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

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
• impregnation
• catheter
• biofilms
• antimicrobial coatings

Article Highlights

• Despite the perceived superiority of silver-coated catheters over silicone or latex catheters in short-term catheterization, commercially available silver-coated catheters are not more effective in preventing bacterial infection and encrustation in long-term catheterization.

• Combined coating (antibiotics and silver) offers a synergistic effect against preventing CAUTI.

• Data for NO-, CHX-, enzyme-, liposomal-, and bacteriophage-coated catheter surfaces are limited but appear promising.

• As the majority of available studies are in vitro or animal model studies, prospective human subject testing would constitute a logical next step.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.