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Antimicrobial Agents and Chemotherapy, December 2009, p. 5145-5149, Vol. 53, No. 12
0066-4804/09/$08.00+0     doi:10.1128/AAC.00718-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Novel Antiseptic Urinary Catheters for Prevention of Urinary Tract Infections: Correlation of In Vivo and In Vitro Test Results{triangledown}

Ray Hachem,1* Ruth Reitzel,1 Agatha Borne,2 Ying Jiang,1 Peggy Tinkey,2 Rajesh Uthamanthil,2 Jyotsna Chandra,3 Mahmoud Ghannoum,3 and Issam Raad1

Department of Infectious Diseases, Infection Control and Employee Health,1 Department of Veterinary Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas,2 University Hospitals and Case Medical Center and Case Western Reserve University, Cleveland, Ohio3

Received 27 May 2009/ Returned for modification 17 July 2009/ Accepted 28 September 2009

Urinary catheters are widely used for hospitalized patients and are often associated with high rates of urinary tract infection. We evaluated in vitro the antiadherence activity of a novel antiseptic Gendine-coated urinary catheter against several multidrug-resistant bacteria. Gendine-coated urinary catheters were compared to silver hydrogel-coated Foley catheters and uncoated catheters. Bacterial biofilm formation was assessed by quantitative culture and scanning electron microscopy. These data were further correlated to an in vivo rabbit model. We challenged 31 rabbits daily for 4 days by inoculating the urethral meatus with 1.0 x 109 CFU streptomycin-resistant Escherichia coli per day. In vitro, Gendine-coated urinary catheters reduced the CFU of all organisms tested for biofilm adherence compared with uncoated and silver hydrogel-coated catheters (P < 0.004). Scanning electron microscopy analysis showed that a thick biofilm overlaid the control catheter and the silver hydrogel-coated catheters but not the Gendine-coated urinary catheter. Similar results were found with the rabbit model. Bacteriuria was present in 60% of rabbits with uncoated catheters and 71% of those with silver hydrogel-coated catheters (P < 0.01) but not in those with Gendine-coated urinary catheters. No rabbits with Gendine-coated urinary catheters had invasive bladder infections. Histopathologic assessment revealed no differences in toxicity or staining. Gendine-coated urinary catheters were more efficacious in preventing catheter-associated colonization and urinary tract infections than were silver hydrogel-coated Foley catheters and uncoated catheters.

* Corresponding author. Mailing address: Department of Infectious Diseases, Infection Control and Employee Health, Unit 1460, M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030. Phone: (713) 792-4389. Fax: (713) 792-8233. E-mail: rhachem{at}mdanderson.org

{triangledown} Published ahead of print on 5 October 2009.

Antimicrobial Agents and Chemotherapy, December 2009, p. 5145-5149, Vol. 53, No. 12
0066-4804/09/$08.00+0     doi:10.1128/AAC.00718-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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