title: Anti-adhesive coating and clearance of device associated uropathogenic Escherichia coli cystitis.
abstract: OBJECTIVE
  A previous study showed decreased uropathogen adherence using a novel anti-fouling coating consisting of mussel adhesive protein mimics conjugated to poly(ethylene glycol). We assessed the ability of methoxy polyethylene glycol-dihydroxyphenylalanine (Nerites Corp. Ltd., Madison, Wisconsin) coated ureteral stents to resist bacterial adherence, infection development and encrustation in a rabbit model of uropathogenic Escherichia coli cystitis.
  
  
  METHODS
  Sof-Flex stent curls that were uncoated and coated with 3 coatings, including Surphys 002, 008 and 009, respectively, and uncoated Percuflex Plus stents were inserted transurethrally into the bladder of 50 male New Zealand White rabbits (Charles River Laboratories, Montreal, Quebec, Canada), followed by instillation of uropathogenic E. coli strain GR12 (10(7) cfu). Urine was examined for bacteria on days 0, 1, 3 and 7, and for cytokine levels on day 7. On day 7 the animals were sacrificed. Stent curls and bladders were harvested for analysis. In a parallel experiment stents were challenged in vitro for 7 days with GR12 in human urine.
  
  
  RESULTS
  Surphys 009 coated devices showed decreased urine and stent bacterial counts compared to those in controls. Eight of 10 rabbits in the Surphys 009 group had sterile urine by day 3 vs 1 in each control group (p = 0.013), while stent adherent organisms were decreased by more than 75%. While no statistical differences were found in encrustation and bladder inflammation across the groups, immune scoring was lowest in the uncoated Sof-Flex control and Surphys 009 groups (p = 0.030).
  
  
  CONCLUSIONS
  Surphys 009 strongly resisted bacterial attachment, resulting in improved infection clearance over that of uncoated devices. However, this did not translate to decreased encrustation, which appeared to be independent of infection in this model.
authors.affiliation: Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pechey
authors.forename: Chelsea N
authors.initials: CN
authors.lastname: Elwood
authors.forename: Geoffrey R
authors.initials: GR
authors.lastname: Wignall
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Dalsin
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Lee
authors.forename: Maaike
authors.initials: M
authors.lastname: Vanjecek
authors.forename: Ian
authors.initials: I
authors.lastname: Welch
authors.forename: Raymond
authors.initials: R
authors.lastname: Ko
authors.forename: Hassan
authors.initials: H
authors.lastname: Razvi
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cadieux
mesh_terms: D000818:Animals; D001422:Bacterial Adhesion; D003556:Cystitis / Q000382:microbiology* / Q000652:urine; D004926:Escherichia coli / Q000472:pathogenicity*; D008297:Male; D010649:Phenylalanine / Q000031:analogs & derivatives*; D011092:Polyethylene Glycols; D011474:Prosthesis Design; D011817:Rabbits; D015607:Stents
chemical_list: C543960:methoxy polyethylene glycol-dihydroxyphenylalanine; D011092:Polyethylene Glycols; D010649:Phenylalanine
references.citation: Ann Urol (Paris). 2003 Dec;37(6):339-44
references.pmid: 14717036
references.citation: J Hosp Infect. 2001 Oct;49(2):87-93
references.pmid: 11567552
references.citation: Eur J Nutr. 2005 Dec;44(8):499-508
references.pmid: 15696401
references.citation: J Ind Microbiol Biotechnol. 2005 Jul;32(7):309-18
references.pmid: 15868157
references.citation: J Endourol. 2004 Nov;18(9):891-6
references.pmid: 15659928
references.citation: Am J Infect Control. 2000 Feb;28(1):8-13
references.pmid: 10679131
references.citation: J Endourol. 2003 Jun;17(5):269-74
references.pmid: 12885351
references.citation: J Chemother. 2001 Nov;13 Spec No 1(1):239-50
references.pmid: 11936373
references.citation: Int J Antimicrob Agents. 2002 Jun;19(6):511-6
references.pmid: 12135842
references.citation: Am J Infect Control. 2006 May;34(4):188-92
references.pmid: 16679175
references.citation: J Urol. 2004 Jun;171(6 Pt 1):2438-44
references.pmid: 15126872
references.citation: Clin Microbiol Rev. 2008 Jan;21(1):26-59
references.pmid: 18202436
references.citation: J Urol. 2006 Jun;175(6):2331-5
references.pmid: 16697868
references.citation: Proc Natl Acad Sci U S A. 2006 Aug 29;103(35):12999-3003
references.pmid: 16920796
references.citation: J Immunol Methods. 2000 Sep 21;243(1-2):243-55
references.pmid: 10986418
references.citation: J Endourol. 2008 Jun;22(6):1153-60
references.pmid: 18484883
references.citation: World J Urol. 2000 Sep;18(4):237-42
references.pmid: 11000305
references.citation: Nat Clin Pract Urol. 2004 Nov;1(1):44-8
references.pmid: 16474466