A strategy for the control of catheter blockage by crystalline Proteus mirabilis biofilm using the antibacterial agent triclosan

Objectives: Catheter blockage by crystalline Proteus mirabilis biofilm is a common complication in patients undergoing long-term indwelling bladder catheterisation. Previously we have shown that inflating the retention balloons of all-silicone catheters with triclosan solutions prevents the encrustation process. The aim of the present work was to examine whether this strategy is effective in latex-based catheters. Methods: Laboratory bladder models were fitted with catheters and the retention balloons inflated with water or various concentrations of triclosan. The urine was inoculated with Pr. mirabilis and the times catheters took to block recorded. Results: Control catheters blocked in mean times ranging from 18 to 27 h. The pH of the urine rose from 6.1 to > 8.6. In models with latex-based catheters inflated with 1-10 mg/ml triclosan, the urinary pH was controlled, the numbers of organisms in the urine was reduced and the catheters drained freely for the 7 day experimental period. Electron microscopy confirmed that crystalline biofilm was blocking control catheters. Little sign of encrustation was visible on the test catheters. Conclusion: Inflating the retention balloons with triclosan could have practical applications in controlling encrustation on both latex and silicone-based catheters. (c) 2005 Elsevier B.V. All rights reserved.