Promising catheters to reduce hospital-acquired urinary tract infections

Introduction and Aim: Hospital-acquired infection with multidrug-resistant bacteria following urinary catheter use in hospitalized patients is mainly due to the biofilm-forming ability of these bacteria. It becomes essential to look at the other options of treatment of such urinary tract infections (UTI) and one such option has been the use of bacteriophages. The study aimed to compare the biofilms formed by uropathogenic Escherichia coli on three different types of urinary catheters in the presence of crude coliphage and sub-inhibitory concentration of ciprofloxacin.   Materials and Methods:  It was an Institution based experimental study. A total of 10 red rubber (latex) catheter pieces, 10 Foley (PVC) catheter pieces and 10 silicone Foley catheter pieces were used for the study. Crude coliphage suspension was prepared from sewage samples taken from the sewage treatment plant.  Biofilm production by ten uropathogenic E. coli isolates on these catheters was determined by Kolter and O’Toole’s method with certain modifications. Biofilm assay was repeated with conditions using crude bacteriophage and sub-inhibitory concentration.  An electron micrograph of the catheter pieces was taken to visualize the biofilm formed. P value of 0.05 was considered statistically significant.   Results: It was observed that, in the presence of crude bacteriophage there was a significant reduction in the biofilm formation on all three catheters (p 0.05). Also, there was a significant reduction in biofilm production in the presence of sub-inhibitory concentration of ciprofloxacin on silicone Foley’s catheter (p=0.001) but not on red rubber catheter or PVC Foley’s catheter (p 0.05). It was also observed that in some of the isolates the colony counts increased following the addition of ciprofloxacin in case of PVC Foley catheters.   Conclusion: Bacteriophage-coated catheters may be the gateway to overcoming the hurdle of multidrug-resistant catheter-associated urinary tract infection.