The Rabbit Model of Catheter-associated Urinary Tract Infection

Morck, Douglas W.; Olson, Merle E.; Read, Ronald R.; Buret, André G.

doi:10.1016/b978-012775390-4/50192-5

Cited by 3 publications

(6 citation statements)

References 27 publications

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“…Rabbits were inoculated with 1.0 ϫ 10 9 CFU of a streptomycinresistant E. coli (WE 6933) inoculum daily for 4 days (days 1 to 4). This E. coli strain was previously shown to cause UTIs in an established rabbit model which is reflective of the clinical setting (15). Each rabbit was inoculated on the prepuce of the penis immediately after catheter placement (day 0) and again daily for 3 days (days 1 to 3).…”

Section: Methodsmentioning

confidence: 99%

“…By use of protocols described by Morck et al (15), 31 male New Zealand White rabbits were surgically implanted with indwelling intravenous catheters to allow continuous infusion of intravenous fluids to maintain normal hydration. In addition, rabbits were catheterized with uncoated 12-Fr Cook silicone Foley catheters (control 1; n ϭ 9), Bard hydrogel-uncoated 12-Fr Foley catheters (control 2; n ϭ 7), Gendine-coated 12-Fr Cook silicone Foley catheters (n ϭ 8), or Bardex IC silver hydrogel-coated 12-Fr Foley catheters (n ϭ 7).…”

Section: Methodsmentioning

confidence: 99%

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Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results

Hachem¹,

Reitzel²,

Borne

et al. 2009

Antimicrob Agents Chemother

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Urinary catheters are widely used for hospitalized patients and are often associated with high rates of urinary tract infection. We evaluated in vitro the antiadherence activity of a novel antiseptic Gendine-coated urinary catheter against several multidrug-resistant bacteria. Gendine-coated urinary catheters were compared to silver hydrogel-coated Foley catheters and uncoated catheters. Bacterial biofilm formation was assessed by quantitative culture and scanning electron microscopy. These data were further correlated to an in vivo rabbit model. We challenged 31 rabbits daily for 4 days by inoculating the urethral meatus with 1.0 ؋ 10 9 CFU streptomycin-resistant Escherichia coli per day. In vitro, Gendine-coated urinary catheters reduced the CFU of all organisms tested for biofilm adherence compared with uncoated and silver hydrogel-coated catheters (P < 0.004). Scanning electron microscopy analysis showed that a thick biofilm overlaid the control catheter and the silver hydrogel-coated catheters but not the Gendine-coated urinary catheter. Similar results were found with the rabbit model. Bacteriuria was present in 60% of rabbits with uncoated catheters and 71% of those with silver hydrogel-coated catheters (P < 0.01) but not in those with Gendine-coated urinary catheters. No rabbits with Gendine-coated urinary catheters had invasive bladder infections. Histopathologic assessment revealed no differences in toxicity or staining. Gendine-coated urinary catheters were more efficacious in preventing catheter-associated colonization and urinary tract infections than were silver hydrogelcoated Foley catheters and uncoated catheters.In the United States, nosocomial catheter-related urinary tract infections (UTIs) account for almost 1 million cases (24) and approximately 31% of nosocomial infections seen in the intensive care unit each year (16). Approximately 10% to 30% of patients with indwelling bladder catheters develop bacteruria or UTI (24). This contributes not only to increased morbidity and mortality but also to longer hospital stays and increased medical costs (13). Microbiologic cultures of catheter-related UTIs in the intensive care unit reveal several common pathogens. Of these, Escherichia coli and Pseudomonas aeruginosa account for over 39%.Several different methods have been used to prevent nosocomial UTIs. Of these, the most common and longest-used method is the sterile closed drainage system, which has substantially reduced the prevalence of catheter-associated UTIs (11). More recently, other preventive methods involving the use of antimicrobial devices, including urinary catheters impregnated with silver, nitrofurazone, and a combination of minocycline and rifampin (rifampicin), have led to a reduced incidence of bacteruria; however, they were not significant at preventing catheter-related UTIs compared to results with uncoated controls (4,12,22).The use of antibiotic (minocycline and rifampin)-impregnated catheters has led to a reduced incidence of gram-positive bacteruria (4). However, given the ...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results

Hachem¹,

Reitzel²,

Borne

et al. 2009

Antimicrob Agents Chemother

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“…We used pigs, which is the only convenient animal for studying human‐relevant catheter performance 9,10,13 . Others have used mice, rabbits, and dogs for investigating catheter‐associated urinary tract infection, but these animals are not large enough to accurately recapitulate the human bladder anatomy or to support catheter sizes designed for adults 13–15 . Identical catheter size is critical when analysing mucosal trauma, as the shape and size of eyelets and catheter shaft are shown to influence the hydrodynamic pressure gradient that ultimately dictates mucosal suction and associated trauma 6 .…”

Section: Discussionmentioning

confidence: 99%

“…9,10,13 Others have used mice, rabbits, and dogs for investigating catheter-associated urinary tract infection, but these animals are not large enough to accurately recapitulate the human bladder anatomy or to support catheter sizes designed for adults. [13][14][15] Identical catheter size is critical when analysing mucosal trauma, as the shape and size of eyelets and catheter shaft are shown to influence the hydrodynamic pressure gradient that ultimately dictates mucosal suction and associated trauma. 6 Arguably, the use of pigs makes the results more translatable to human; however, pigs are more expensive than smaller animal models precluding the use of large sample sizes.…”

Section: Discussionmentioning

confidence: 99%

“…Trauma during IC is described as a risk factor for UTI. 15 Singleuse catheters with hydrophilic coating are shown to reduce urethral trauma and are associated with significantly less UTIs compared with uncoated catheters. 16 This suggests that catheters which minimize bladder mucosal trauma, such as the MHZC, may reduce the risk of UTI in IC users.…”

Section: Discussionmentioning

confidence: 99%

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Catheter‐associated bladder mucosal trauma during intermittent voiding: An experimental study in pigs

Stærk,

Schrøder,

Jensen

et al. 2023

BJUI Compass

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ObjectiveThe objective of this study is to characterize bladder mucosal trauma associated with intermittent catheterization with conventional eyelet catheters (CECs) and to assess if a microhole zone catheter (MHZC) design concept reduces this adverse effect.Materials and MethodsA porcine model was developed to reflect human catheterization and bladder drainage. Nine pigs were randomized for catheterization with CEC (n = 6) or MHZC (n = 3). The bladder was drained repeatedly 20 times through the catheter. Cystoscopy was performed before and after the procedure, and bladders were analysed by histopathology. Two additional pigs were used for cystoscopy visualization of suction events in vivo. Cystoscopy, gross pathology, histopathological score, leucocyte infiltration, and intracatheter pressure at flow stops during voiding were compared for each group.ResultsA significant higher pressure gradient was measured inside the CECs compared with MHZCs during flow stop. Consequently, CECs resulted in suction events inflicting bladder trauma characterized by loss of epithelium, oedema, haemorrhage, and neutrophil tissue infiltration. No significant trauma was identified when using MHZC.ConclusionsConsiderable mucosal bladder trauma is inflicted by CECs which may be an overlooked risk factor for urinary tract infection. Catheters can be designed to minimize mucosal suction and reduce associated trauma. This may be a solution to reduce infection frequency and increase user comfort. Furthermore, the study demonstrates the potential of pigs as an attractive animal model for investigating urinary catheter performances.

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Induction of bacterial cystitis in female rabbits by uropathogenic Escherichia coli and the differences between the bladder dome and trigone

Othman

Ezzat

Rizk

et al. 2021

Ultrastructural Pathology

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The Rabbit Model of Catheter-associated Urinary Tract Infection

Cited by 3 publications

References 27 publications

Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results

Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results

Catheter‐associated bladder mucosal trauma during intermittent voiding: An experimental study in pigs

Induction of bacterial cystitis in female rabbits by uropathogenic Escherichia coli and the differences between the bladder dome and trigone

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