Antimicrobial strategies for urinary catheters

J Biomed Mater Res A. 2019 Feb;107(2):445-467. doi: 10.1002/jbm.a.36561. Epub 2018 Nov 23.

Abstract

Over 75% of hospital-acquired or nosocomial urinary tract infections are initiated by urinary catheters, which are used during the treatment of 16% of hospitalized patients. Taking the United States as an example, the costs of catheter-associated urinary tract infections (CAUTI) are in excess of $451 million dollars/year. The biofilm formation by pathogenic microbes that protects pathogens from host immune defense and antimicrobial agents is the leading cause for CAUTI. Thus, tremendous efforts have been devoted to antimicrobial coating for urinary catheters in the past few decades, and it has been demonstrated to be one of the most direct and efficient strategies to reduce infections. In this article, we briefly summarize the current methods for preparation of antimicrobial coatings based on different stages in the biofilm formation, highlight recent progress in the urinary catheter coating material design and selection, discuss approaches to improving their long-term antimicrobial efficacy, biocompatibility, multidrug resistance and recurrent infections, and finally outline future requirements and prospects in antimicrobial coating material design. The scope of the works surveyed is confined to antimicrobial urinary catheters. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 445-467, 2019.

Keywords: antimicrobial coatings; biofilm; catheter-associated urinary tract infection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / chemistry
  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Bacteria / drug effects
  • Bacterial Infections / etiology
  • Bacterial Infections / microbiology
  • Bacterial Infections / prevention & control
  • Biofilms / drug effects
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control*
  • Coated Materials, Biocompatible / chemistry
  • Coated Materials, Biocompatible / pharmacology*
  • Coated Materials, Biocompatible / therapeutic use
  • Humans
  • Urinary Catheters / adverse effects
  • Urinary Catheters / microbiology*
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / prevention & control*

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Coated Materials, Biocompatible