In-vitro activity of triclosan-eluting ureteral stents against common bacterial uropathogens.
OBJECTIVE
Ureteral stents are commonly used in urology today, but the biofilms that form on them within hours of placement may harbor bacteria that can result in infection or encrustation. Triclosan is an antimicrobial commonly used in consumer and medical products that inhibits bacterial fatty-acid synthesis. The bactericidal and bacteriostatic effect of a triclosan-eluting ureteral stent was tested against clinical isolates of common bacterial uropathogens in an in-vitro setting.


METHODS
Triclosan eluted from a drug-loaded ureteral stent was suspended in artificial urine with bacterial pathogens (Escherichia coli C1214, Proteus mirabilis 296, Enterococcus faecalis 1131, Klebsiella pneumoniae 280, Staphylococcus aureus Newman, Pseudomonas aeruginosa AK1) to assess growth, virulence-promoter activity, and bacterial adherence to the stent. Generic stents were utilized as controls.


RESULTS
Triclosan inhibited the growth of E. faecalis, K. pneumoniae, S. aureus, and P. mirabilis in a dose-dependent manner. Pseudomonas aeruginosa demonstrated significant resistance. Lower concentrations of triclosan downregulated E. coli virulence-factor promoters of outer membrane protein X and p-fimbriae. Triclosan stents had significantly fewer adherent viable bacteria than control stents.


CONCLUSIONS
Triclosan-eluting ureteral stents inhibit the growth of common bacterial uropathogens and thus may reduce the incidence of urinary-tract infections and, potentially, encrustation. This drug-eluting stent provides both mechanical drainage of the upper urinary tract and local antibiosis.
Chew
Ben H
BH
Division of Urology, Department of Surgery, University of Western Ontario, London, Ontario, Canada.
Cadieux
Peter A
PA
Reid
Gregor
G
Denstedt
John D
JD
D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D001422:Bacterial Adhesion / Q000187:drug effects; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D018441:Biofilms / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects / Q000235:genetics; D029968:Escherichia coli Proteins / Q000235:genetics; D036781:Fimbriae Proteins / Q000235:genetics; D006867:Hydrolases / Q000235:genetics; D008855:Microscopy, Electron, Scanning; D011401:Promoter Regions, Genetic; D015607:Stents / Q000382:microbiology; D014260:Triclosan / Q000494:pharmacology*; D014513:Ureter
D000891:Anti-Infective Agents, Local; C078802:AtpA protein, E coli; D001425:Bacterial Outer Membrane Proteins; D029968:Escherichia coli Proteins; C482905:OmpX protein, E coli; D036781:Fimbriae Proteins; C078167:OMPA outer membrane proteins; D014260:Triclosan; D006867:Hydrolases