Application of a nanotechnology antimicrobial spray to prevent lower urinary tract infection: a multicenter urology trial

Abstract

BackgroundCatheter-associated urinary tract infection (CAUTI) is a common nosocomial device-associated infection. It is now recognized that the high infection rates were caused by the formation of biofilm on the surface of the catheters that decreases the susceptibility to antibiotics and results in anti-microbial resistance.In this study, we performed an in vitro test to explore the mechanism of biofilm formation and subsequently conducted a multi-center clinical trial to investigate the efficacy of CAUTI prevention with the application of JUC, a nanotechnology antimicrobial spray.MethodsSiliconized latex urinary catheters were cut into fragments and sterilized by autoclaving. The sterilized sample fragments were randomly divided into the therapy and control group, whereby they were sprayed with JUC and distilled water respectively and dried before use.The experimental standard strains of Escherichia coli (E. coli) were isolated from the urine samples of patients. At 16 hours and 7 days of incubation, the samples were extracted for confocal laser scanning microscopy.A total of 1,150 patients were accrued in the clinical study. Patients were randomized according to the order of surgical treatment. The odd array of patients was assigned as the therapy group (JUC), and the even array of patients was assigned as the control group (normal saline).ResultsAfter 16 hours of culture, bacterial biofilm formed on the surface of sample fragments from the control group. In the therapy group, no bacterial biofilm formation was observed on the sample fragments. No significant increase in bacterial colony count was observed in the therapy group after 7 days of incubation.On the 7th day of catheterization, urine samples were collected for bacterial culture before extubation. Significant difference was observed in the incidence of bacteriuria between the therapy group and control group (4.52% vs. 13.04%, p < 0.001).ConclusionsIn this study, the effectiveness of JUC in preventing CAUTI in a hospital setting was demonstrated in both in vitro and clinical studies.

Escherichia coli biofilm: development and therapeutic strategies

“…It formed an invisible, protective positively charged film on the surface after it was sprayed, and prevented the bacterial growth. In the clinical study, catheter sprayed with JUC therapy group, 4Á52% of patients were diagnosed with CAUTI as compared to 13Á04% in the control group (catheter sprayed with distilled water) (He et al 2012). In a recent study, selenium and tellurium nanoparticles obtained from the strains Stenotrophomonas maltophilia and Ochrobactrum sp.…”

Antimicrobial Models in Nanotechnology

“…Also, using a platform with plastic 12-well plate, the Biofilm Eradication Surface Test (BEST) Assayt is designed for testing specialized coatings and surfaces for antibiofilm activity and can be an interesting assay for product testing of NMs (Harding et al, 2011). For studying biofilm structure and biological changes during NM exposure, the use of a confocal laser scanning microscopy (CLSM) can offer more data about the mechanism of action of the compound and formulation with antibiofilm activity (He et al, 2012). CLSM can also be used to study antibiofilm activity in NMs deposited in antimicrobial coatings or surfaces (Applerot et al, 2012).…”

Advancing Technologies for the Diagnosis and Management of Infections

“…When applied to catheters before insertion followed by twice-daily application to both the urethral orifice and catheter, rates of UTIs are significantly lowered. 56 In a preclinical study, urinary catheters modified with a nitric oxide and acetic acid impeded bacterial growth and biofilms formation from clinically significant organisms, including P aeruginosa, K pneumoniae, and Enterococcus faecalis. 46 Orthopedic implant infections are associated with significant morbidity.…”