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Polymer surface properties and their effect on the adhesion of Proteus mirabilis.

A problem encountered in patients undergoing long-term catheterization of the urinary tract is that of encrustation and blockage of the catheter by crystalline bacterial biofilms. This is principally caused by the action of the urease-producing pathogen Proteus mirabilis. A major aim of this work is to develop materials resistant to encrustation. Here, the effects of polymer surface properties on the adhesion of P. mirabilis are examined. Spin-coated polymer films were characterized through contact angle measurements to give the Lifschitz-van der Waals, electron acceptor and electron donor terms of the surface free energy, gamma(s)LW, gamma(s)+ and gamma(s)- respectively. A parallel-plate flow cell was used to assess adhesion to these polymer films of P. mirabilis suspended in an aqueous phosphate buffer, pH 7.4, ionic strength 0.26 mol/kg. P. mirabilis was found to adhere significantly less (p < 0.02) to films of agarose, poly(2-hydroxyethylmethacrylate) and cross-linked poly(vinyl alcohol) than to more hydrophobic materials. These polymer films were found to be strongly electron donating, i.e. possessing large gamma(s)-. Films examined using scanning electron microscopy mostly showed no evidence of roughness down to a scale of 1-10 microm. The better performance is thought to be due to a repulsive interaction with the bacterial surface caused by acid/base-type interactions.

Bacterial Adhesion↗

[Early treatment of intraoperative infections based on bacteriological testing (author's transl)].

Validity and efficiency of an antibiotic prophylaxis after extensive orthopedic and traumatological procedures are not universally accepted. Often the systematic antibiotic prophylaxis is withhold because of considerable disadvantages. A new method is reported, which enables a bactericidal antibiotic therapy based on bacteriological testing of swabs taken during and after surgery. Thus the administration of antibiotics is possible long before the clinical manifestation of an infection. Immediate therapy diminishes the danger of complications from infections. With this method microbial contamination was found and treated in 53 (17.44%) of 305 operations. Of these, only 0.66% resulted in deep infections and 3.6% delayed healings without further complications.

Anti-Bacterial Agents↗

Cellular energetics and ATP-MgCl2 therapy in sepsis.

Studies in rats with a clinically relevant form of peritonitis indicate that tissue adenine nucleotide levels do not decrease in the early stages of sepsis. In contrast, hepatocellular active transport appears to be depressed even in the very early stages of sepsis. In late sepsis, however, tissue adenine nucleotide levels decrease significantly because of inadequate perfusion associated with peritonitis. Reticuloendothelial function (RES) is also significantly depressed at the late stages of sepsis. Administration of saline, glucose, or ATP-MgCl2 alone following sepsis does not produce any beneficial effects on survival. However, administration of high concentrations of ATP-MgCl2 together with hypertonic glucose results in a significant improvement in the survival of animals. This treatment regimen restores cellular ATP levels and also restores the depressed RES function to normal within three hours. Thus, extirpation of the lesion producing the septic process, combined with metabolic support, proves helpful without antibiotic treatment.

Adenosine Diphosphate↗

Three episodes of nosocomial urinary tract infections caused by one O-serotype of Providencia stuartii.

The results of O-serotyping Providencia stuartii isolates in a general hospital showed that 43 isolates were the same serotype (063) and were from 15 patients located in 1 or 2 adjacent wards. On retrospective examination it was found that the series of infections occurred during a 9-month period and could be separated into 3 episodes, involving 7, 6 and 2 patients. All patients who acquired the Providencia stuartii 063 strain were catheterized. The introduction of the strain into the hospital was attributed to a patient catheterized before admission from an institution in which the 063 strain had been identified previously. Antibiotic irrigation was not successful in eliminating Providencia stuartii from the urine and the procedure may be a predisposing factor in preferentially selecting strains of this species.

Cross Infection↗

[Evaluation of diagnostic parameters in chronic recurrent urinary tract infection in children. III. Pyuria, hematuria, and proteinuria (author's transl)].

Pyuria, proteinuria and haematuria have been shown to be unreliable parameters for the diagnosis of bacteriuria in 171 children with 455 recurrences of chronic urinary tract infection. Bacteriuria caused haematuria in 5%, proteinuria in 18% and even pyuria in only 47% of all instances. Pyuria has been also found in 11% of sterile urines. The incidence of pyuria increases with the age of the children and depends on the type of the organisms, but the latter was true mainly in children with obstructive lesions of the urinary tract. Children with repeated proteinuria during follow-up tend to have a higher incidence of pathologic findings on the i.v.-pyelogram.

Age Factors↗