Does antimicrobial coating and impregnation of urinary catheters prevent catheter-associated urinary tract infection? A review of clinical and preclinical studies

Majeed, Aneela; Sagar, Fnu; Latif, Azka; Hassan, Hamza; Ahmad, Iftikhar; Darouiche, Rabih O.; Mohajer, Mayar Al

doi:10.1080/17434440.2019.1661774

Cited by 19 publications

(12 citation statements)

References 66 publications

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“…Multimodal prevention of UTI e the HAI type on which the effect of age is greatest e has been a focus for some years in the form of care bundles for all catheterized patients [56]. There has been a great deal of research into device-related UTI over the last 10 years, especially in relation to antimicrobial materials used in catheters; and although evidence exists for efficacy, there is very limited literature on the costeffectiveness of infection prevention interventions [57,58]. Despite the increased cost of these specialized IPC measures, if overall numbers of infections are reduced significantly and their use is limited to patients who are likely to benefit the most, it is possible that they may well be cost-effective [59].…”

Section: Discussionmentioning

confidence: 99%

Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection

Stewart

Robertson

Kennedy

et al. 2021

Journal of Hospital Infection

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Background: Few healthcare-associated infection (HAI) studies focus on risk of HAI at the point of admission. Understanding this will enable planning and management of care with infection prevention at the heart of the patient journey from the point of admission. Aim: To determine intrinsic characteristics of patients at hospital admission and extrinsic events, during the two years preceding admission, that increase risk of developing HAI. Methods: An incidence survey of adults within two hospitals in NHS Scotland was undertaken for one year in 2018/19 as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. The primary outcome measure was developing any HAI using recognized case definitions. The cohort was derived from routine hospital episode data and linkage to community dispensed prescribing data. Findings: The risk factors present on admission observed as being the most significant for the acquisition of HAI were: being treated in a teaching hospital, increasing age, comorbidities of cancer, cardiovascular disease, chronic renal failure and diabetes; and emergency admission. Relative risk of developing HAI increased with intensive care unit, high-dependency unit, and surgical specialties, and surgery <30 days before admission and a total length of stay of >30 days in the two years to admission. Conclusion: Targeting patients at risk of HAI from the point of admission maximizes the potential for prevention, especially when extrinsic risk factors are known and managed. This study proposes a new approach to infection prevention and control (IPC), identifying

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Section: Discussionmentioning

confidence: 99%

Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection

Stewart

Robertson

Kennedy

et al. 2021

Journal of Hospital Infection

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“…e effectiveness of antimicrobial irrigation of the bladder followed by drainage had been contested in CDC guidelines [20] but more recently reported effective elsewhere [21,22]. Effectiveness of antimicrobial catheter coatings has similarly been reported to be inconclusive [23][24][25]. CDC guidelines contest the effectiveness of meatal disinfection, but in recent study reports it was effective [26].…”

Section: Discussionmentioning

confidence: 99%

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)

Vargas-Cruz

Rosenblatt

Reitzel

et al. 2019

BioMed Research International

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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.

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“…In the case of antimicrobial coatings that release active materials, there would be a finite time of effectiveness until the concentration of the inhibitory compound dropped beneath an effective level (reviewed in Refs. [ 115 , 116 ]). Another issue relates to the long-term mechanical and chemical stability of coatings.…”

Section: Biofilm Control Strategiesmentioning

confidence: 99%

“…Antimicrobial coatings are used in some cases, e.g. silver-containing urinary catheters [ 116 ], although the long-term effectiveness would be reduced due to silver leaching from the catheter. There have also been developments in the use of bacterial signal disrupting molecules (including furanones, nitric oxide, and other small molecules) (reviewed in Ref.…”

Section: Biofilm Control Strategiesmentioning

confidence: 99%

Potential biofilm control strategies for extended spaceflight missions

Zea

McLean

Rook

et al. 2020

Biofilm

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Does antimicrobial coating and impregnation of urinary catheters prevent catheter-associated urinary tract infection? A review of clinical and preclinical studies

Cited by 19 publications

References 66 publications

Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection

Personalized infection prevention and control: identifying patients at risk of healthcare-associated infection

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)

Potential biofilm control strategies for extended spaceflight missions

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