Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Stiegstück 34, 22339, Hamburg, Germany.
Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMC Urol. 2021 Apr 9;21(1):58. doi: 10.1186/s12894-021-00826-3.
Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation.
Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution versus no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration.
Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.002) or no treatment (p = 0.011). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.74).
A 0.02% polyhexanide solution is able to reduce bacterial biofilm from catheters artificially contaminated with clinically relevant bacteria in vitro. The data shows a reduction of the viability of thick bacterial biofilms in a variety of commercially available urinary catheters made from silicone, latex-free silicone, hydrogel-coated silicone and PVC. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.
长期使用尿道导管与尿路感染（UTI）和阻塞的高风险相关。微生物生物膜是导管阻塞的常见原因，降低了其使用寿命，并显著增加了 UTI 的发病率。一种 0.02%的聚己定冲洗液，用于常规机械冲洗，显示出对尿道导管细菌去定植的潜力，并有可能减少或预防生物膜的形成。
使用体外试验，用标准的市场领先类型的导管人工污染具有临床相关细菌，评估 0.02%聚己定溶液对生物膜减少和预防的潜力，与无干预（标准方法）和生理盐水（NaCl 0.9%）冲洗进行比较。通过微生物平板计数和膜过滤测量去定植效率。
使用 0.02%聚己定溶液冲洗适用于各种经尿道导管的去定植。与用 0.9%生理盐水冲洗（p=0.002）或不治疗（p=0.011）相比，观察到的效果显著。用 0.9%生理盐水冲洗与不治疗之间无显著差异（p=0.74）。
0.02%聚己定溶液能够减少体外人工污染的与临床相关细菌的导管上的细菌生物膜。数据显示，在各种市售的硅酮、无乳胶硅酮、水凝胶涂层硅酮和 PVC 制成的尿液导管中，厚细菌生物膜的活力降低。需要进一步研究以评估聚己定在临床实践中的长期耐受性和疗效。
