title: Biomaterial modification of urinary catheters with antimicrobials to give long-term broadspectrum antibiofilm activity.
abstract: Catheter-associated urinary tract infection (CAUTI) is the commonest hospital-acquired infection, accounting for over 100,000 hospital admissions within the USA annually. Biomaterials and processes intended to reduce the risk of bacterial colonization of the catheters for long-term users have not been successful, mainly because of the need for long duration of activity in flow conditions. Here we report the results of impregnation of urinary catheters with a combination of rifampicin, sparfloxacin and triclosan. In flow experiments, the antimicrobial catheters were able to prevent colonization by common uropathogens Proteus mirabilis, Staphylococcus aureus and Escherichia coli for 7 to 12weeks in vitro compared with 1-3days for other, commercially available antimicrobial catheters currently used clinically. Resistance development was minimized by careful choice of antimicrobial combinations. Drug release profiles and distribution in the polymer, and surface analysis were also carried out and the process had no deleterious effect on the mechanical performance of the catheter or its balloon. The antimicrobial catheter therefore offers for the first time a means of reducing infection and its complications in long-term urinary catheter users.
authors: Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK. Electronic address: le.fisher@btinternet.com.
authors: Leanne E
authors: LE
authors: Fisher
authors: Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: Andrew.hook@nottingham.ac.uk.
authors: Andrew L
authors: AL
authors: Hook
authors: Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK. Electronic address: waheed.ashraf@nottingham.ac.uk.
authors: Waheed
authors: W
authors: Ashraf
authors: Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK. Electronic address: anfalyousef@gmail.com.
authors: Anfal
authors: A
authors: Yousef
authors: Centre for Analytical Bioscience, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: david.barrett@nottingham.ac.uk.
authors: David A
authors: DA
authors: Barrett
authors: Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: david.scurr@nottingham.ac.uk.
authors: David J
authors: DJ
authors: Scurr
authors: Laboratory of Biophysics and Surface Analysis, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: x.chen@nottingham.ac.uk.
authors: Xinyong
authors: X
authors: Chen
authors: Nottingham Nanotechnology & Nanoscience Centre, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: Emily.smith@nottingham.ac.uk.
authors: Emily F
authors: EF
authors: Smith
authors: Nottingham Nanotechnology & Nanoscience Centre, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: Michael.fay@nottingham.ac.uk.
authors: Michael
authors: M
authors: Fay
authors: Nottingham Nanotechnology & Nanoscience Centre, University of Nottingham, Nottingham NG7 2RD, UK. Electronic address: Christopher.parmenter@nottingham.ac.uk.
authors: Christopher D J
authors: CD
authors: Parmenter
authors: Nottingham Urology Centre, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK. Electronic address: Richard.parkinson@nuh.nhs.uk.
authors: Richard
authors: R
authors: Parkinson
authors: Biomaterials-Related Infection Group, School of Medicine, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK. Electronic address: roger.bayston@nottingham.ac.uk.
authors: Roger
authors: R
authors: Bayston
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000737:chemistry; D001419:Bacteria / Q000187:drug effects / Q000254:growth & development; D018441:Biofilms; D065546:Drug Liberation; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000737:chemistry; D012293:Rifampin / Q000008:administration & dosage / Q000737:chemistry; D014260:Triclosan / Q000008:administration & dosage / Q000737:chemistry; D062885:Urinary Catheters
chemical_list: D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D014260:Triclosan; C061363:sparfloxacin; D012293:Rifampin
keywords: Antimicrobial; Bladder; Catheter infection; Drug release; Silicone; Urinary tract