title: Application of a nanotechnology antimicrobial spray to prevent lower urinary tract infection: a multicenter urology trial.
abstract: BACKGROUND
  Catheter-associated urinary tract infection (CAUTI) is a common nosocomial device-associated infection. It is now recognized that the high infection rates were caused by the formation of biofilm on the surface of the catheters that decreases the susceptibility to antibiotics and results in anti-microbial resistance.In this study, we performed an in vitro test to explore the mechanism of biofilm formation and subsequently conducted a multi-center clinical trial to investigate the efficacy of CAUTI prevention with the application of JUC, a nanotechnology antimicrobial spray.
  
  
  METHODS
  Siliconized latex urinary catheters were cut into fragments and sterilized by autoclaving. The sterilized sample fragments were randomly divided into the therapy and control group, whereby they were sprayed with JUC and distilled water respectively and dried before use.The experimental standard strains of Escherichia coli (E. coli) were isolated from the urine samples of patients. At 16 hours and 7 days of incubation, the samples were extracted for confocal laser scanning microscopy.A total of 1,150 patients were accrued in the clinical study. Patients were randomized according to the order of surgical treatment. The odd array of patients was assigned as the therapy group (JUC), and the even array of patients was assigned as the control group (normal saline).
  
  
  RESULTS
  After 16 hours of culture, bacterial biofilm formed on the surface of sample fragments from the control group. In the therapy group, no bacterial biofilm formation was observed on the sample fragments. No significant increase in bacterial colony count was observed in the therapy group after 7 days of incubation.On the 7th day of catheterization, urine samples were collected for bacterial culture before extubation. Significant difference was observed in the incidence of bacteriuria between the therapy group and control group (4.52% vs. 13.04%, p < 0.001).
  
  
  CONCLUSIONS
  In this study, the effectiveness of JUC in preventing CAUTI in a hospital setting was demonstrated in both in vitro and clinical studies.
authors.affiliation: School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR.
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.forename: Dongmin
authors.initials: D
authors.lastname: Wang
authors.forename: Zhangqun
authors.initials: Z
authors.lastname: Ye
authors.forename: Weihong
authors.initials: W
authors.lastname: Qian
authors.forename: Yan
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authors.lastname: Tao
authors.forename: Xiaofeng
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authors.lastname: Shi
authors.forename: Ling
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authors.lastname: Liu
authors.forename: Jin
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authors.lastname: Qiu
authors.forename: Peng
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authors.lastname: Wan
authors.forename: Xiaojun
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authors.lastname: Jia
authors.forename: Xia
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authors.forename: Caixia
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authors.lastname: Gao
authors.forename: Xuexia
authors.initials: X
authors.lastname: Ma
authors.forename: Biyan
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authors.lastname: Wen
authors.forename: Nianzhen
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authors.lastname: Chen
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Zhengzheng
authors.initials: Z
authors.lastname: Ren
authors.forename: Li
authors.initials: L
authors.lastname: Lan
authors.forename: Siyi
authors.initials: S
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Zuo
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.forename: Liming
authors.initials: L
authors.lastname: Ma
authors.forename: Yueping
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhicong
authors.initials: Z
authors.lastname: Li
authors.forename: Weiping
authors.initials: W
authors.lastname: Su
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.forename: Qingli
authors.initials: Q
authors.lastname: Chen
authors.forename: Xuejing
authors.initials: X
authors.lastname: Wang
authors.forename: Zhenni
authors.initials: Z
authors.lastname: Ye
authors.forename: J P
authors.initials: JP
authors.lastname: Chen
authors.forename: Wings T Y
authors.initials: WT
authors.lastname: Loo
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Chow
authors.forename: Adrian Y S
authors.initials: AY
authors.lastname: Yip
authors.forename: Elizabeth L Y
authors.initials: EL
authors.lastname: Ng
authors.forename: Mary N B
authors.initials: MN
authors.lastname: Cheung
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005658:Fungi / Q000187:drug effects; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D036103:Nanotechnology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control* / Q000601:surgery; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents