Observations on the development of the crystalline bacterial biofilms that encrust and block Foley catheters.
The care of many patients undergoing long-term bladder catheterisation is complicated when the flow of urine through the catheter is blocked by encrustation. The problem results from infection by urease-producing bacteria, especially Proteus mirabilis, and the subsequent formation of crystalline bio...
| Published in: | Journal of Hospital Infection Vol. 69; no. 4; pp. 350 - 361 |
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| Main Authors: | , |
| Format: | research Journal Article |
| Published: |
W B Saunders
Aug2008
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105680786&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105680786 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01956701 4C3 jtl: Journal of Hospital Infection issn: 01956701 maglogo: N pubinfo: dt: Aug2008 vid: 69 iid: 4 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 105680786 2010031669 10.1016/j.jhin.2008.04.031 NLM18550219 105680786 ppf: 350 ppct: 11 formats: tig: atl: Observations on the development of the crystalline bacterial biofilms that encrust and block Foley catheters. aug: au: Stickler DJ Morgan SD affil: Cardiff School of Biosciences, Cardiff University, Cardiff CF10 3TL, UK; stickler@cardiff.ac.uk sug: subj: Biofilms Catheters Proteus Physiology Urinary Catheterization Hydrogen-Ion Concentration Microscopy, Electron, Scanning Phosphates Analysis Proteus Metabolism Proteus Spectrometry, X-Ray Emission Urine Microbiology Urine Human ab: The care of many patients undergoing long-term bladder catheterisation is complicated when the flow of urine through the catheter is blocked by encrustation. The problem results from infection by urease-producing bacteria, especially Proteus mirabilis, and the subsequent formation of crystalline biofilms on the catheter. The aim of this study was to discover how P. mirabilis initiates the development of these crystalline biofilms. The early stages in the formation of the biofilms were observed on a range of Foley catheters in a laboratory model of the catheterised bladder. Scanning electron micrographs revealed that when all-silicone, silicone-coated latex, hydrogel-coated latex, hydrogel/silver-coated latex and nitrofurazone silicone catheters were inserted into bladder models containing P. mirabilis and alkaline urine, their surfaces were rapidly coated with a microcrystalline foundation layer. X-ray microanalysis showed that this material was composed of calcium phosphate. Bacterial colonisation of the foundation layer followed and by 18h the catheters were encrusted by densely populated crystalline P. mirabilis biofilms. These observations have important implications for the development of encrustation-resistant catheters. In the case of silver catheters for example, bacterial cells can attach to the crystalline foundation layer and continue to grow, protected from contact with the underlying silver. If antimicrobials are to be incorporated into catheters to prevent encrustation, it is important that they diffuse into the urine and prevent the rise in pH that triggers crystal formation. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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