Abstract
Bacterial biofilms forming on indwelling urinary catheters continue to represent a public health problem because they are associated with urinary tract infections (UTIs). This study was undertaken to evaluate the ability of immobilized Lactobacillus acidophilus cells to inhibit biofilm formation on catheter surfaces. Urine bacteria and Lactobacillus species were isolated from urine and vaginal swabs (HVS), respectively. Immobilization of L. acidophilus on catheter samples was achieved using sodium alginate and the inhibition of urine bacteria by the immobilized Lactobacillus cells was evaluated by microscopy and viable cell count procedures following co-culture of the immobilized cells and urine bacteria. Results showed that pre-coating of catheter surfaces with L. acidophilus before exposure to urine bacteria significantly (p<0.05) reduced attachment of some urine bacteria to the catheter surfaces. Staphylococcus aureus, Klebsiella and Escherichia coli were significantly inhibited, while Pseudomonas aeruginosa was not inhibited. Furthermore, crude bacteriocin preparations from the Lactobacillus cells had antimicrobial activity against the urine bacteria. This study shows that pre-coating of catheter surfaces with L. acidophilus could be an effective strategy for controlling biofilm formation on urinary catheters. Key words: Biofilm, catheter, Lactobacillus, immobilization, sodium alginate.  
Highlights
Urinary tract infections (UTIs) account for about 25-40% of nosocomial infections, out of which about 90% are catheter-associated (Trautner and Darouiche, 2004; Ghanwate et al, 2012)
Bacterial biofilms forming on indwelling urinary catheters continue to represent a public health problem because they are associated with urinary tract infections (UTIs)
This study shows that precoating of catheter surfaces with L. acidophilus could be an effective strategy for controlling biofilm formation on urinary catheters
Summary
Urinary tract infections (UTIs) account for about 25-40% of nosocomial infections, out of which about 90% are catheter-associated (Trautner and Darouiche, 2004; Ghanwate et al, 2012). Lactobacilli have long been known for their antimicrobial activity and capability to interfere with adhesion of pathogens to epithelial cells of the urogenital tract (Reid et al, 2001; Reid and Burton, 2002; Borchert et al, 2008; Fracchia et al, 2010; Ali 2012; Sambanthamoorthy et al, 2014), their application in vaginal suppositories for the treatment of vaginal and urinary tract infections (Reid and Burton, 2002; Uehara et al, 2006; Borchert et al, 2008) This property of bacterial interference of lactobacilli presents a potential intervention strategy for the control of urinary catheter biofilms. This study evaluated the capability of Lactobacillus acidophilus cells, immobilized on catheter surfaces with sodium alginate, to inhibit the formation of biofilms by Escherichia coli, Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa in vitro
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