Urological Research

, Volume 21, Issue 6, pp 407–411

Proteus mirabilis biofilms and the encrustation of urethral catheters

  • D. Stickler
  • L. Ganderton
  • J. King
  • J. Nettleton
  • C. Winters
Original Articles

Summary

Bacterial biofilms were observed on 69 of 75 catheters taken from patients undergoing long-term bladder management. Ten catheters were colonized by pure cultures of Proteus mirabilis. In each of these cases the bacteria formed layers on the catheter surface, underlying encrustations of struvite and hydroxyapatite which partially or completely occluded the catheter lumen. Encrustation was also apparent on catheters colonized by P. mirabilis plus other species, but was rarely seen on catheters colonized by non-urease-producing species. These observations support the hypothesis that catheter encrustation is brought about by the activity of urease-producing biofilms and confirms that the main target in the control of catheter encrustation should be P. mirabilis.

Key words

Bacterial biofilms Catheter encrustation Urethral catheters 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Clapham I, McLean RJC, Nickel JC, Downey J, Costerton JW (1990) The influence of bacteria on struvite crystal habit and its importance in urinary stone formation. J Crystal Growth 104:475Google Scholar
  2. 2.
    Costerton JW, Cheng KJ, Geesey GG, Ladd TI, Nickel JC, Dasgupta M, Marrie TJ (1987) Bacterial biofilms in nature and disease. Annu Rev Microbiol 41:435Google Scholar
  3. 3.
    Cox AJ, Hukins DWL (1989) Morphology of minerals deposits on encrusted urinary catheters investigated by scanning electron microscopy. J Urol 142:1347Google Scholar
  4. 4.
    Cox AJ, Hukins DWL, Sutton TM (1989) Infection of catheterized patients: bacterial colonization of encrusted Foley catheters shown by scanning electron microscopy. Urol Res 17:349Google Scholar
  5. 5.
    Ganderton L, Chawla JC, Winters C, Wimpenny J, Stickler D (1992) Scanning electron microscopy of bacterial biofilms on indwelling bladder catheters. Eur J Clin Microbiol Infect Dis 11:789Google Scholar
  6. 6.
    Getliffe KA, Mulhall AB (1991) The encrustation of indwelling catheters. Br J Urol 67:337Google Scholar
  7. 7.
    Gristina AG (1987) Biomaterial-centred infection: microbial adhesion versus tissue integration. Science 237:1588Google Scholar
  8. 8.
    Hedelin H, Eddeland A, Larsson L, Pettersson S, Ohman S (1984) The composition of catheter encrustations, including the effects of allopurinol treatment. Br J Urol 56:250Google Scholar
  9. 9.
    Hedelin H, Larsson L, Eddeland A, Pettersson S (1985) Factors influencing the time long-term indwelling Foley catheters can be kept in situ. Eur Urol 11:177Google Scholar
  10. 10.
    Hukins DWL, Hickey DS, Kennedy AP (1983) Catheter encrustation by struvite. Br J Urol 55:304Google Scholar
  11. 11.
    Jensen ET, Kharazmi A, Lam K, Costerton JW, Hoiby N (1990) Human polymorphonuclear leukocyte response to Pseudomonas aeruginosa grown in biofilms. Infect Immun 58:2383Google Scholar
  12. 12.
    Kennedy AP, Brocklehurst JC, Robinson JM, Faragher EB (1992) Assessment of the use of bladder washouts/instillations in patients with long-term indwelling catheters. B J Urol 70:610Google Scholar
  13. 13.
    Kunin CM (1987) Detection, prevention and management of urinary tract infections, 4th edn. Lea and Febiger, Philadelphia, p265Google Scholar
  14. 14.
    Kunin CM (1989) Blockage of urinary catheters: role of microorganisms and constituents of the urine on formation of encrustations. J Clin Epidemiol 42:835Google Scholar
  15. 15.
    Kunin CM, Chin QF, Chambers S (1987) Formation of encrustations on indwelling urinary catheters in the elderly. J Urol 138:899Google Scholar
  16. 16.
    Nickel JC, Gristina AG, Costerton JW (1985) Electron microscope study of an infected Foley catheter. Can J Surg 28:50Google Scholar
  17. 17.
    Nickel JC, Ruseska I, Wright JB, Costerton JW (1985) Tobramycin resistance of Pseudomonas aeruginosa cells growing as a biofilm on urinary catheter material. Antimicrob Agents Chemother 27:619Google Scholar
  18. 18.
    Ohkawa M, Sugata LT, Sawaki M, Nakashima T, Fuse H, Hisazumi H (1990) Bacterial and crystal adherence to the surfaces of indwelling urethral catheters. J Urol 143:717Google Scholar
  19. 19.
    Ramsay JWA, Garnham AJ, Mulhall AB, Crow RA, Bryan JM, Eardley I, Vale JA, Whitfield HN (1989) Biofilms, bacteria and bladder catheters. B J Urol 64:395Google Scholar
  20. 20.
    Roe BH (1989) Use of bladder washouts: a study of nurses recommendations. J Adv Nurs 14:494Google Scholar
  21. 21.
    Stickler DJ, Clayton CL, Chawla JC (1987) The resistance of urinary tract pathogens to chlorhexidine bladder washouts. J Hosp Infect 10:219Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • D. Stickler
    • 1
  • L. Ganderton
    • 1
  • J. King
    • 1
  • J. Nettleton
    • 1
  • C. Winters
    • 1
  1. 1.School of Pure and Applied BiologyUniversity of Wales College of CardiffCardiffUK

Personalised recommendations