[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

New strategies to prevent catheter-associated urinary tract infections

Nature Reviews Urology volume 9, pages 305–314 (2012)Cite this article

Subjects

Abstract

Catheter-associated urinary tract infection (CAUTI) is the most common health-care-associated infection worldwide. Although not all cases of bacteriuria result in clinical infection, several hundred thousand episodes of CAUTI occur each year in the USA alone. The milieu in which the catheter is placed is highly conducive to bacterial colonization, biofilm formation on the catheter surface, and inevitable catheter-associated bacteriuria. A multitude of novel methods of CAUTI prevention have been described, including established approaches that are routinely recommended, such as the use of a secured, closed, silicone urinary catheter drainage system that mimics normal voiding, and newer strategies focusing on biocompatible catheter materials that cause minimal host inflammatory response and retard biofilm formation. Much recent research has focused on modification of the catheter surface by either coating or impregnation with antimicrobials or antiseptics. However, clinical trials that analyse cost-effectiveness and rates of antimicrobial resistance are awaited. More recently, innovative use of iontophoresis, vibroacoustic stimulation, bacterial interference and bacteriophage cocktails has been reported.

Key Points

  • Catheter-associated urinary tract infection (CAUTI) is the most common health-care-associated infection in the USA and worldwide

  • There is significant heterogeneity and overlap in the definitions of CAUTI, catheter-associated asymptomatic bacteriuria and catheter-associated bacteriuria

  • Prevention of CAUTI is predominantly based on reviewing the criteria for appropriate placement and early removal of catheters

  • The design of the indwelling urinary catheter remains largely unchanged since its inception

  • New strategies to prevent CAUTI must be based on a comprehensive understanding of the pathogenesis and key factors that influence the development of the infection

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Urinary bladder with an indwelling urinary catheter.

Similar content being viewed by others

References

  1. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am. J. Infect. Control 32, 470–485 (2004).

  2. Haley, R. W. et al. Nosocomial infections in U. S. hospitals, 1975–1976: estimated frequency by selected characteristics of patients. Am. J. Med. 70, 947–959 (1981).

    Article  CAS  PubMed  Google Scholar 

  3. Tambyah, P. A. Catheter-associated urinary tract infections: diagnosis and prophylaxis. Int. J. Antimicrob. Agents 24 (Suppl. 1), S44–S48 (2004).

    Article  CAS  PubMed  Google Scholar 

  4. Platt, R., Polk, B. F., Murdock, B. & Rosner, B. Mortality associated with nosocomial urinary-tract infection. N. Engl. J. Med. 307, 637–642 (1982).

    Article  CAS  PubMed  Google Scholar 

  5. Weinstein, J. W. et al. A decade of prevalence surveys in a tertiary-care center: trends in nosocomial infection rates, device utilization, and patient acuity. Infect. Control Hosp. Epidemiol. 20, 543–548 (1999).

    Article  CAS  PubMed  Google Scholar 

  6. Warren, J. W. Catheter-associated urinary tract infections. Infect. Dis. Clin. North Am. 11, 609–622 (1997).

    Article  CAS  PubMed  Google Scholar 

  7. Hooton, T. M. et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin. Infect. Dis. 50, 625–663 (2010).

    Article  PubMed  Google Scholar 

  8. Warren, J. W., Tenney, J. H., Hoopes, J. M., Muncie, H. L. & Anthony, W. C. A prospective microbiologic study of bacteriuria in patients with chronic indwelling urethral catheters. J. Infect. Dis. 146, 719–723 (1982).

    Article  CAS  PubMed  Google Scholar 

  9. Rebmann, T. & Greene, L. R. Preventing catheter-associated urinary tract infections: an executive summary of the Association for Professionals in Infection Control and Epidemiology, Inc, Elimination Guide. Am. J. Infect. Control 38, 644–646 (2010).

    Article  PubMed  Google Scholar 

  10. Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G. & Pegues, D. A. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect. Control Hosp. Epidemiol. 31, 319–326 (2010).

    Article  PubMed  Google Scholar 

  11. Umscheid, C. A. et al. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect. Control Hosp. Epidemiol. 32, 101–114 (2011).

    Article  PubMed  Google Scholar 

  12. O'Grady, F. & Cattell, W. R. Kinetics of urinary tract infection. II. The bladder. Br. J. Urol. 38, 156–162 (1966).

    Article  CAS  PubMed  Google Scholar 

  13. Kunin, C. M. Can we build a better urinary catheter? N. Engl. J. Med. 319, 365–366 (1988).

    Article  CAS  PubMed  Google Scholar 

  14. Garcia, M. M. et al. Traditional Foley drainage systems—do they drain the bladder? J. Urol. 177, 203–207; discussion 207 (2007).

    Article  PubMed  Google Scholar 

  15. Stamm, W. E. Catheter-associated urinary tract infections: epidemiology, pathogenesis, and prevention. Am. J. Med. 91, 65S–71S (1991).

    Article  CAS  PubMed  Google Scholar 

  16. Tambyah, P. A., Halvorson, K. T. & Maki, D. G. A prospective study of pathogenesis of catheter-associated urinary tract infections. Mayo Clin. Proc. 74, 131–136 (1999).

    Article  CAS  PubMed  Google Scholar 

  17. Donlan, R. M. & Costerton, J. W. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin. Microbiol. Rev. 15, 167–193 (2002).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ong, C. L. et al. Identification of type 3 fimbriae in uropathogenic Escherichia coli reveals a role in biofilm formation. J. Bacteriol. 190, 1054–1063 (2008).

    Article  CAS  PubMed  Google Scholar 

  19. Davies, D. G. et al. The involvement of cell-to-cell signals in the development of a bacterial biofilm. Science 280, 295–298 (1998).

    Article  CAS  PubMed  Google Scholar 

  20. Costerton, J. W., Lewandowski, Z., Caldwell, D. E., Korber, D. R. & Lappin-Scott, H. M. Microbial biofilms. Ann. Rev. Microbiol. 49, 711–745 (1995).

    Article  CAS  Google Scholar 

  21. Stickler, D., Morris, N., Moreno, M. C. & Sabbuba, N. Studies on the formation of crystalline bacterial biofilms on urethral catheters. Eur. J. Clin. Microbiol. Infect. Dis. 17, 649–652 (1998).

    Article  CAS  PubMed  Google Scholar 

  22. Jain, P., Parada, J. P., David, A. & Smith, L. G. Overuse of the indwelling urinary tract catheter in hospitalized medical patients. Arch. Intern. Med. 155, 1425–1429 (1995).

    Article  CAS  PubMed  Google Scholar 

  23. Munasinghe, R. L., Yazdani, H., Siddique, M. & Hafeez, W. Appropriateness of use of indwelling urinary catheters in patients admitted to the medical service. Infect. Control Hosp. Epidemiol. 22, 647–649 (2001).

    Article  CAS  PubMed  Google Scholar 

  24. Griffiths, R. & Fernandez, R. Strategies for the removal of short-term indwelling urethral catheters in adults. Cochrane Database Syst. Rev. CD004011 (2007).

  25. Loeb, M. et al. Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: a randomized controlled trial. J. Gen. Intern. Med. 23, 816–820 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  26. Saint, S., Kaufman, S. R., Thompson, M., Rogers, M. A. & Chenoweth, C. E. A reminder reduces urinary catheterization in hospitalized patients. Jt Comm. J. Qual. Patient Saf. 31, 455–462 (2005).

    Article  PubMed  Google Scholar 

  27. Topal, J. et al. Prevention of nosocomial catheter-associated urinary tract infections through computerized feedback to physicians and a nurse-directed protocol. Am. J. Med. Qual. 20, 121–126 (2005).

    Article  PubMed  Google Scholar 

  28. Gokula, R. M., Smith, M. A. & Hickner, J. Emergency room staff education and use of a urinary catheter indication sheet improves appropriate use of foley catheters. Am. J. Infect. Control 35, 589–593 (2007).

    Article  PubMed  Google Scholar 

  29. Lukasse, M., Cederkvist, H. R. & Rosseland, L. A. Reliability of an automatic ultrasound system for detecting postpartum urinary retention after vaginal birth. Acta Obstet. Gynecol. Scand. 86, 1251–1255 (2007).

    Article  PubMed  Google Scholar 

  30. Slappendel, R. & Weber, E. W. Non-invasive measurement of bladder volume as an indication for bladder catheterization after orthopaedic surgery and its effect on urinary tract infections. Eur. J. Anaesthesiol. 16, 503–506 (1999).

    Article  CAS  PubMed  Google Scholar 

  31. Fedorkow, D. M., Dore, S. & Cotton, A. The use of an ultrasound bladder scanning device in women undergoing urogynaecologic surgery. J. Obstet. Gynaecol. Can. 27, 945–948 (2005).

    Article  PubMed  Google Scholar 

  32. Boyce, J. M. & Pittet, D. Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect. Control Hosp. Epidemiol. 23, S3–S40 (2002).

    Article  PubMed  Google Scholar 

  33. Carapeti, E. A., Andrews, S. M. & Bentley, P. G. Randomised study of sterile versus non-sterile urethral catheterisation. Ann. R. Coll. Surg. Engl. 78, 59–60 (1996).

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Platt, R., Polk, B. F., Murdock, B. & Rosner, B. Reduction of mortality associated with nosocomial urinary tract infection. Lancet 1, 893–897 (1983).

    Article  CAS  PubMed  Google Scholar 

  35. Classen, D. C., Larsen, R. A., Burke, J. P. & Stevens, L. E. Prevention of catheter-associated bacteriuria: clinical trial of methods to block three known pathways of infection. Am. J. Infect. Control 19, 136–142 (1991).

    Article  CAS  PubMed  Google Scholar 

  36. Maki, D. G. & Tambyah, P. A. Engineering out the risk for infection with urinary catheters. Emerg. Infect. Dis. 7, 342–347 (2001).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Darouiche, R. O. et al. Impact of StatLock securing device on symptomatic catheter-related urinary tract infection: a prospective, randomized, multicenter clinical trial. Am. J. Infect. Control 34, 555–560 (2006).

    Article  PubMed  Google Scholar 

  38. Burke, J. P. et al. Prevention of catheter-associated urinary tract infections. Efficacy of daily meatal care regimens. Am. J. Med. 70, 655–658 (1981).

    Article  CAS  PubMed  Google Scholar 

  39. Dudley, M. N. & Barriere, S. L. Antimicrobial irrigations in the prevention and treatment of catheter-related urinary tract infections. Am. J. Hosp. Pharm. 38, 59–65 (1981).

    CAS  PubMed  Google Scholar 

  40. Warren, J. W., Platt, R., Thomas, R. J., Rosner, B. & Kass, E. H. Antibiotic irrigation and catheter-associated urinary-tract infections. N. Engl. J. Med. 299, 570–573 (1978).

    Article  CAS  PubMed  Google Scholar 

  41. Davies, A. J., Desai, H. N., Turton, S. & Dyas, A. Does instillation of chlorhexidine into the bladder of catheterized geriatric patients help reduce bacteriuria? J. Hosp. Infect. 9, 72–75 (1987).

    Article  CAS  PubMed  Google Scholar 

  42. Ball, A. J. et al. Bladder irrigation with chlorhexidine for the prevention of urinary infection after transurethral operations: a prospective controlled study. J. Urol. 138, 491–494 (1987).

    Article  CAS  PubMed  Google Scholar 

  43. Richter, S., Kotliroff, O. & Nissenkorn, I. Single preoperative bladder instillation of povidone-iodine for the prevention of postprostatectomy bacteriuria and wound infection. Infect. Control Hosp. Epidemiol. 12, 579–582 (1991).

    Article  CAS  PubMed  Google Scholar 

  44. Elliott, T. S., Reid, L., Rao, G. G., Rigby, R. C. & Woodhouse, K. Bladder irrigation or irritation? Br. J. Urol. 64, 391–394 (1989).

    Article  CAS  PubMed  Google Scholar 

  45. Mattelaer, J. J. & Billiet, I. Catheters and sounds: the history of bladder catheterisation. Paraplegia 33, 429–433 (1995).

    CAS  PubMed  Google Scholar 

  46. Stickler, D., Young, R., Jones, G., Sabbuba, N. & Morris, N. Why are Foley catheters so vulnerable to encrustation and blockage by crystalline bacterial biofilm? Urol. Res. 31, 306–311 (2003).

    Article  PubMed  Google Scholar 

  47. Ruutu, M., Alfthan, O., Talja, M. & Andersson, L. C. Cytotoxicity of latex urinary catheters. Br. J. Urol. 57, 82–87 (1985).

    Article  CAS  PubMed  Google Scholar 

  48. Edwards, L. E., Lock, R., Powell, C. & Jones, P. Post-catheterisation urethral strictures. A clinical and experimental study. Br. J. Urol. 55, 53–56 (1983).

    Article  CAS  PubMed  Google Scholar 

  49. Goble, N. M., Clarke, T. & Hammonds, J. C. Histological changes in the urinary bladder secondary to urethral catheterisation. Br. J. Urol. 63, 354–357 (1989).

    Article  CAS  PubMed  Google Scholar 

  50. Denstedt, J. D., Wollin, T. A. & Reid, G. Biomaterials used in urology: current issues of biocompatibility, infection, and encrustation. J. Endourol. 12, 493–500 (1998).

    Article  CAS  PubMed  Google Scholar 

  51. Morris, N. S., Stickler, D. J. & Winters, C. Which indwelling urethral catheters resist encrustation by Proteus mirabilis biofilms? Br. J. Urol. 80, 58–63 (1997).

    Article  CAS  PubMed  Google Scholar 

  52. Sun, Y. et al. Decreased urethral mucosal damage and delayed bacterial colonization during short-term urethral catheterization using a novel trefoil urethral catheter profile in rabbits. J. Urol. 186, 1497–1501 (2011).

    Article  PubMed  Google Scholar 

  53. Morris, N. S. & Stickler, D. J. Encrustation of indwelling urethral catheters by Proteus mirabilis biofilms growing in human urine. J. Hosp. Infect. 39, 227–234 (1998).

    Article  CAS  PubMed  Google Scholar 

  54. Beiko, D. T. et al. Urinary tract biomaterials. J. Urol. 171, 2438–2444 (2004).

    Article  CAS  PubMed  Google Scholar 

  55. Bull, E., Chilton, C. P., Gould, C. A. & Sutton, T. M. Single-blind, randomised, parallel group study of the Bard Biocath catheter and a silicone elastomer coated catheter. Br. J. Urol. 68, 394–399 (1991).

    Article  CAS  PubMed  Google Scholar 

  56. Sabbuba, N., Hughes, G. & Stickler, D. J. The migration of Proteus mirabilis and other urinary tract pathogens over Foley catheters. BJU Int. 89, 55–60 (2002).

    Article  CAS  PubMed  Google Scholar 

  57. Tunney, M. M. & Gorman, S. P. Evaluation of a poly(vinyl pyrollidone)-coated biomaterial for urological use. Biomaterials 23, 4601–4608 (2002).

    Article  CAS  PubMed  Google Scholar 

  58. Park, J. H., Cho, Y. W., Kwon, I. C., Jeong, S. Y. & Bae, Y. H. Assessment of PEO/PTMO multiblock copolymer/segmented polyurethane blends as coating materials for urinary catheters: in vitro bacterial adhesion and encrustation behavior. Biomaterials 23, 3991–4000 (2002).

    Article  CAS  PubMed  Google Scholar 

  59. Kazmierska, K. A., Thompson, R., Morris, N., Long, A. & Ciach, T. In vitro multicompartmental bladder model for assessing blockage of urinary catheters: effect of hydrogel coating on dynamics of Proteus mirabilis growth. Urology 76, 515.e15–e20 (2010).

    Article  Google Scholar 

  60. Hamill, T. M., Gilmore, B. F., Jones, D. S. & Gorman, S. P. Strategies for the development of the urinary catheter. Expert Rev. Med. Devices 4, 215–225 (2007).

    Article  PubMed  Google Scholar 

  61. Matsumura, Y., Yoshikata, K., Kunisaki, S. & Tsuchido, T. Mode of bactericidal action of silver zeolite and its comparison with that of silver nitrate. Appl. Environ. Microbiol. 69, 4278–4281 (2003).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Saint, S., Elmore, J. G., Sullivan, S. D., Emerson, S. S. & Koepsell, T. D. The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis. Am. J. Med. 105, 236–241 (1998).

    Article  CAS  PubMed  Google Scholar 

  63. Schumm, K. & Lam, T. B. Types of urethral catheters for management of short-term voiding problems in hospitalised adults. Cochrane Database Syst. Rev. CD004013 (2008).

  64. Srinivasan, A., Karchmer, T., Richards, A., Song, X. & Perl, T. M. A prospective trial of a novel, silicone-based, silver-coated foley catheter for the prevention of nosocomial urinary tract infections. Infect. Control Hosp. Epidemiol. 27, 38–43 (2006).

    Article  PubMed  Google Scholar 

  65. Regev-Shoshani, G., Ko, M., Crowe, A. & Av-Gay, Y. Comparative efficacy of commercially available and emerging antimicrobial urinary catheters against bacteriuria caused by E. coli in vitro. Urology 78, 334–339 (2011).

    Article  PubMed  Google Scholar 

  66. Lellouche, J., Kahana, E., Elias, S., Gedanken, A. & Banin, E. Antibiofilm activity of nanosized magnesium fluoride. Biomaterials 30, 5969–5978 (2009).

    Article  CAS  PubMed  Google Scholar 

  67. Costerton, J. W., Ellis, B., Lam, K., Johnson, F. & Khoury, A. E. Mechanism of electrical enhancement of efficacy of antibiotics in killing biofilm bacteria. Antimicrob. Agents Chemother. 38, 2803–2809 (1994).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Chakravarti, A. et al. An electrified catheter to resist encrustation by Proteus mirabilis biofilm. J. Urol. 174, 1129–1132 (2005).

    Article  PubMed  Google Scholar 

  69. Davis, C. P., Shirtliff, M. E., Scimeca, J. M., Hoskins, S. L. & Warren, M. M. In vivo reduction of bacterial populations in the urinary tract of catheterized sheep by iontophoresis. J. Urol. 154, 1948–1953 (1995).

    Article  CAS  PubMed  Google Scholar 

  70. Stewart, M. J., Parikh, S., Xiao, G., Tonge, P. J. & Kisker, C. Structural basis and mechanism of enoyl reductase inhibition by triclosan. J. Mol. Biol. 290, 859–865 (1999).

    Article  CAS  PubMed  Google Scholar 

  71. Bibby, J. M. Feasibility of preventing encrustation of urinary catheters. Cells Mater. 2, 183–195 (1995).

    Google Scholar 

  72. Williams, G. J. & Stickler, D. J. Effect of triclosan on the formation of crystalline biofilms by mixed communities of urinary tract pathogens on urinary catheters. J. Med. Microbiol 57, 1135–1140 (2008).

    Article  CAS  PubMed  Google Scholar 

  73. Hachem, R. et al. Novel antiseptic urinary catheters for prevention of urinary tract infections: correlation of in vivo and in vitro test results. Antimicrob. Agents Chemother. 53, 5145–5149 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Regev-Shoshani, G., Ko, M., Miller, C. & Av-Gay, Y. Slow release of nitric oxide from charged catheters and its effect on biofilm formation by Escherichia coli. Antimicrob. Agents Chemother. 54, 273–279 (2010).

    Article  CAS  PubMed  Google Scholar 

  75. Park, J. H. et al. Norfloxacin-releasing urethral catheter for long-term catheterization. J. Biomater. Sci. Polym. Ed. 14, 951–962 (2003).

    Article  CAS  PubMed  Google Scholar 

  76. Cho, Y. W. et al. Gentamicin-releasing urethral catheter for short-term catheterization. J. Biomater. Sci. Polym. Ed. 14, 963–972 (2003).

    Article  CAS  PubMed  Google Scholar 

  77. Kowalczuk, D., Ginalska, G. & Golus, J. Characterization of the developed antimicrobial urological catheters. Int. J. Pharm. 402, 175–183 (2010).

    Article  CAS  PubMed  Google Scholar 

  78. Morris, N. S. & Stickler, D. J. The effect of urease inhibitors on the encrustation of urethral catheters. Urol. Res. 26, 275–279 (1998).

    Article  CAS  PubMed  Google Scholar 

  79. Burton, E. et al. Antibiofilm activity of GlmU enzyme inhibitors against catheter-associated uropathogens. Antimicrob. Agents Chemother. 50, 1835–1840 (2006).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Tamilvanan, S., Venkateshan, N. & Ludwig, A. The potential of lipid- and polymer-based drug delivery carriers for eradicating biofilm consortia on device-related nosocomial infections. J. Control Release 128, 2–22 (2008).

    Article  CAS  PubMed  Google Scholar 

  81. Pugach, J. L. et al. Antibiotic hydrogel coated Foley catheters for prevention of urinary tract infection in a rabbit model. J. Urol. 162, 883–887 (1999).

    Article  CAS  PubMed  Google Scholar 

  82. Stickler, D. J. Bacterial biofilms in patients with indwelling urinary catheters. Nat. Clin. Pract. Urol. 5, 598–608 (2008).

    Article  CAS  PubMed  Google Scholar 

  83. Hull, R. A. et al. Virulence properties of Escherichia coli 83972, a prototype strain associated with asymptomatic bacteriuria. Infect. Immun. 67, 429–432 (1999).

    CAS  PubMed  PubMed Central  Google Scholar 

  84. Darouiche, R. O. et al. Multicenter randomized controlled trial of bacterial interference for prevention of urinary tract infection in patients with neurogenic bladder. Urology 78, 341–346 (2011).

    Article  PubMed  Google Scholar 

  85. Trautner, B. W., Hull, R. A., Thornby, J. I. & Darouiche, R. O. Coating urinary catheters with an avirulent strain of Escherichia coli as a means to establish asymptomatic colonization. Infect. Control Hosp. Epidemiol. 28, 92–94 (2007).

    Article  PubMed  Google Scholar 

  86. Lopez, A. I. et al. Biofunctionalization of silicone polymers using poly(amidoamine) dendrimers and a mannose derivative for prolonged interference against pathogen colonization. Biomaterials 32, 4336–4346 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Trautner, B. W. et al. Nanoscale surface modification favors benign biofilm formation and impedes adherence by pathogens. Nanomedicine 8, 261–270 (2012).

    Article  CAS  PubMed  Google Scholar 

  88. Carson, L., Gorman, S. P. & Gilmore, B. F. The use of lytic bacteriophages in the prevention and eradication of biofilms of Proteus mirabilis and Escherichia coli. FEMS Immunol. Med. Microbiol. 59, 447–455 (2010).

    Article  CAS  PubMed  Google Scholar 

  89. Sulakvelidze, A., Alavidze, Z. & Morris, J. G. Jr. Bacteriophage therapy. Antimicrob. Agents Chemother. 45, 649–659 (2001).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Fu, W. et al. Bacteriophage cocktail for the prevention of biofilm formation by Pseudomonas aeruginosa on catheters in an in vitro model system. Antimicrob. Agents Chemother. 54, 397–404 (2010).

    Article  CAS  PubMed  Google Scholar 

  91. Lazar, V. Quorum sensing in biofilms—how to destroy the bacterial citadels or their cohesion/power? Anaerobe 17, 280–285 (2011).

    Article  PubMed  Google Scholar 

  92. Manefield, M. et al. Evidence that halogenated furanones from Delisea pulchra inhibit acylated homoserine lactone (AHL)-mediated gene expression by displacing the AHL signal from its receptor protein. Microbiology 145 (Pt 2), 283–291 (1999).

    Article  CAS  PubMed  Google Scholar 

  93. de Nys, R., Givskov, M., Kumar, N., Kjelleberg, S. & Steinberg, P. D. Furanones. Prog. Mol. Subcell. Biol. 42, 55–86 (2006).

    CAS  PubMed  Google Scholar 

  94. Dror, N., Mandel, M., Hazan, Z. & Lavie, G. Advances in microbial biofilm prevention on indwelling medical devices with emphasis on usage of acoustic energy. Sensors 9, 2538–2554 (2009).

    Article  CAS  PubMed  Google Scholar 

  95. Hazan, Z. et al. Effective prevention of microbial biofilm formation on medical devices by low-energy surface acoustic waves. Antimicrob. Agents Chemother. 50, 4144–4152 (2006).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, BCM 286, Room N-1319, 1 Baylor Plaza, Houston, 77030-3498, TX, USA

    Danish M. Siddiq

  2. Michael E. DeBakey Veteran Affairs Medical Center, SCI Service (128), 2002 Holcombe Boulevard, Houston, 77004, TX, USA

    Rabih O. Darouiche

Authors
  1. Danish M. Siddiq
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rabih O. Darouiche
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

D. M. Siddiq and R. O. Darouiche contributed equally to researching data for the article, discussion of content, writing and reviewing the manuscript before submission.

Corresponding author

Correspondence to Danish M. Siddiq.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siddiq, D., Darouiche, R. New strategies to prevent catheter-associated urinary tract infections. Nat Rev Urol 9, 305–314 (2012). https://doi.org/10.1038/nrurol.2012.68

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrurol.2012.68

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing