Document Detail


Observations on the development of the crystalline bacterial biofilms that encrust and block Foley catheters.
MedLine Citation:
PMID:  18550219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The care of many patients undergoing long-term bladder catheterisation is complicated when the flow of urine through the catheter is blocked by encrustation. The problem results from infection by urease-producing bacteria, especially Proteus mirabilis, and the subsequent formation of crystalline biofilms on the catheter. The aim of this study was to discover how P. mirabilis initiates the development of these crystalline biofilms. The early stages in the formation of the biofilms were observed on a range of Foley catheters in a laboratory model of the catheterised bladder. Scanning electron micrographs revealed that when all-silicone, silicone-coated latex, hydrogel-coated latex, hydrogel/silver-coated latex and nitrofurazone silicone catheters were inserted into bladder models containing P. mirabilis and alkaline urine, their surfaces were rapidly coated with a microcrystalline foundation layer. X-ray microanalysis showed that this material was composed of calcium phosphate. Bacterial colonisation of the foundation layer followed and by 18h the catheters were encrusted by densely populated crystalline P. mirabilis biofilms. These observations have important implications for the development of encrustation-resistant catheters. In the case of silver catheters for example, bacterial cells can attach to the crystalline foundation layer and continue to grow, protected from contact with the underlying silver. If antimicrobials are to be incorporated into catheters to prevent encrustation, it is important that they diffuse into the urine and prevent the rise in pH that triggers crystal formation.
Authors:
D J Stickler; S D Morgan
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Publication Detail:
Type:  Journal Article     Date:  2008-06-11
Journal Detail:
Title:  The Journal of hospital infection     Volume:  69     ISSN:  0195-6701     ISO Abbreviation:  J. Hosp. Infect.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007166     Medline TA:  J Hosp Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  350-60     Citation Subset:  IM    
Affiliation:
Cardiff School of Biosciences, Cardiff University, Cardiff, UK. stickler@cardiff.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Biofilms / growth & development*
Calcium Phosphates / analysis
Catheters, Indwelling / microbiology*
Humans
Hydrogen-Ion Concentration
Microscopy, Electron, Scanning
Proteus mirabilis / metabolism,  physiology*,  ultrastructure
Spectrometry, X-Ray Emission
Urinary Catheterization*
Urine / chemistry,  microbiology
Chemical
Reg. No./Substance:
0/Calcium Phosphates; 10103-46-5/calcium phosphate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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