Clinical complications of urinary catheters caused by crystalline biofilms: something needs to be done.

摘要: This review is largely based on a previous paper published in the journal Spinal Cord. The care of many patients undergoing long-term bladder catheterization complicated by encrustation and blockage their Foley catheters. problem stems from infection urease-producing bacteria, particularly Proteus mirabilis. These organisms colonize catheter forming an extensive biofilm; they also generate ammonia urea, thus elevating pH urine. As rises, crystals calcium magnesium phosphates precipitate urine biofilm. continued development this crystalline biofilm blocks flow through catheter. Urine then either leaks along outside patient becomes incontinent or retained causing painful distension reflux to kidneys. process crystal deposition can initiate stone formation. Most suffering recurrent develop stones. P. mirabilis establishes stable residence these stones extremely difficult eliminate catheterized urinary tract antibiotic therapy. If blocked catheters are not identified changed, serious symptomatic episodes pyelonephritis, septicaemia endotoxic shock result. All types including silver- nitrofurazone-coated devices vulnerable problem. In review, ways which formation initiated will be described. implications understanding mechanisms for encrustation-resistant discussed. Finally, way forward prevention control considered.