You have accessJournal of UrologyStone Disease: Basic Research I1 Apr 2014MP20-01 AURICLOSENE IRRIGATION SOLUTION PREVENTS ENCRUSTATION BY CRYSTALLINE BIOFILM DUE TO PROTEUS MIRABILIS IN AN IN VITRO URINARY CATHETER PATENCY MODEL Suriani Abdul Rani, Ramin (Ron) Najafi, Keith Bley, William Costerton, David Stickler, Bernard Churchill, and Dmitri Debabov Suriani Abdul RaniSuriani Abdul Rani More articles by this author , Ramin (Ron) NajafiRamin (Ron) Najafi More articles by this author , Keith BleyKeith Bley More articles by this author , William CostertonWilliam Costerton More articles by this author , David SticklerDavid Stickler More articles by this author , Bernard ChurchillBernard Churchill More articles by this author , and Dmitri DebabovDmitri Debabov More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.723AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Long-term indwelling urinary catheters are susceptible to blockage due to formation of crystalline biofilms by urease-producing microorganisms such as Proteus mirabilis. An in vitro catheter biofilm model (CBM) was developed to compare current methods for maintaining urinary catheter patency. We compared various bladder irrigation solutions or antimicrobial-coated urinary catheters, versus a novel antimicrobial catheter irrigation solution containing auriclosene (N,N-dichloro-2,2-dimethyltaurine; formerly designated NVC-422). METHODS CBM units were fed artificial urine at 0.5 mL per min. The artificial bladder chamber was inoculated with 108 colony forming units (CFU) of P. mirabilis and biofilm was allowed to establish for 48 hours before daily treatments commenced. A single treatment consisted of two sequential 50 mL irrigations. Each irrigation was retained in the catheter for 15 min and then drained, with a 30 min washout period between the two irrigations. Experiments were conducted for up to 10 days or until catheter blockage. The pH of the effluent, CFU counts in the bladder chamber and the time to catheter blockage were recorded. The area of catheter encrustation was measured using Stereo Zoom imaging. RESULTS Inoculation of the CBM reactor with 108 CFU of P. mirabilis resulted in blockage of the urinary catheters within 5 days. The use of silver-hydrogel or nitrofurazone-coated catheters did not extend the period of catheter patency. Catheter irrigation with 0.25% acetic acid or isotonic saline blocked at the same rate as untreated catheters. Catheters irrigated with a citrate-buffered formulation of 0.2% auriclosene resulted in maintenance of catheter patency for 10 days and complete eradication of P. mirabilis and biofilm within one treatment day. In contrast, daily irrigations of infected catheters with 10 mM acetate-buffered saline (at pH 4) or Renacidin® Irrigation Solution had no effect on P. mirabilis colonization of the bladder chamber, even though catheter patency was maintained throughout 10-day studies. CONCLUSIONS Irrigation with the rapidly bactericidal antimicrobial auriclosene in a buffered acidic formulation - termed Auriclosene Irrigation Solution - significantly enhanced catheter patency in vitro versus other irrigation solutions and antimicrobial-coated urinary catheters. Clinical evaluation of Auriclosene Irrigation Solution is ongoing. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e196 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Suriani Abdul Rani More articles by this author Ramin (Ron) Najafi More articles by this author Keith Bley More articles by this author William Costerton More articles by this author David Stickler More articles by this author Bernard Churchill More articles by this author Dmitri Debabov More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Objectives. Intestinal metaplasia often coexists with adenocarcinoma of the urinary bladder, suggesting to some investigators that it is premalignant. However, the natural history and long-term outcome of intestinal metaplasia in isolation are unknown. We report 53 cases of intestinal metaplasia of the urinary bladder followed for more than 10 years. Methods. We reviewed the Mayo Clinic surgical pathology files between 1926 and 1996 and all patients with exstrophic bladder recorded in the files of the Hospital for Sick Children (Toronto, Ontario, Canada) and Dallas Children's Hospital (Dallas, Texas) between 1953 and 1987, and identified all patients with intestinal metaplasia of the bladder. Results. A total of 53 cases were identified from both series, and none of the patients developed adenocarcinoma of the bladder. The Mayo Clinic series consisted of 24 patients. Nineteen of the 24 (79.1 %) were alive without evidence of cancer (median follow-up 14 years, range 0.9 to 53), and 5 patients died of intercurrent disease (at 0.9, 4, 8, 11, and 53 years after diagnosis) without evidence of bladder cancer. The Dallas Children's Hospital and the Hospital for Sick Children series consisted of 29 patients. Twenty-seven of the 29 (93.1%) were alive without evidence of cancer (median follow-up 13 years, range 3 to 23.9). Two patients died of trauma (at 10.9 and 12 years after diagnosis) and at autopsy had no evidence of bladder cancer. Conclusions. Intestinal metaplasia of the urinary bladder is not a strong risk factor for adenocarcinoma or urothelial cancer. (C) 1997, Elsevier Science Inc. All rights reserved.