Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
Neuro-Urology, Swiss Paraplegic Research, Guido A. Zäch Str. 4, Nottwil, 6207, Switzerland.
World J Urol. 2024 Aug 7;42(1):469. doi: 10.1007/s00345-024-05191-y.
PURPOSE: About 50% of individuals with long-term indwelling catheters are affected by catheter encrustations and bladder stone formation. Therefore, prophylaxis of catheter encrustations is important. Currently, however, neither an established prophylaxis nor a standardized in-vitro model to test different measures exist. We have therefore developed and qualitatively evaluated an in-vitro model of catheter encrustation. METHODS: Size 14 French suprapubic catheters were incubated under sterile conditions at 37 degrees Celsius in five different media: (1) sterile artificial urine (n = 16), (2) artificial urine with E. coli (n = 8), (3) with Pseudomonas aeruginosa (n = 8), (4) with Proteus mirabilis (n = 8), and (5) with a mix of these three strains (n = 8). Catheter balloons were inflated either a glycerine or a bactericidal solution. After 6 weeks, the catheters were removed from the solution, dried, and weighed, and a photometric determination of the retrieved encrustations was performed. RESULTS: Most frequently and pronounced encrustations were detected in the Pseudomonas group. The median weight of these encrustations (50% struvite and brushite) was 84.4 mg (47.7 mg / 127.3 mg). Even on catheters stored in sterile urine, encrustations (69.2% struvite) were found. Bacterial growth was not affected by the medium used for catheter blockage. CONCLUSION: Although in-vitro models appear to be limited because they lack "the human factor", they are valuable for systematically assessing physico-chemical factors affecting encrustations. Therefore, our model, being reliable and cost-effective, may foster further research despite its limitations.
目的:约 50%长期留置导尿管的个体受到导管结石和膀胱结石形成的影响。因此,预防导管结石形成非常重要。然而,目前既没有既定的预防措施,也没有用于测试不同措施的标准化体外模型。因此,我们开发并定性评估了一种导管结石形成的体外模型。
方法:在无菌条件下,将 14 号 F 型耻骨上导尿管在 37°C 的 5 种不同介质中孵育:(1)无菌人工尿液(n=16)、(2)含大肠杆菌的人工尿液(n=8)、(3)铜绿假单胞菌(n=8)、(4)奇异变形杆菌(n=8)和(5)这三种菌株的混合物(n=8)。导管球囊充有甘油或杀菌溶液。6 周后,将导管从溶液中取出、干燥并称重,并对取回的结石进行分光光度测定。
结果:在铜绿假单胞菌组中检测到最频繁和最明显的结石。这些结石(50%为鸟粪石和羟磷灰石)的中位重量为 84.4mg(47.7mg/127.3mg)。即使在储存在无菌尿液中的导管中,也发现了结石(69.2%为鸟粪石)。细菌生长不受用于阻塞导管的培养基的影响。
结论:尽管体外模型似乎受到限制,因为它们缺乏“人为因素”,但它们对于系统评估影响结石形成的物理化学因素非常有价值。因此,尽管存在局限性,但我们的模型具有可靠性和成本效益,可能会促进进一步的研究。
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