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Does the valve-regulated release of urine from the bladder decrease encrustation and blockage of indwelling catheters by crystalline Proteus mirabilis biofilms?

Sabbuba, N.A.; Stickler, D.J.; Long, M.J.; Dong, Z.; Short, T.D.; Feneley, R.J.C.

Authors

N.A. Sabbuba

D.J. Stickler

M.J. Long

Z. Dong

T.D. Short

R.J.C. Feneley



Abstract

We tested whether valve regulated, intermittent flow of urine from catheterized bladders decreases catheter encrustation. Materials and Methods Laboratory models of the catheterized bladder were infected with Proteus mirabilis. Urine was allowed to drain continuously through the catheters or regulated by valves to drain intermittently at predetermined intervals. The time that catheters required to become blocked was recorded and encrustation was visualized by scanning electron microscopy. Results When a manual valve was used to drain urine from the bladder at 2-hour intervals 4 times during the day, catheters required significantly longer to become blocked than those on continuous drainage (mean 62.6 vs 35.9 hours, p = 0.039). A similar 1.7-fold increase occurred when urine was drained at 4-hour intervals 3 times daily. Experiments with an automatic valve in which urine was released at 2 or 4-hour intervals through the day and night also showed a significant increase in mean time to blockage compared with continuous drainage (p = 0.001). Scanning electron microscopy confirmed that crystalline biofilm was less extensive on valve regulated catheters. Conclusions Valve regulated, intermittent flow of urine through catheters increases the time that catheters require to become blocked with crystalline biofilm. The most beneficial effect was recorded when urine was released from the bladder at 4-hour intervals throughout the day and night by an automatic valve.

Citation

Sabbuba, N., Stickler, D., Long, M., Dong, Z., Short, T., & Feneley, R. (2005). Does the valve-regulated release of urine from the bladder decrease encrustation and blockage of indwelling catheters by crystalline Proteus mirabilis biofilms?. The Journal of Urology, 173(1), 262-266. https://doi.org/10.1097/01.ju.0000141139.76350.49

Journal Article Type Article
Publication Date Jan 1, 2005
Deposit Date Feb 8, 2007
Journal Journal of Urology
Print ISSN 0022-5347
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 173
Issue 1
Pages 262-266
DOI https://doi.org/10.1097/01.ju.0000141139.76350.49
Keywords bladder, catheters, indwelling, Proteus mirabilis, urinary tract infections, urinary calculi.