Application of a nanotechnology antimicrobial spray to prevent lower urinary tract infection: a multicenter urology tria

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Application of a nanotechnology antimicrobial spray to prevent lower urinary tract infection: a multicenter urology trial Wei He1, Dongmin Wang2, Zhangqun Ye1, Weihong Qian3, Yan Tao3, Xiaofeng Shi3, Ling Liu4, Jin Chen5, Ling Qiu6, Peng Wan7, Xiaojun Jia8, Xia Li9, Caixia Gao10, Xuexia Ma11, Biyan Wen9, Nianzhen Chen12, Ping Li13, Zhengzheng Ren14, Li Lan15, Siyi Li16, Yi Zuo17, Hua Zhang18, Liming Ma18, Yueping Zhang18, Zhicong Li19, Weiping Su20, Qing Yang21, Qingli Chen22, Xuejing Wang22, Zhenni Ye23, JP Chen24, Wings TY Loo24,25*, Louis WC Chow25, Adrian YS Yip25, Elizabeth LY Ng25, Mary NB Cheung25, Zhiping Wang2† From Organisation for Oncology and Translational Research (OOTR) 7th Annual Conference Hong Kong. 13-14 May 2011

Abstract Background: Catheter-associated urinary tract infection (CAUTI) is a common nosocomial device-associated infection. It is now recognized that the high infection rates were caused by the formation of biofilm on the surface of the catheters that decreases the susceptibility to antibiotics and results in anti-microbial resistance. In this study, we performed an in vitro test to explore the mechanism of biofilm formation and subsequently conducted a multi-center clinical trial to investigate the efficacy of CAUTI prevention with the application of JUC, a nanotechnology antimicrobial spray. Methods: Siliconized latex urinary catheters were cut into fragments and sterilized by autoclaving. The sterilized sample fragments were randomly divided into the therapy and control group, whereby they were sprayed with JUC and distilled water respectively and dried before use. The experimental standard strains of Escherichia coli (E. coli) were isolated from the urine samples of patients. At 16 hours and 7 days of incubation, the samples were extracted for confocal laser scanning microscopy. A total of 1,150 patients were accrued in the clinical study. Patients were randomized according to the order of surgical treatment. The odd array of patients was assigned as the therapy group (JUC), and the even array of patients was assigned as the control group (normal saline). Results: After 16 hours of culture, bacterial biofilm formed on the surface of sample fragments from the control group. In the therapy group, no bacterial biofilm formation was observed on the sample fragments. No significant increase in bacterial colony count was observed in the therapy group after 7 days of incubation. On the 7th day of catheterization, urine samples were collected for bacterial culture before extubation. Significant difference was observed in the incidence of bacteriuria between the therapy group and control group (4.52% vs. 13.04%, p < 0.001). Conclusions: In this study, the effectiveness of JUC in preventing CAUTI in a hospital setting was demonstrated in both in vitro and clinical studies.

* Correspondence: [email protected] † Contributed equally 24 School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR Full list of author information is available at the end of the ar