title: Ultrastructural study of microbiologic colonization of urinary catheters.
abstract: We examined ten urinary catheters, associated with catheter-related urinary tract infections, by scanning and transmission electron microscopy to study the morphology of bacterial adherence. We confirmed that the bacteria associated with catheter-associated urinary tract infections grow in glycocalyx-enclosed microcolonies in a biofilm on the catheter surface. The bacterial populations demonstrated a heterogeneity that was not evident from the culture results, and it was demonstrated that only a small proportion of the microorganisms, including fungi, identified morphologically by scanning or transmission electron microscopy are recovered by routine culture methods. The persistence of the bacterial pathogens in catheter-associated infection, even in the face of antibiotic treatment, may be attributed to their adherent mode of growth in protected biofilms and their production of extensive enveloping anionic glycocalyces.
authors.affiliation: Department of Urology, Queen's University, Kingston, Canada.
authors.forename: J C
authors.initials: JC
authors.lastname: Nickel
authors.forename: J A
authors.initials: JA
authors.lastname: Downey
authors.forename: J W
authors.initials: JW
authors.lastname: Costerton
mesh_terms: D001422:Bacterial Adhesion; D001424:Bacterial Infections / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008855:Microscopy, Electron, Scanning; D011134:Polysaccharides / Q000032:analysis; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000209:etiology* / Q000382:microbiology
chemical_list: D006023:Glycoproteins; D011134:Polysaccharides