MP23-17 THE CHARACTERISTICS AND PROGRESSION OF BACTERIAL BIOFILMS ON URINARY CATHETERS

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2017MP23-17 THE CHARACTERISTICS AND PROGRESSION OF BACTERIAL BIOFILMS ON URINARY CATHETERS Anh Nguyen, Glenn Werneburg, Jason Kim, Annie Rohan, and David Thanassi Anh NguyenAnh Nguyen More articles by this author , Glenn WerneburgGlenn Werneburg More articles by this author , Jason KimJason Kim More articles by this author , Annie RohanAnnie Rohan More articles by this author , and David ThanassiDavid Thanassi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.745AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The majority of hospital-acquired urinary tract infections (UTIs) are catheter-associated UTIs (CAUTIs), which are associated with increased morbidity and mortality in patients, with 13,000 attributed deaths annually. CAUTIs are also associated with increased length of hospital stays and 0.4-0.5 billion USD in annual healthcare costs, as well as unnecessary antimicrobial use. The formation of biofilms (groups of bacterial cells that adhere to one another and to a fixed surface) on catheters is critical to the development and persistence of CAUTI, as biofilms function as both barriers to antibiotics and reservoirs of microbes. We sought to determine the natural history of biofilm formation on urinary catheters. In particular, we were interested in the starting location(s) of biofilm formation, and whether biofilms predominated proximally or distally on catheters, their timing and manner of progression, and whether catheter biofilm formation was predominantly extraluminal or intraluminal. METHODS Foley catheters (n=19) were collected from outpatient and inpatient clinics at a large university medical center from post-surgical patients at 1 to 28 days indwelling time. Each catheter was sectioned and stained, and biofilms were quantitated using spectrophotometry. RESULTS Short-term catheters (indwelling <1 week) displayed predominant biofilm formation at the proximal (bladder-exposed) end, whereas long-term catheters (indwelling 3-4 weeks) displayed significant biofilm formation throughout all segments. Biofilm growth on short-term catheters was predominantly extra-luminal, whereas long-term catheters demonstrated significant extra- and intra-luminal biofilm staining. CONCLUSIONS The results of this preliminary study inform approaches to developing novel strategies to prevent and eradicate bacterial biofilms from urinary catheters. For example, this study suggests that catheter-coating techniques targeting the extraluminal surface of the proximal end of the urinary catheter may contribute to a delay of biofilm formation, and reduce the overall risk of CAUTI. Efforts are under way to further investigate biofilm progression with larger sample sizes, and to determine how a reduction in biofilm formation and progression may contribute to reduced CAUTI risk. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e300 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Anh Nguyen More articles by this author Glenn Werneburg More articles by this author Jason Kim More articles by this author Annie Rohan More articles by this author David Thanassi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...