Pilot Ex Vivo and In Vitro Evaluation of a Novel Foley Catheter with Antimicrobial Periurethral Irrigation for Prevention of Extraluminal Biofilm Colonization Leading to Catheter-Associated Urinary Tract Infections (CAUTIs).

Publisher: Wiley Country of Publication: United States NLM ID: 101600173 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6141 (Electronic) NLM ISO Abbreviation: Biomed Res Int Subsets: MEDLINE

Publication: 2024- : [Hoboken, NJ] : Wiley
Original Publication: New York, NY : Hindawi Pub. Co.

Anti-Infective Agents/*pharmacology ; Bacteria/*drug effects ; Biofilms/*drug effects ; Catheter-Related Infections/*prevention & control ; Urinary Catheterization/*methods ; Urinary Tract Infections/*prevention & control; Animals ; Candida albicans/drug effects ; Catheter-Related Infections/microbiology ; Catheters, Indwelling ; Drug Resistance, Multiple, Bacterial/drug effects ; Enterococcus faecalis/drug effects ; Escherichia coli/drug effects ; Female ; Humans ; In Vitro Techniques ; Infection Control/methods ; Klebsiella pneumoniae/drug effects ; Models, Animal ; Proteus mirabilis/drug effects ; Pseudomonas aeruginosa/drug effects ; Swine ; Urinary Catheterization/instrumentation ; Urinary Tract Infections/microbiology

Competing Interests: The authors declare that they have no conflicts of interest.
CAUTI remains a serious healthcare issue for incontinent patients whose urine drainage is managed by catheters. A novel double-balloon Foley catheter was developed which was capable of irrigating the extraluminal catheter surfaces within the periurethral space between the urethral-bladder junction and meatus. The catheter has a retention cuff that is inflated to secure the catheter in the bladder and a novel irrigation cuff proximal to the urethral-bladder junction capable of providing periurethral irrigation from the urethral-bladder junction to the meatus. Uniform periurethral irrigation was demonstrated in an ex vivo porcine model by adding a dye to the antimicrobial urethral irrigation solution. An in vitro biofilm colonization model was adapted to study the ability of periurethral irrigation with a newly developed antimicrobial combination consisting of polygalacturonic acid + caprylic acid (PG + CAP) to prevent axial colonization of the extraluminal urethral indwelling catheter shaft by common uropathogens. The extraluminal surface of control catheters that were not irrigated formed biofilms along the entire axial urethral tract after 24 hours. Significant ( p < 0.001) inhibition of colonization was seen against multidrug-resistant Pseudomonas aeruginosa (PA), carbapenem-resistant Escherichia coli (EC), and carbapenem-resistant Klebsiella pneumoniae (KB). For other common uropathogens including Candida albicans (CA), Proteus mirabilis (PR), and Enterococcus faecalis (EF), a first irrigation treatment completely inhibited colonization of half of the indwelling catheter closest to the bladder and a second treatment largely disinfected the remaining intraurethral portion of the catheter towards the meatus. The novel Foley catheter and PG + CAP antimicrobial irrigant prevented biofilm colonization in an in vitro CAUTI model and merits further testing in an in vivo CAUTI prevention model.
(Copyright © 2019 Nylev Vargas-Cruz et al.)

Int J Crit Illn Inj Sci. 2018 Jan-Mar;8(1):17-21. (PMID: 29619335)
Urol Res. 2009 Aug;37(4):205-9. (PMID: 19468723)
J Endourol. 2005 Oct;19(8):1016-20. (PMID: 16253073)
Prof Nurse. 2004 May;19(9):515-8. (PMID: 15152410)
Eur Radiol. 2003 Mar;13(3):536-42. (PMID: 12594557)
Acta Biomater. 2017 Mar 1;50:20-40. (PMID: 27916738)
Cochrane Database Syst Rev. 2014 Sep 23;(9):CD004013. (PMID: 25248140)
BJU Int. 2012 Jun;109(12):1746-9. (PMID: 22094023)
Clin Microbiol Rev. 2008 Jan;21(1):26-59. (PMID: 18202436)
Lancet Infect Dis. 2019 Jun;19(6):611-619. (PMID: 30987814)
Arch Intern Med. 2000 Mar 13;160(5):678-82. (PMID: 10724054)
Front Microbiol. 2017 Oct 18;8:1999. (PMID: 29093703)
J Clin Diagn Res. 2016 Jun;10(6):PC01-3. (PMID: 27504341)
Infect Control Hosp Epidemiol. 2003 Jul;24(7):506-13. (PMID: 12887239)
J Appl Microbiol. 2019 Dec;127(6):1876-1888. (PMID: 31502331)
Mayo Clin Proc. 1999 Feb;74(2):131-6. (PMID: 10069349)
Am J Infect Control. 2017 Oct 1;45(10):1101-1105. (PMID: 28629757)
J Rehabil Med. 2018 Feb 13;50(2):181-184. (PMID: 29355293)
Am J Infect Control. 2010 Oct;38(8):644-6. (PMID: 20868930)
Expert Rev Med Devices. 2019 Sep;16(9):809-820. (PMID: 31478395)
J Urol. 2020 Feb;203(2):357-364. (PMID: 31430245)
Infect Control Hosp Epidemiol. 2014 Sep;35 Suppl 2:S32-47. (PMID: 25376068)
Infect Control Hosp Epidemiol. 2010 Apr;31(4):319-26. (PMID: 20156062)
Proc Inst Mech Eng H. 2019 Jan;233(1):48-57. (PMID: 29792114)
Urology. 1992 Oct;40(4):322-5. (PMID: 1413348)
Am J Med. 1991 Sep 16;91(3B):65S-71S. (PMID: 1928194)

0 (Anti-Infective Agents)

Date Created: 20200125 Date Completed: 20200706 Latest Revision: 20200706

20250114

PMC6959145

10.1155/2019/2869039

31976318