Combination of urease inhibitor and antiseptic inhibits urea decomposition‐induced ammonia production by Proteus mirabilis

Abstract

The decomposition of urea into ammonia by urease‐producing bacterium shows an elevation in the pH level, which can lead to incontinence‐associated dermatitis (IAD). This study aimed to examine the efficacy of a combination of antiseptic and urease inhibitor in inhibiting the decomposition of urea by the urease‐producing bacterium Proteus mirabilis. We performed in vitro assays to compare the effects of a combination of antiseptic and urease inhibitor, antiseptic only, urease inhibitor only, and an untreated control with the effects of a urea‐containing solution. Cultured P. mirabilis was mixed with urea‐containing solution, followed by the addition of antiseptic and/or urease inhibitor. The main outcome used to assess the efficacy of the different treatments was ammonia concentration at 4‐hours post‐treatment initiation, and multiple comparison analysis was performed using Dunnett's test to compare the results between groups. Ammonia concentrations in samples treated with either antiseptic or urease inhibitor were lower than those in the untreated control, while the combination of antiseptic and urease inhibitor resulted in decreased ammonia concentrations compared with either treatment alone. Therefore, the application of both urease inhibitor and antiseptic is more effective for the inhibition of urea decomposition by urease‐producing bacteria. Novel preventive strategies using these reagents may be effective for preventing IAD.

An Exploratory Study of the Effects of the pH of Synthetic Urine on Skin Integrity in Healthy Participants

“…In particular, the presence of bacteria in urine is commonly found in patients with urinary incontinence [61], and indeed, bacteria contaminated urine has been recognized as a risk factor for IAD [62]. Therefore, future studies need to examine the mechanisms of IAD following combined exposure of skin to urine and common uropathogens associated with IAD, including Pseudomonas aeruginosa and Proteus mirabilis , which can also contribute to pH elevation due to its high urease activity [63].…”

Bacterial invasion into the epidermis of rats with sodium lauryl sulphate‐irritated skin increases damage and induces incontinence‐associated dermatitis

“…As such, inhibiting bacterial virulence factors, for example, urease activity and ammonia generation may offer another possible preventive strategy against IAD development. 24 In summary, we have developed a novel animal model for IAD induced by urine and bacteria. We believe that this model can serve to understand in detail the mechanisms that lead to IAD in relation to urinary incontinence, guide the development of novel interventions, and test their effectiveness in preventing IAD or in promoting the healing of such lesions.…”

“…2X Luria‐Bertani (LB) broth was prepared in distilled water containing 20 g/L peptones (Nakalai Tesque Inc., Kyoto, Japan), 10 g/L yeast extract (Nakalai Tesque Inc., Kyoto, Japan) and 20 g/L sodium chloride (Fujifilm Wako Pure Chemicals, Osaka, Japan) and diluted to 1X with distilled water or synthetic human urine (s‐urine, pH 6.50). 2X s‐urine was used as the moisture irritant source experienced by patients with urinary incontinence, and prepared as previously described 24 by adding the following chemicals to constantly stirring distilled water: 4% urea, 1.6% sodium chloride, 0.06% magnesium sulphate, and 0.016% calcium chloride. All chemicals were purchased from Fujifilm Wako Pure Chemicals (Osaka, Japan).…”

Isolation and Characterization of Effective Bacteria That Reduce Ammonia Emission from Livestock Manure

“…The reversal pattern between the aerobic and anaerobic control groups could be a phenomenon due to the metabolism of aerobic ammonia producing bacteria in the manure. Ammonia producing bacteria via urea hydrolysis are present in livestock manure [9,10,51]. Furthermore, the DNA of C. aminophilum and P. mirabilis, representative HAB strains with urease activity [9,10], was present in the manure used in this study.…”