Long-term use of noble metal alloy coated urinary catheters reduces recurrent CAUTI and decreases proinflammatory markers

Birgitta Magnusson; Ylva Kai-Larsen; Petter Granlund; Åke Seiger; Lena Lindbo; Javier Sanchez; Dorota Johansson

doi:10.1177/1756287219854915

Long-term use of noble metal alloy coated urinary catheters reduces recurrent CAUTI and decreases proinflammatory markers

Ther Adv Urol. 2019 Jun 18:11:1756287219854915. doi: 10.1177/1756287219854915. eCollection 2019 Jan-Dec.

Authors

Birgitta Magnusson¹, Ylva Kai-Larsen², Petter Granlund¹, Åke Seiger³, Lena Lindbo⁴, Javier Sanchez⁵, Dorota Johansson⁶

Affiliations

¹ Section of Urology, Central hospital Karlstad, Sweden.
² Bactiguard AB, Alfred Nobels Allé 150, 146 48 Tullinge, Stockholm, Sweden.
³ Rehab Station Stockholm, Spinalis, Stockholm, Sweden Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
⁴ Rehab Station Stockholm, Spinalis, Stockholm, Sweden.
⁵ Bactiguard AB, Tullinge, Stockholm, Sweden Danderyd Hospital, Stockholm, Sweden.
⁶ Bactiguard AB, Tullinge, Stockholm, Sweden.

Abstract

Background: The objective of this study was to investigate a case of a permanently (suprapubic) catheterized woman with neurogenic bladder dysfunction. The patient had suffered from recurrent catheter-associated urinary tract infections (CAUTIs) since 2009, despite several prevention approaches and attempts. In 2013, the patient's catheter was substituted for the BIP Foley Catheter, coated with a noble metal alloy (NMA) of gold, silver, and palladium.

Method: This is a retrospective-prospective clinical case study covering 4 years history for the control catheters and up to 2.5 years for the anti-infective BIP Foley Catheter. CAUTI incidences, symptoms, antibiotics, catheter performance, and comfort were evaluated. Levels of proinflammatory cytokines were measured pre- and post-substitution to BIP Foley Catheter in urine of the case and of four other permanently catheterized patients. In addition, the levels of noble metals were assessed in urine of the case subject during use of the BIP Foley Catheter.

Results: While using control catheters, the patient experienced symptomatic CAUTIs requiring antibiotics almost every month for 4 years. After 1 month with the BIP Foley Catheter, the symptoms disappeared, and the patient remained free of symptomatic CAUTIs and antibiotic treatment for the following 2.5 years, despite bacteriuria. The patient was satisfied with the comfort during insertion, use, and removal of the BIP Foley Catheter. Urinary levels of the proinflammatory cytokines interleukin (IL)-6, IL-8, and tumor necrosis factor alpha (TNFα) decreased towards normal levels post catheter type substitution. Traces of noble metals detected in a few urine samples were ⩽4% of the permitted daily exposure. The levels of the noble metals gold, silver, and palladium remaining on the BIP Foley Catheter after use were the same as for unused catheters.

Conclusion: Long-term use of a NMA-coated catheter was associated with cessation of frequent CAUTIs. The catheter was experienced as comfortable and inflammatory markers were reduced with time. The coating was stable, with no significant metal release into urine and is therefore safe for patient use.

Keywords: CAUTI; coating; cystitis; noble metal alloy; urinary catheters; urinary tract infection.