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Evaluation of the Antimicrobial Efficacy of Urinary Catheters Impregnated With Antiseptics in an In Vitro Urinary Tract Model

Published online by Cambridge University Press:  02 January 2015

Trupti A. Gaonkar ,
Lester A. Sampath  and
Shanta M. Modak
Trupti A. Gaonkar
Affiliation:
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York
Lester A. Sampath
Affiliation:
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York
Shanta M. Modak*
Affiliation:
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York
*
Department of Surgery, College of Physicians and Surgeons, Columbia University, 650 West, 168th Street, New York, NY 10032
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Abstract

Objectives:

To evaluate the long-term efficacy of urinary Foley catheters (latex and silicone) impregnated with (1) chlorhexidine and silver sulfadiazine (CXS) and (2) chlorhexidine, silver sulfadiazine, and triclosan (CXST) in inhibiting extra-luminal bacterial adherence and to compare their efficacy with that of silver hydrogel latex (SH) and nitrofurazone-treated silicone (NF) catheters.

Design:

The antimicrobial spectrum of these catheters was evaluated using a zone of inhibition assay. A novel in vitro urinary tract model was developed to study the potential in vivo efficacy of antimicrobial catheters in preventing extraluminal bacterial colonization. The “meatus” was inoculated daily with Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans. The “bladder” portion of the model was cultured daily to determine bacterial growth.

Results:

Both CXS and CXST catheters had a broader antimicrobial spectrum than SH and NF catheters. In the in vitro model, CXST latex and silicone catheters exhibited significantly better efficacy (3 to 25 days) against uropathogens, compared with CXS (1 to 14 days) and control (0 to 5 days) catheters (P = .01). CXST latex catheters exhibited significantly longer protection against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa, compared with SH catheters (P = .01). CXST silicone catheters resisted colonization with Staphylococcus aureus and Staphylococcus epidermidis for a significantly longer period (23 to 24 days) than did NF catheters (9 to 11 days) (P = .01).

Conclusion:

Catheters impregnated with synergistic combinations of chlorhexidine, silver sulfadiazine, and triclosan exhibited broad-spectrum, long-term resistance against microbial colonization on their outer surfaces (Infect Control Hosp Epidemiol 2003;24:506-513)

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 7 , July 2003 , pp. 506 - 513
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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