Poster, Podium & Video Sessions
Presentation Authors: Tyler M. Bauman*, Saint Louis, MO, Aaron M. Potretzke, Rochester, MN, Ana L. Flores-Mireles, Jennifer N. Walker, Alyssa M. Park, Henry L. Schreiber IV, Jerome S. Pinkner, Michael G. Caparon, Scott J. Hultgren, Alana Desai, Saint Louis, MO
Introduction: There is mounting evidence that fibrinogen deposition on urinary catheters is a key step in the pathogenesis of catheter-associated urinary tract infection (CAUTI). The aim of this study was to investigate whether fibrinogen and Enterococcus faecalis co-localize on catheters acquired from patients with post-operative urine cultures positive for E. faecalis.
Methods: Urinary catheters from a series of 50 patients undergoing elective urologic procedures were collected post-operatively and analyzed via immunofluorescence to detect deposited fibrinogen. Pearson correlation was performed to measure the correlation between fibrinogen deposition and dwell time. Additional catheters and urine cultures were collected at time of catheter removal. Catheters from patients with positive Enterococcus cultures were probed for fibrinogen and Enterococcus via immunofluorescence.
Results: A total of 50 adult patients undergoing urinary catheterization as standard of care were prospectively identified at our institution. Fibrinogen concentration quantified as mg/catheter using a standard curve was highly correlated with catheter dwell time (r=0.63; p<0.0001) (Figure 1). E. faecalis was capable of binding to fibrinogen on these catheters ex vivo.
Five additional catheters were obtained from patients with E. faecalis-positive post-operative urine cultures. Fibrinogen was present at all time points (18 hours, 1 day, 1 day, 8 days, 9 days) and co-localized with E. faecalis (Figure 2) in vivo.
Conclusions: We have previously shown that fibrinogen deposits on urinary catheters, and that E. faecalis is capable of binding to these catheters ex vivo. In this study, we demonstrate that E. faecalis co-localizes with fibrinogen in catheterized patients with urine cultures positive for E. faecalis. This data strengthens the clinical association of fibrinogen deposition with CAUTI and suggests that targeting the binding of E. faecalis with fibrinogen may help reduce the rate of Enterococcus CAUTI.
Source Of Funding: 1F32DK104516-01 (ALF-M), and National Institute of Allergy and Infectious Diseases and National Institute of Diabetes and Digestive and Kidney Diseases Grants R01-DK051406, R01-AI108749-01 and P50-DK0645400 (ALF-M, JNW, HLS, JSP, MGC, SJH).
Washington University in St. Louis School of Medicine
Tyler Bauman is a third year medical student at Washington University School of Medicine in Saint Louis, Missouri. He graduated with honors in medical microbiology and immunology and was Phi Beta Kappa at the University of Wisconsin-Madison in 2013. His research interests include urologic oncology and automated pathology platforms for evaluation of tissue biomarkers.