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Pretreatment of urinary silicone latex catheters in vitro with 0.1 and 0.5 microgram of ciprofloxacin per ml for 1, 24, and 48 h significantly reduced the adhesion and survival of the clinical isolate Pseudomonas aeruginosa AK1. UV spectroscopy and high-performance liquid chromatography confirmed the presence of ciprofloxacin adsorbed onto the catheters and showed that up to 56% of the drug leached into the surrounding fluid within 24 h. Scanning electron microscopy demonstrated that the adherent organisms were malformed and elongated after exposure to ciprofloxacin. Transmission electron microscopy showed the presence of fimbriae on the bacterial surfaces, but there was no conclusive evidence of changes in the fimbriae upon exposure to ciprofloxacin. It was found that a significant eradication of 24-h Pseudomonas biofilms could be achieved with ciprofloxacin as well as with ofloxacin and norfloxacin. Preincubation of catheters with 50- and 100-micrograms/ml concentrations of ciprofloxacin resulted in up to a 99% reduction in the number of adherent bacteria in comparison with the reduction on control catheters. In addition, adherent biofilms were eradicated by 24 h of challenge with 50 and 100 micrograms of ciprofloxacin per ml at pH 7.0 and 5.5. Results of these in vitro studies suggest that there could be a clinical role for fluoroquinolones in preventing and treating urinary tract infections associated with P. aeruginosa adherence to prosthetic devices.

Effects of ciprofloxacin, norfloxacin, and ofloxacin on in vitro adhesion and survival of Pseudomonas aeruginosa AK1 on urinary catheters