Does antimicrobial coating and impregnation of urinary catheters prevent catheter-associated urinary tract infection? A review of clinical and preclinical studies

Expert Rev Med Devices. 2019 Sep;16(9):809-820. doi: 10.1080/17434440.2019.1661774. Epub 2019 Sep 6.

Abstract

Introduction: Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections in hospitals, accounting for 36% of all health care-associated infections. Areas covered: We aimed to address the potential impact of antimicrobial coating of catheter materials for the prevention of CAUTI and to analyze the progress made in this field. We conducted literature searches in the PubMed, Embase, and Cochrane Library databases, and found 578 articles. Data from 60 articles in either the preclinical or clinical stage were analyzed in this expert review. Expert opinion: The literature review revealed many promising methods for preventing CAUTI. Recent studies have suggested the combination of silver-based products and antibiotics, owing to their synergistic effect, to help address the problem of antibiotic resistance. Other coating materials that have been tested include nitric oxide, chlorhexidine, antimicrobial peptides, enzymes, and bacteriophages. Because of heterogeneity among studies, it is difficult to reliably comment on the clinical efficacy of different coating materials. Future research should focus on double-blind randomized clinical trials for evaluating the role of these potential coating agents.

Keywords: Catheter associated urinary tract infection; antimicrobial coatings; biofilms; catheter; impregnation.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Infective Agents / pharmacology*
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control*
  • Coated Materials, Biocompatible / pharmacology*
  • Humans
  • Silver / pharmacology
  • Urinary Catheters / microbiology*
  • Urinary Tract Infections / prevention & control*

Substances

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