Introduction: Ureteral stents are exceedingly being used is the field of Urology, and with advancements in endourology this trend is increasing.
Bacterial colonization and proliferation on the stents surface may result in urinary tract infections requiring the administration of antibiotics which in turn may lead to the development of antibiotic-resistant bacterial strains. Several studies have shown that sustained release varnish (SRV) combined with antibiotics or antiseptics can prevent the proliferation of bacteria on urethral catheters. This is the first study that evaluate this technique implemented on ureteral stents
Materials and Methods: We evaluated growth inhibition on ureteral stent segments coated with chlorhexidine 1% (CHX) SRV. The tests were conducted using common urinary pathogens: Enterococci, Pseudomanas and E. coli. Coated stent segments were inserted into bacterial suspensions. Controls included uncoated stent segments and stents coated with placebo SRV (without CHX).
Results: Bacterial growth measured as turbidity and as colony forming units (CFU) showed a significant inhibition effect of initial bacteria adhesion to the CHX-SRV coated stent segments compared with the controls (P< 0.001) . This inhibitory effect was apparent in each of the bacteria tested and was confirmed by inspection of the stent segments under and electron microscope. In a kinetic experiment using CHX 2% SRV we were able to prolong the growth inhibition effect from one week to nearly two weeks.
Conclusions: We believe this technique may play a significant role in reducing ureteral stent-associated UTI's. Further studies are required before this approach can be implemented into clinical practice.
Written by:
Zelichenko G, Steinberg D, Lorber G, Friedman M, Zaks B, Lavy E, Hidas G, Landau EH, Gofrit ON, Pode D, Duvdevani M. Are you the author?
Hadassah Hebrew University Hospital, Urology, Jerusalem, Israel.
Reference: J Endourol. 2012 Sep 12. Epub ahead of print.
doi: 10.1089/end.2012.0193
PubMed Abstract
PMID: 22970837
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