Clinical complications of urinary catheters caused by crystalline biofilms: something needs to be done.
This review is largely based on a previous paper published in the journal Spinal Cord. The care of many patients undergoing long-term bladder catheterization is complicated by encrustation and blockage of their Foley catheters. This problem stems from infection by urease-producing bacteria, particul...
| Publicado en: | Journal of Internal Medicine Vol. 276; no. 2; pp. 120 - 130 |
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| Autor principal: | |
| Formato: | Journal Article |
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Wiley-Blackwell
Aug2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103975999&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103975999 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09546820 0IU jtl: Journal of Internal Medicine issn: 09546820 maglogo: Y pubinfo: dt: Aug2014 vid: 276 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103975999 2012655592 10.1111/joim.12220 NLM24635559 103975999 ppf: 120 ppct: 10 formats: tig: atl: Clinical complications of urinary catheters caused by crystalline biofilms: something needs to be done. aug: au: Stickler, D J affil: Cardiff School of Biosciences, Cardiff University, Cardiff, UK. sug: subj: Biofilms Catheter-Related Infections Microbiology Proteus Urinary Catheterization Adverse Effects Catheters, Urinary Adverse Effects Urinary Tract Infections Microbiology Calcium Compounds Metabolism Catheter-Related Infections Prevention and Control Citrates Urine Crystallization Magnesium Compounds Metabolism Proteus Infections Etiology Proteus Infections Prevention and Control Time Factors Urinary Catheterization Equipment and Supplies Urinary Catheterization Methods Urinary Tract Infections Urinary Tract Infections Prevention and Control Urine Urine Microbiology ab: This review is largely based on a previous paper published in the journal Spinal Cord. The care of many patients undergoing long-term bladder catheterization is complicated by encrustation and blockage of their Foley catheters. This problem stems from infection by urease-producing bacteria, particularly Proteus mirabilis. These organisms colonize the catheter forming an extensive biofilm; they also generate ammonia from urea, thus elevating the pH of urine. As the pH rises, crystals of calcium and magnesium phosphates precipitate in the urine and in the catheter biofilm. The continued development of this crystalline biofilm blocks the flow of urine through the catheter. Urine then either leaks along the outside of the catheter and the patient becomes incontinent or is retained causing painful distension of the bladder and reflux of urine to the kidneys. The process of crystal deposition can also initiate stone formation. Most patients suffering from recurrent catheter encrustation develop bladder stones. P. mirabilis establishes stable residence in these stones and is extremely difficult to eliminate from the catheterized urinary tract by antibiotic therapy. If blocked catheters are not identified and changed, serious symptomatic episodes of pyelonephritis, septicaemia and endotoxic shock can result. All types of Foley catheters including silver- or nitrofurazone-coated devices are vulnerable to this problem. In this review, the ways in which biofilm formation on Foley catheters is initiated by P. mirabilis will be described. The implications of understanding these mechanisms for the development of an encrustation-resistant catheter will be discussed. Finally, the way forward for the prevention and control of this problem will be considered. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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