Abstract
Urinary catheters are common medical devices, whose main function is to drain the bladder. Although they improve patients’ quality of life, catheter placement predisposes the patient to develop a catheter-associated urinary tract infection (CAUTI). The catheter is used by pathogens as a platform for colonization and biofilm formation, leading to bacteriuria and increasing the risk of developing secondary bloodstream infections. In an effort to prevent microbial colonization, several catheter modifications have been made ranging from introduction of antimicrobial compounds to antifouling coatings. In this review, we discuss the effectiveness of different coatings in preventing catheter colonization in vitro and in vivo, the challenges in fighting CAUTIs, and novel approaches targeting host–catheter–microbe interactions.
Highlights
The use of modern medical devices has revolutionized medical treatments, helping and improving quality of life for people with chronic and lifestyle diseases
The results showed that Poly(Ethylene Glycol) (PEG)-antimicrobial-coating had both antifouling and antimicrobial properties against S. aureus and Escherichia coli [46]
Given that antibiotics have different minimal inhibitory concentrations depending on the bacterial group, and that the microbial species diversity that causes catheter-associated urinary tract infection (CAUTI) is extensive, multiple antibiotics should be used for coating urinary catheters to increase its effectiveness and decrease the potential development of antibiotic resistance
Summary
The use of modern medical devices has revolutionized medical treatments, helping and improving quality of life for people with chronic and lifestyle diseases. It is estimated that 100 million urinary catheters are sold worldwide each year [2] and more than 30 million are used annually in the United States [2,8,9] This is reflected by the fact that that catheterization rates remain high at 20% in non-intensive care units (ICUs) and 61% in the ICU [10,11]. Great efforts have been made to prevent and manage CAUTI [12], a few of those strategies includes reducing usage and minimizing catheter dwell time [13,19] These prevention methods appear to reduce incidence of CAUTI [13]. We will discuss the current challenges, the role of the host response to urinary catheterization, and new strategies based on the host–catheter–microbe interactions
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