title: Bacteriophages are synergistic with bacterial interference for the prevention of Pseudomonas aeruginosa biofilm formation on urinary catheters.
abstract: OBJECTIVE
  We hypothesized that pretreating urinary catheters with benign Escherichia coli HU2117 plus an antipseudomonal bacteriophage (ΦE2005-A) would prevent Pseudomonas aeruginosa biofilm formation on catheters--a pivotal event in the pathogenesis of catheter-associated urinary tract infection (CAUTI).
  
  
  RESULTS
  Silicone catheter segments were exposed to one of four pretreatments (sterile media; E. coli alone; phage alone; E. coli plus phage), inoculated with P. aeruginosa and then incubated up to 72 h in human urine before rinsing and sonicating to recover adherent bacteria. Pseudomonas aeruginosa adherence to catheters was almost 4 log(10) units lower when pretreated with E. coli plus phage compared to no pretreatment (P < 0.001) in 24-h experiments and more than 3 log(10) units lower in 72-h experiments (P < 0.05). Neither E. coli nor phage alone generated significant decreases.
  
  
  CONCLUSIONS
  The combination of phages with a pre-established biofilm of E. coli HU2117 was synergistic in preventing catheter colonization by P. aeruginosa.
  
  
  CONCLUSIONS
  We describe a synergistic protection against colonization of urinary catheters by a common uropathogen. Escherichia coli-coated catheters are in clinical trials; adding phage may offer additional benefit.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Liao
authors.forename: S M
authors.initials: SM
authors.lastname: Lehman
authors.forename: D J
authors.initials: DJ
authors.lastname: Tweardy
authors.forename: R M
authors.initials: RM
authors.lastname: Donlan
authors.forename: B W
authors.initials: BW
authors.lastname: Trautner
mesh_terms: D000898:Antibiosis; D001422:Bacterial Adhesion; D018441:Biofilms; D055499:Catheter-Related Infections / Q000517:prevention & control*; D004926:Escherichia coli / Q000502:physiology; D006801:Humans; D017105:Pseudomonas Phages / Q000502:physiology*; D011550:Pseudomonas aeruginosa / Q000254:growth & development* / Q000821:virology; D062885:Urinary Catheters / Q000382:microbiology*