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Role of biofilm in catheter-associated urinary tract infection

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Author/s: 
Trautner, B. W., Darouiche, R. O.
Date Added: 
September 23, 2021
Journal/Publication: 
American Journal of Infection Control
Publication Date: 
May 19, 2004
Issue: 
3
Volume: 
32
Pages: 
177-183
Type: 
Meta-analyses, Reviews, and Guidelines
DOI (1): 
10.1016/j.ajic.2003.08.005
MeSH 
Urinary Catheters
Bacteriuria
Catheters, Indwelling
Reinfection
Urinary Catheterization
urinary tract infections
Biofilms
anti-bacterial agents
Biological Products

RPR Commentary

A classic article on urinary tract infections in patients with indwelling catheters.

Abstract

The predominant form of life for the majority of microorganisms in any hydrated biologic system is a cooperative community termed a “biofilm.” A biofilm on an indwelling urinary catheter consists of adherent microorganisms, their extracellular products, and host components deposited on the catheter. The biofilm mode of life conveys a survival advantage to the microorganisms associated with it and, thus, biofilm on urinary catheters results in persistent infections that are resistant to antimicrobial therapy. Because chronic catheterization leads almost inevitably to bacteriuria, routine treatment of asymptomatic bacteriuria in persons who are catheterized is not recommended. When symptoms of a urinary tract infection develop in a person who is catheterized, changing the catheter before collecting urine improves the accuracy of urine culture results. Changing the catheter may also improve the response to antibiotic therapy by removing the biofilm that probably contains the infecting organisms and that can serve as a nidus for reinfection. Currently, no proven effective strategies exist for prevention of catheter-associated urinary tract infection in persons who are chronically catheterized.