Presentation Authors: Glenn T. Werneburg*, Shaker Heights, OH, Anh Nguyen, Nadine Henderson, Stony Brook, NY, Amanda Le Sueur, Anthony Corcoran, Aaron Katz, Mineola, NY, Jason Kim, Annie Rohan, David G. Thanassi, Stony Brook, NY
Introduction: Urinary catheter biofilm formation is common and consists of adherent bacteria, metabolic products, and host components. Through biofilms, bacteria can resist both antibiotics and host defense mechanisms. Biofilm formation on urinary catheters is a critical step in the pathogenesis of catheter-associated UTI. We sought to determine the catheter locations of onset and progression of biofilm formation.
Methods: Urinary catheters of 0-5 weeks indwelling time were collected. Catheters were then analyzed using spectrophotometry. Specifically, catheters were sectioned and stained with crystal violet, and excess dye was removed. Adherent crystal violet, which represented adherent biofilm, was then dissolved, and the concentration was spectrophotometrically quantitated relative to controls.
Results: 33 urinary catheters were collected: 10 in week 1, 6 in week 2, 3 in week 3, 8 in week 4, and 6 in week 5. Biofilms progressed throughout all aspects of the catheter over the 5 weeks indwelling time. The distal end of the catheter exhibited significantly greater staining relative to the proximal side (Figure). The balloon of the catheter consistently showed intense staining, indicative of significant biofilm adherence.
Conclusions: Biofilms progressed as indwelling time increased, and were detected following as little as 1 day indwelling time. The locations of greatest biofilm predominance were the distal portion of the urinary catheter as well as the balloon. We expect that these findings will inform the design and production of novel urinary catheters, which may benefit from focusing antiseptic strategies on the distal and balloon portions of the catheter. Importantly, our findings suggest that biofilms may proliferate through a multimodal etiology, and that sterile insertion technique may prevent early proximal biofilm formation, but may not reduce distal growth. Ongoing studies will determine the bacterial species responsible for biofilm formation, and whether biofilm proliferation is affected by patient sex.
Source of Funding: GTW was supported by award T32GM008444 and Award F30AI112252 from the NIH.