The Influence of Urinary Catheter Materials on Forming Biofilms of Microorganisms

Assessment of the biofilm-forming ability on solid surfaces of periprosthetic infection-associated pathogens

Biofilm formation is one of the leading causes of complications after surgery in clinical settings. In this study, we profiled the biofilm-forming ability of various periprosthetic infection-associated pathogens on medically relevant surfaces, polystyrene (PS) and titanium (Ti). We also explored how a specific environmental stressor, epigallocatechin gallate (EGCG), affected biofilm formation. First, Congo red tests revealed that all microorganisms formed biofilms within 72 h. Then, the amounts of biofilm formation on PS at 24, 48 and 72 h and also on a Ti plate for 72 h were determined. Some microbes preferred one surface over the other, whereas other microbes formed consistent levels of biofilm regardless of the surface material. Staphylococcus lugdunenensis was the most potent, while Enterococcus faecalis and Staphylococcus aureus were the weakest. Bacterial adhesion to hydrocarbon (BATH) tests indicated that the biofilm-forming abilities were not directly correlated with cell surface hydrophobicity (CSH). Finally, an external signal, EGCG, was applied to challenge the biofilm formation of each microorganism. EGCG regulated each microorganism's ability differently, though the change was consistent across surfaces for most pathogens. This study can help a better understanding of a broad spectrum of periprosthetic infection-associated pathogens by relative comparison of their biofilm-forming abilities.

Use of Raman Spectroscopy, Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy in a Multi-Technique Approach for Physical Characterization of Purple Urine Bag Syndrome

Purple urine bag syndrome (PUBS) is a rare condition characterized by purple discoloration of urine and urine bags. Although it is benign, it represents an alarming symptom to the patients and their relatives because of purple discoloration. We have physically characterized urine and urine bags belonging to a patient suffering from PUBS using an approach that combines Raman spectroscopy (RS) and scanning electron microscopy (SEM) coupled with energy dispersive X-ray (EDX). Five “blue” discolored bags and one sterile urine bag, representing the control, were cut into 1 cm2 square samples and analyzed by using RS and SEM + EDX technique. RS enabled us to identify the presence of indigo, a metabolite of tryptophan, while SEM analysis showed the biofilm deposit, probably due to the presence of microorganisms, and the EDX measurements exhibited the elemental composition of the bags. In particular, urine bags before and after the presence of PUBS urine showed an increase of ~32% of Cl, ~33% of O, ~667% of Ca, ~65% of Al and Mg, while C decreased by about 41%. Our results, to be taken as a proof-of-principle study, are promising for the aim to characterizing the urine bags in a flexible, inexpensive, and comprehensive manner.

Cell adhesion and twitching motility influence strong biofilm formation in Pseudomonas aeruginosa

In the present study, biofilm formation was quantified in UTI isolates of Pseudomonas aeruginosa (n = 22) using the crystal violet assay and was categorized into; strong (n = 16), weak (n = 4), and moderate (n = 2) biofilm producers. Further experiments were done using strong (n = 4) and weak (n = 4) biofilm producers. Biofilm formation was greater in Luria broth followed by natural urine and artificial urine on silicone and silicone-coated latex. Cell adhesion and twitching motility were greater in strong biofilm producers. The presence of thick biofilm with an increased number of dead and total number of cells of strong biofilm producers was observed using CLSM. The concentrations of exopolymeric substances (eDNA, protein, and pel polysaccharide) were high in strong biofilm producers. FEG-SEM visualization of biofilm produced by strong biofilm producers showed more cells encased in thick biofilm matrix than weak ones. Overall results provide evidence for increased cell adhesion and twitching motility in strong biofilm producers.

Assessment of organic carbon migration and biofilm formation potential on polymeric tubes in contact with water

Biofilm formation has been frequently identified as a pathway of nosocomial infection in polymeric tubes used for patients of all ages. Biofilm formation on tube surfaces can lead to hygienic failure and cause diarrhea, stomach pain, inflammation, and digestive system disease. This study investigated the influence of polymeric tube materials in contact with water on the biomass formation potential and migration potential of microbially available carbon from plasticizers using a BioMig test. The thermoplastic elastomer tube, which is reusable, leached a relatively low amount of assimilable organic carbon to water. In contrast, the assimilable organic carbon migration potential of polyurethane was the most significant, 6-fold greater than that of the thermoplastic elastomer. Moreover, the same materials (e.g., silicone) produced via different manufacturing processes showed significant differences in migration behaviors. The potential biomass formation observed in polyurethane was approximately 7 × 10⁹ cells cm^-2 for both Aeromonas hydrophila and Escherichia coli strains. This study highlights the importance of choosing the correct material characteristics of polymeric tubes in contact with water to protect them from bacterial contamination. Therefore, manufacturers can use the BioMig test to evaluate and produce more hygienic and biostable tubes.

Impact of DMPEI on Biofilm Adhesion on Latex Urinary Catheter

BACKGROUND

Microorganisms can migrate from the external environment to the patient's organism through the insertion of catheters. Despite being indispensable medical device, the catheter surface can be colonized by microorganisms and become a starting point for biofilm formation. Therefore, new technologies are being developed in order to modify surfaces to prevent the adhesion and survival of microorganisms. Patents with the use of DMPEI have been filed.

OBJECTIVE

In the present work, we coated latex catheter surfaces with 2 mg mL-1 DMPEI in different solvents, evaluated the wettability of the surface and the anti- biofilm activity of the coated catheter against Escherichia coli, Staphylococcus aureus, and Candida albicans.

METHODS

We coated the inner and outer catheter surfaces with 2 mg mL-1 of DMPEI solubilized in butanol, dimethylformamide, and cyclohexanone and the surfaces were analyzed visually. Contact angle measurement allowed the analysis of the wettability of the surfaces. The CFU mL-1 count evaluated E. coli, S. aureus, and C. albicans adhesion onto the control and treated surfaces.

RESULTS

The contact angle decreased from 50.48º to 46.93º on the inner surface and from 55.83º to 50.91º on the outer surface of latex catheters coated with DMPEI. The catheter coated with DMPEI showed anti-biofilm activity of 83%, 88%, and 93% on the inner surface and 100%, 92%, and 86% on the outer surface for E. coli, S. aureus, and C. albicans, respectively.

CONCLUSION

Latex catheter coated with DMPEI efficiently impaired the biofilm formation both on the outer and inner surfaces, showing a potential antimicrobial activity along with a high anti-biofilm activity for medical devices.

High Adhesion and Increased Cell Death Contribute to Strong Biofilm Formation in Klebsiella pneumoniae

Klebsiella pneumoniae (Kp), is a frequent cause of hospital and community-acquired infections and WHO had declared it as a "priority pathogen". Biofilm is a major virulence factor of Kp and yet the mechanism of strong biofilm formation in Kp is unclear. A key objective of the present study is to investigate the differences between strong and weak biofilms formed by clinical isolates of Kp on various catheters and in different media conditions and to identify constituents contributing to strong biofilm formation. Quantification of matrix components (extracellular DNA (eDNA), protein, exopolysaccharides (EPS), and bacterial cells), confocal laser scanning microscopy (CLSM), field emission gun scanning electron microscopy (FEG-SEM) and flow-cytometry analysis were performed to compare strong and weak biofilm matrix. Our results suggest increased biofilm formation on latex catheters compared to silicone and silicone-coated latex catheters. Higher amounts of eDNA, protein, EPS, and dead cells were observed in the strong biofilm of Kp. High adhesion capacity and cell death seem to play a major role in formation of strong Kp biofilms. The enhanced eDNA, EPS, and protein in the biofilm matrix appear as a consequence of increased cell death.