Abstract
BackgroundUrinary catheters are associated, commonly with bacteriuria and frequently with urinary tract infection. Tamm-Horsfall Protein (THP) is urine's most abundant protein and is known to bind to uropathogenic bacteria. The role of THP in the pathogenesis of catheter associated urinary tract infection (CAUTI) is not clear. We examined the role of THP in facilitating bacterial binding to urinary catheters in vivo and in vitro.FindingsTwenty one urinary catheters were obtained from 20 hospitalized patients. THP was eluted from the catheter surface and catheter segments were cultured. Additional studies were performed in vitro on unused silicone and latex catheters to determine the binding of THP, and the effect of THP on the binding of Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa), to the catheter surface.On catheters obtained from patients, the THP deposition was significantly more on culture positive catheters than on culture negative catheters. In the in vitro studies, THP bound to both silicone and latex catheters, and THP enhanced the adherence of E. coli and P. aeruginosa to both types of catheters.ConclusionTHP binds to urinary catheters and facilitates the binding of uropathogenic bacteria to catheters.
Highlights
Urinary catheters are associated, commonly with bacteriuria and frequently with urinary tract infection
On catheters obtained from patients, the Tamm-Horsfall Protein (THP) deposition was significantly more on culture positive catheters than on culture negative catheters
In the in vitro studies, THP bound to both silicone and latex catheters, and THP enhanced the adherence of E. coli and P. aeruginosa to both types of catheters
Summary
Commonly with bacteriuria and frequently with urinary tract infection. Tamm-Horsfall Protein (THP) is urine's most abundant protein and is known to bind to uropathogenic bacteria. The role of THP in the pathogenesis of catheter associated urinary tract infection (CAUTI) is not clear. Catheter Associated Urinary Tract Infection (CAUTI) is a common hospital acquired infection. Urinary catheters are placed in one of four hospitalized patients in the United States [1]. About 26% of catheterized patients develop asymptomatic catheter associated bacteriuria (CAB) of which 24% progress to symptomatic CAUTI [2]. In adult intensive care units, more than 95% of urinary tract infections are caused by urinary catheters [6]. Tamm-Horsfall protein (THP) is the most abundant protein in normal urine with multiple postulated biological functions [7-9]. We [10] and others [11] have previously shown that THP
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