Intermittent catheters (ICs) are commonly used in bladder management but catheter-associated urinary tract infections (CAUTIs) remain challenging. Insertion tips may reduce the risk of CAUTIs by minimizing bacterial transfer along the urinary tract. However, there are few laboratory tests to evaluate such technologies. We describe the use of an adapted in vitro urethra agar model to assess bacterial displacement by ICs.
Simulated urethra agar channels (UACs) were prepared with catheter-specific sized channels in selective media specific to the challenge organisms. UACs were inoculated with E. coli and E. faecalis before insertion of ICs and enumeration of UAC sections were performed following insertion. Four ICs were evaluated: Cure Catheter® Closed System (CCS), VaPro Plus PocketTM, Bard® Touchless® Plus, and SpeediCath® Flex Set. CCS demonstrated significantly reduced bacterial displacement along the UACs compared to the other ICs and was also the only IC with undetectable levels of bacteria towards the end of the UAC (representing the proximal urethra).
The bacterial displacement test demonstrated significant differences in bacterial transfer between the test ICs with insertion tips which may reflect their different designs. This method is useful for evaluating CAUTI prevention technology and may help guide future technology innovations.
Journal of applied microbiology. 2024 Aug 06 [Epub ahead of print]
Kate Meredith, David Pollard, Victoria Mason, Ased Ali
Convatec Ltd., Deeside, UK.