Open AccessEvaluation of Polyethylene Glycol-Based Antimicrobial Coatings on Urinary Catheters in the Prevention ofEscherichia coliInfections in a Rabbit Model
Author(s) -
Thomas Tailly,
Rod A MacPhee,
Peter A. Cadieux,
Jeremy P. Burton,
Jeff Dalsin,
Chris Wattengel,
Justin Koepsel,
Hassan Razvi
Publication year - 2021
Publication title -
journal of endourology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.121
H-Index - 92
eISSN - 1557-900X
pISSN - 0892-7790
DOI - 10.1089/end.2020.0186
Subject(s) - medicine , urinary system , biomaterial , antimicrobial , escherichia coli , in vivo , polyethylene glycol , catheter , urology , microbiology and biotechnology , urine , biofilm , surgery , pathology , biomedical engineering , bacteria , biology , biochemistry , gene , genetics
and Objective: Catheter-associated urinary tract infections are a major cause of patient morbidity and mortality. Despite many attempts to design biomaterials that might reduce the risk, none has had a profound impact on reducing the incidence of this most common nosocomial infection. Recent in vitro work, however, has shown promise for a silver-based biomaterial coating composed of methoxylated polyethylene glycol 3,4-dihydroxyphenylalanine (mPEG-DOPA 3 ) in reducing uropathogen attachment and biofilm formation. The aim of this work was to investigate whether these results translate into a meaningful impact on infection development and bacterial adherence in an in vivo rabbit model. Materials and Methods: New Zealand white rabbits were randomized into groups of 12 and had the following catheters inserted: Group 1-uncoated polyurethane, Group 2-Coating A (mPEG-DOPA 3 + 2 mg/mL AgNO 3 ), and Group 3-Coating B (mPEG-DOPA 3 + 10 mg/mL AgNO 3 ). Each rabbit was challenged with 10 8 colony-forming units of Escherichia coli GR-12 instilled directly into the bladder at the time of catheter insertion and urine was monitored over 7 days for bacterial counts. Catheters were retrieved and evaluated for encrustation and attachment analysis, and tissues collected for histopathologic characterization and bacterial invasion. Results: Urinary bacterial colony counts were lower among rabbits in the Coating A group vs controls (4/11 vs 10/12, respectively) ( p = 0.029), and there were fewer rabbits with invasive infections (3/12 vs 9/12, p = 0.02). More encrustation was observed among animals in the Coating B group vs controls (7.22 vs 2.69 mg/cm 2 , p = 0.033). There were no significant differences in tissue effects between groups. Conclusions: The use of a mPEG-DOPA 3 urinary catheter coating effectively reduced urinary pathogen counts, while not causing adverse tissue effects in this model. Further clinical evaluation is warranted.