MP02-17 MOLECULAR ANALYSIS OF CETYLPYRIDINIUM CHLORIDE FOR USE IN BLADDER INSTILLATION THERAPY IN THE ADVANCED MANAGEMENT OF RECURRENT URINARY TRACT INFECTIONS

Abstract

You have accessJournal of UrologyCME1 May 2022MP02-17 MOLECULAR ANALYSIS OF CETYLPYRIDINIUM CHLORIDE FOR USE IN BLADDER INSTILLATION THERAPY IN THE ADVANCED MANAGEMENT OF RECURRENT URINARY TRACT INFECTIONS Samuel Chang, Namrata Sawant, William Warner, Philippe Zimmern, and Nicole De Nisco Samuel ChangSamuel Chang More articles by this author , Namrata SawantNamrata Sawant More articles by this author , William WarnerWilliam Warner More articles by this author , Philippe ZimmernPhilippe Zimmern More articles by this author , and Nicole De NiscoNicole De Nisco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002514.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Treatment of recurrent urinary tract infections (rUTI) has become increasingly difficult due to the rise of antibiotic resistance among uropathogens. Alternative uses of existing antimicrobials, such as antimicrobial bladder instillations, have become the subject of increased attention. Cetylpyridinium chloride (CPC), a cationic detergent, may be a promising candidate for use in bladder instillations. A preliminary trial reported mild symptoms of bladder irritation in women with antibiotic refractory rUTI, who underwent bladder instillation using 0.05% CPC. The aim of this study was to identify the minimum inhibitory and bactericidal concentrations (MIC/MBCs) of CPC against diverse uropathogenic bacteria to design an optimal CPC instillation strategy for women with rUTI. METHODS: Following IRB approval, uropathogenic Escherichia coli (UPEC), Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa were isolated from urine collected from postmenopausal women with active rUTI. Serial two-fold dilutions of CPC were placed into a microtiter plate. Overnight cultures grown in Mueller Hinton (MH) broth were normalized to an OD600 of 0.05 and were inoculated into each well. Following overnight static incubation at 37°C, growth was measured. The MIC was recorded as the lowest concentration of CPC for which no growth was visible. 10 μL from wells with no growth was spotted onto MH Agar (MHA). The concentration for which no growth occurred on MHA was recorded as the MBC. RESULTS: The MIC and MBC of CPC ranged from 0.0008% to 0.0016% for UPEC and from 0.0016% to 0.0063% for K. pneumoniae. P. mirabilis had an MIC of 0.0063% and MBC of 0.0125%. The MIC and MBC of CPC for P. aeruginosa were both 0.0125%. A CPC concentration as low as 0.0125% exhibited bactericidal activity against all tested uropathogens. CONCLUSIONS: This study determined that 0.0125% CPC shows bactericidal activity against diverse uropathogens. Future bladder instillation trials using 0.0125% CPC could potentially alleviate reported symptoms of bladder irritation. Continued work will focus on studying the cytotoxic effects of CPC against bladder epithelial cells and the pharmacodynamics of CPC through a time-kill kinetic assay. Source of Funding: The Felecia and John Cain Distinguished Chair in Women’s Health, in Honor of Philippe Zimmern, M.D. © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e16 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samuel Chang More articles by this author Namrata Sawant More articles by this author William Warner More articles by this author Philippe Zimmern More articles by this author Nicole De Nisco More articles by this author Expand All Advertisement PDF DownloadLoading ...