract by virtue of their production of a battery of virulence factors, including urease, flagella, fimbriae, haemolysin and IgA protease (Belas, 1996;Mobley et al., 1994;Musher et al., 1975;Peerbooms et al., 1984; Walker et al., 1999), and formation of crystalline biofilm on indwelling catheters (Stickler et al., 1993).Biofilm formation -one of the most important mechanisms of pathogenicity of this micro-organism in the urinary tract -may be defined as a community of surface-attached bacteria encased in an extracellular matrix consisting of secreted carbohydrates, proteins and DNA. Indeed, biofilms have been associated with the virulence of a number of pathogens (Castelli et al., 2006). Organisms in these communities display phenotypic differences from planktonic cells, including a slower rate of growth and increased resistance to antibiotics (Lewis, 2001;Stoodley et al., 2002). P. mirabilis biofilms in urine are unique in that the extracellular polysaccharide matrix is enmeshed with struvite and carbonate apatite crystals (Jones et al., 2006).Abbreviations: CLSM, confocal ...

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The development of bacterial biofilms on indwelling urethral catheters

Cited by 181 publications

References 45 publications

Impact of the lack of community urinary catheter care services on the Emergency Department

Impact of the lack of community urinary catheter care services on the Emergency Department

Curli Fibers Are Required for Development of Biofilm Architecture in Escherichia coli K‐12 and Enhance Bacterial Adherence to Human Uroepithelial Cells

The high-affinity phosphate transporter Pst in Proteus mirabilis HI4320 and its importance in biofilm formation

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