Observations on the development of the crystalline bacterial biofilms that encrust and block Foley catheters
Observations on the development of the crystalline bacterial biofilms that encrust and block Foley catheters
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DOI：
10.1016/j.jhin.2008.04.031
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发表时间：
2008-08-01
影响因子：
6.9
通讯作者：
Morgan, S. D.
中科院分区：
文献类型：
--
作者：
Stickler, D. J.;Morgan, S. D.
许多长期接受膀胱导尿术的患者的护理是复杂的，当尿液通过导管的流动被结壳阻塞时。该问题是由产生尿素酶的细菌（特别是奇异变形杆菌）感染以及随后在导管上形成结晶生物膜引起的。本研究的目的是发现奇异变形杆菌如何启动这些结晶生物膜的发展。生物膜形成的早期阶段，在一系列的弗利导管在实验室模型的导尿管膀胱观察。扫描电子显微镜照片显示，当将全硅胶、硅胶涂层乳胶、水凝胶涂层乳胶、水凝胶/银涂层乳胶和呋喃西林硅胶导管插入含有奇异变形杆菌和碱性尿液的膀胱模型中时，其表面迅速涂覆有微晶基础层。X射线显微分析表明，该材料由磷酸钙组成。细菌。在基础层的定殖之后，到18小时，导管被密集分布的结晶奇异变形杆菌生物膜结壳。这些观察结果对抗结壳导管的开发具有重要意义。例如，在银导管的情况下，细菌。细胞可以附着在结晶基础层上并继续生长，从而避免与下面的银接触。如果要将抗菌剂掺入导管中以防止结垢，重要的是它们扩散到尿液中并防止pH值升高引发晶体形成。(c)2008医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
The care of many patients undergoing long-term bladder catheterisation is complicated when the flow of urine through the catheter is blocked by encrustation. The problem results from infection by urease producing bacteria, especially Proteus mirabilis, and the subsequent formation of crystalline biofilms on the catheter. The aim of this study was to discover how P. mirabilis initiates the development of these crystalline biofilms. The early stages in the formation of the biofilms were observed on a range of Foley catheters in a laboratory model of the catheterised bladder. Scanning electron micrographs revealed that when all-silicone, silicone-coated latex, hydrogel-coated latex, hydrogel/silver-coated latex and nitrofurazone silicone catheters were inserted into bladder models containing P. mirabilis and alkaline urine, their surfaces were rapidly coated with a microcrystalline foundation layer. X-ray microanalysis showed that this material was composed of calcium phosphate. Bacterial. colonisation of the foundation layer followed and by 18 h the catheters were encrusted by densely populated crystalline P. mirabilis biofilms. These observations have important implications for the development of encrustation-resistant catheters. In the case of silver catheters for example, bacterial. cells can attach to the crystalline foundation layer and continue to grow, protected from contact with the underlying silver. If antimicrobials are to be incorporated into catheters to prevent encrustation, it is important that they diffuse into the urine and prevent the rise in pH that triggers crystal formation. (c) 2008 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.