Abstract

Urinary tract infections (UTI) are the most common hospital-acquired infections in humans and are caused primarily by uropathogenic Escherichia coli (UPEC). Indwelling urinary catheters become encrusted with UPEC biofilms that are resistant to common antibiotics, resulting in chronic infections. Therefore, it is important to control UPEC biofilms on catheters to reduce the risk for UTIs. This study investigated the efficacy of selenium for inhibiting and inactivating UPEC biofilms on urinary catheters. Urinary catheters were inoculated with UPEC and treated with 0 and 35 mM selenium at 37 °C for 5 days for the biofilm inhibition assay. In addition, catheters with preformed UPEC biofilms were treated with 0, 45, 60, and 85 mM selenium and incubated at 37 °C. Biofilm-associated UPEC counts on catheters were enumerated on days 0, 1, 3, and 5 of incubation. Additionally, the effect of selenium on exopolysacchride (EPS) production and expression of UPEC biofilm-associated genes was evaluated. Selenium at 35 mM concentration was effective in preventing UPEC biofilm formation on catheters compared to controls (p < 0.05). Further, this inhibitory effect was associated with a reduction in EPS production and UPEC gene expression. Moreover, at higher concentrations, selenium was effective in inactivating preformed UPEC biofilms on catheters as early as day 3 of incubation. Results suggest that selenium could be potentially used in the control of UPEC biofilms on urinary catheters.

Highlights

  • Urinary tract infection (UTI) is one of the most common infections in humans, accounting for more than 150 million cases worldwide [1]

  • Attachment, and exopolysaccharide (EPS) production are critical to the establishment of a mature biofilm, compounds that inhibit the growth of bacteria have been routinely used to impair biofilm formation [29,30,31,32,33]

  • Since selenium is employed at the sub inhibitory concentration (SIC), it is expected that the antimicrobial metal would inhibit biofilm formation by regulating the process and not by inactivating the organism

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Summary

Introduction

Urinary tract infection (UTI) is one of the most common infections in humans, accounting for more than 150 million cases worldwide [1]. In addition to being the most common bacterial infection, UTIs account for 36% of all health-care associated infections (HAI; [3]). Of these 36% infections, 80% of them are estimated to be catheter-associated [3,4]. Beyond the initial urinary infection, CAUTIs can lead to complications including bacteremia, endocarditis, osteomyelitis, septic arthritis, and meningitis [4]. These pathologies collectively result in prolonged hospital stays and increased morbidity and mortality [8,9]

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