Urological Research

, Volume 17, Issue 6, pp 349–352 | Cite as

Infection of catheterised patients: bacterial colonisation of encrusted Foley catheters shown by scanning electron microscopy

  • A. J. Cox Cox
  • D. W. L. Hukins
  • T. M. Sutton
Original Articles


The surfaces of 32 encrusted urinary catheters were examined by scanning electron microscopy to investigate the association of bacteria with the encrusting deposits. Deposits consisted of struvite crystals surrounded by aggregates of very small crystallites of hydroxyapatite. Underneath these minerals there was a layer of closely packed bacteria. Impressions of bacteria were also observed in hydroxyapatite. Crystals were often engulfed by the bacterial layer, which thus appeared to bind the crystals to each other and to the catheter surface. This thick layer of bacteria associated with crystals may protect both the bacteria from antibiotics and the crystals from acidic bladder washout solutions intended to dissolve them. Furthermore, the existence of this sessile population explains why urease-producing bacteria are not invariably detected in the urine of patients with encrusted catheters. The observation of this bacterial layer (or “biofilm”) by scanning electron microscopy provided direct evidence for infection being implicated in catheter encrustation.

Key words

Urinary infection Urinary catheters Encrustation Bacterial colonisation 


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Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • A. J. Cox Cox
    • 1
  • D. W. L. Hukins
    • 1
  • T. M. Sutton
    • 2
  1. 1.Department of Medical BiophysicsUniversity of ManchesterManchester
  2. 2.Bard Ltd.Clacton-on-SeaUnited Kingdom

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