title: Ultrastructural stages of biofilm development of Escherichia coli on urethral catheters and effects of antibiotics on biofilm formation.
abstract: OBJECTIVE
  Biofilm formation on biomaterials by various kinds of bacteria renders the infection chronic, and the bacteria can become resistant to the immune system and antibiotics. Developmental biofilm stages of Escherichia coli on urethral catheters have not yet been thoroughly demonstrated. We aimed to show biofilm formation of E. coli on urethral catheters, and the effects of various antibacterial agents on this formation using scanning electron microscopy.
  
  
  METHODS
  Using urine infected with uropathogenic E. coli type O4 (10(5) to 10(6) colony forming units/mL), biofilm was formed on latex/silicone balloon catheters in a modified Robbin's device. The study included an infected-only group and four antibiotic study groups (ciprofloxacin, cefuroxime, gentamicin, and trimethoprim). The catheters were infused with the antibiotic solutions once before placement in the modified Robbin's devices. Ten 5-mm catheter samples were taken for all groups on the first, fourth, and seventh days. The 4 and 12-hour and 2-day samplings were also taken from the infected-only group. The catheter samples were evaluated by scanning electron microscopy and given scores according to the level of formation.
  
  
  RESULTS
  The biofilm layers emerged between 4 and 12 hours after infection in the infected-only group and had developed completely between 12 and 24 hours. The antibiotics, especially cefuroxime, significantly delayed this process for up to 4 days. However, the biofilm had developed completely in almost all catheter samples after 4 to 7 days.
  
  
  CONCLUSIONS
  Biofilm of E. coli on urethral catheters had completed their maturation at 12 to 24 hours. For short-term urethral catheterization, a single dose of antibiotic can delay the development of biofilm for up to 4 days but eventually cannot prevent it.
authors.affiliation: Department of Urology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Koseoglu
authors.forename: Guven
authors.initials: G
authors.lastname: Aslan
authors.forename: Nuran
authors.initials: N
authors.lastname: Esen
authors.forename: Bilge Hakan
authors.initials: BH
authors.lastname: Sen
authors.forename: Huseyin
authors.initials: H
authors.lastname: Coban
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects*; D004926:Escherichia coli / Q000187:drug effects* / Q000502:physiology*; D008855:Microscopy, Electron, Scanning; D014521:Urethra; D014546:Urinary Catheterization
chemical_list: D000900:Anti-Bacterial Agents