A study of the structure of the crystalline bacterial biofilms that can encrust and block silver Foley catheters

Morgan, Sheridan D.; Rigby, Debbie; Stickler, D.J.

doi:10.1007/s00240-009-0176-6

Cited by 48 publications

(48 citation statements)

References 15 publications

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“…Bacterial colonization of this crystalline foundation layer then led to mature crystalline biofilm formation. 25,32 These observations that crystalline biofilms of P. mirabilis can form in several distinct ways under various conditions have important implications for the development of encrustation-resistant catheters. It is clear that trying to inhibit bacterial attachment and crystalline biofilm formation by immobilizing an antibacterial in the catheter is unlikely to prevent the problem in patients infected with P. mirabilis.…”

Section: Mechanisms Of Crystalline Biofilm Formationmentioning

confidence: 99%

“…Unfortunately, this does not happen with the currently available antimicrobial catheters. 25,32 Controlling the rate of crystalline biofilm formation Clinicians recognize that patients experiencing recurrent catheter blockage show considerable variation in catheter The encrustation of Foley catheters DJ Stickler and RCL Feneley lifespan. In a prospective study of catheterized patients infected with P. mirabilis, Mathur et al 33 found that the time taken for catheters to block varied from 2 to 98 days.…”

Section: Mechanisms Of Crystalline Biofilm Formationmentioning

confidence: 99%

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The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control

2010

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Objectives: To review the literature showing that understanding how Foley catheters become encrusted and blocked by crystalline bacterial biofilms has led to strategies for the control of this complication in the care of patients undergoing long-term indwelling bladder catheterization. Methods: A comprehensive PubMed search of the literature published between 1980 and December 2009 was made for relevant articles using the Medical Subject Heading terms 'biofilms', 'urinary catheterization', 'catheter-associated urinary tract infection' and 'urolithiasis'. Papers on catheterassociated urinary tract infections and bacterial biofilms collected during 40 years of working in the field were also reviewed. Results: There is strong experimental and epidemiological evidence that infection by Proteus mirabilis is the main cause of the crystalline biofilms that encrust and block Foley catheters. The ability of P. mirabilis to generate alkaline urine and to colonize all available types of indwelling catheters allows it to take up stable residence in the catheterized tract in bladder stones and cause recurrent catheter blockage. Conclusion: The elimination of P. mirabilis by antibiotic therapy as soon as it appears in the catheterized urinary tract could improve the quality of life for many patients and reduce the current expenditure of resources when managing the complications of catheter encrustation and blockage. For patients who are already chronic blockers and stone formers, antibiotic treatment is unlikely to be effective owing to the resistance of cells in the crystalline biofilms. Strategies such as increasing fluid intake with citrated drinks could control the problem until bladder stone removal can be organized.

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Section: Mechanisms Of Crystalline Biofilm Formationmentioning

confidence: 99%

Section: Mechanisms Of Crystalline Biofilm Formationmentioning

confidence: 99%

The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control

2010

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“…Another approach using antimicrobials consists of coating and impregnating the catheters with these antimicrobial agents (Ghanwate et al, 2014;Morgan et al, 2009;Brisset et al, 1996).…”

Section: Antimicrobial Treatment Of Biofilmmentioning

confidence: 99%

“…Biofilm can be up to 1000-fold more resistant to antibiotics than planktonic cells due to several mechanisms (Lewis, 2005;Costerton et al, 2007;Lewis, 2005Lewis, , 2008Ghanwate 2014;Ghanwate and Thakare, 2012;Morgan et al, 2009):…”

Section: Biofilm and Antimicrobial Resistancementioning

confidence: 99%

Importance of biofilm in medical sciences: With special reference to uropathogens

Niraj¹,

Anjali²,

Thakare³

2016

Afr. J. Microbiol. Res.

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Biofilm formation is a well organised, genetically-driven process, well characterized for numerous bacterial species which plays important role in urinary tract infections (UTIs). Adherence is a key event initiating each step in UTI pathogenesis. Such UTIs are difficult to treat owing to increased drug resistance within the biofilm cells. The review is mainly focused on biofilm-growing microorganisms because this form of growth poses a threat to chronically infected or immunocompromised patients and is difficult to eradicate from medical devices. Biofim formation process and mechanisms to its increased resistance to various antimicrobials is also discussed together with newer prophylactic and therapeutic approaches like catheters coated with hydrogels or antibiotics, nanoparticles, ionotrophoresis, biofilm enzyme inhibitors, liposomes, bacterial interference, bacteriophages, quorum sensing inhibitor, combining antimicrobial photodynamic therapy and antiadhesion agents. The review justifies the need for new antibiofilm drug.

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“…Although catheters containing antimicrobial coatings are currently available, their efficacy in preventing infection during even short-term use remains questionable, and all available catheter types remain susceptible to P. mirabilis encrustation and blockage (9,10). P. mirabilis is also extremely difficult to eliminate once established in the catheterized urinary tract and often responds poorly to conventional antibiotic therapy.…”

mentioning

confidence: 99%

Bacteriophage Can Prevent Encrustation and Blockage of Urinary Catheters by Proteus mirabilis

Nzakizwanayo

Hanin

Alves

et al. 2016

Antimicrob Agents Chemother

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h Proteus mirabilis forms dense crystalline biofilms on catheter surfaces that occlude urine flow, leading to serious clinical complications in long-term catheterized patients, but there are presently no truly effective approaches to control catheter blockage by this organism. This study evaluated the potential for bacteriophage therapy to control P. mirabilis infection and prevent catheter blockage. Representative in vitro models of the catheterized urinary tract, simulating a complete closed drainage system as used in clinical practice, were employed to evaluate the performance of phage therapy in preventing blockage. Models mimicking either an established infection or early colonization of the catheterized urinary tract were treated with a single dose of a 3-phage cocktail, and the impact on time taken for catheters to block, as well as levels of crystalline biofilm formation, was measured. In models of established infection, phage treatment significantly increased time taken for catheters to block (ϳ3-fold) compared to untreated controls. However, in models simulating early-stage infection, phage treatment eradicated P. mirabilis and prevented blockage entirely. Analysis of catheters from models of established infection 10 h after phage application demonstrated that phage significantly reduced crystalline biofilm formation but did not significantly reduce the level of planktonic cells in the residual bladder urine. Taken together, these results show that bacteriophage constitute a promising strategy for the prevention of catheter blockage but that methods to deliver phage in sufficient numbers and within a key therapeutic window (early infection) will also be important to the successful application of phage to this problem.A frequent complication associated with long-term urethral catheterization is the encrustation and blockage of catheters due to infection with Proteus mirabilis, which can be isolated from around 45% of catheter-associated urinary tract infections (CAUTI) (1, 2). Blockage stems from the ability of P. mirabilis to form dense biofilms on catheter surfaces and the production of a potent urease enzyme which generates ammonia through hydrolysis of urea (1,3,4). Ammonia production elevates urinary pH, causing the precipitation of calcium and magnesium phosphates and the subsequent formation of crystals which become trapped within developing biofilms (1, 5). Once embedded in the biofilm, crystal growth is stabilized and enhanced by the biofilm matrix (6, 7). As this process continues, the biofilm gradually becomes mineralized, leading to development of extensive crystalline biofilm structures which ultimately block catheters (1, 5). If blockage is unnoticed, it can lead to reflux of infected urine to the upper urinary tract and the onset of serious clinical complications, including pyelonephritis, septicemia, and shock (1, 8).Although catheters containing antimicrobial coatings are currently available, their efficacy in preventing infection during even short-term use remains questionable, and all...

show abstract

A study of the structure of the crystalline bacterial biofilms that can encrust and block silver Foley catheters

Cited by 48 publications

References 15 publications

The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control

The encrustation and blockage of long-term indwelling bladder catheters: a way forward in prevention and control

Importance of biofilm in medical sciences: With special reference to uropathogens

Bacteriophage Can Prevent Encrustation and Blockage of Urinary Catheters by Proteus mirabilis

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