CONDITIONING FILM DEPOSITION ON URETERAL STENTS AFTER IMPLANTATION

No AccessJournal of UrologyInvestigative Urology1 Sep 1998CONDITIONING FILM DEPOSITION ON URETERAL STENTS AFTER IMPLANTATION CHRISTINA TIESZER, GREGOR REID, and JOHN DENSTEDT CHRISTINA TIESZERCHRISTINA TIESZER More articles by this author , GREGOR REIDGREGOR REID More articles by this author , and JOHN DENSTEDTJOHN DENSTEDT More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62825-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Three types of ureteral stents were used in a study of 53 patients. Following extracorporeal shock wave lithotripsy, the stents were implanted and retained for periods of between 3 and 40 days. Each patient received daily antibiotic therapy with either ciprofloxacin or trimethoprim. After removal, the devices were analyzed for adherent bacteria and encrustations. The study showed that a conditioning film became deposited onto the stents upon implantation, changing the surface characteristics of the biomaterials. Dense encrustations were found to be least on a low surface energy device. No differences were found related to patient age and gender or duration of stent insertion. Flakiness and apparent sloughing of the stent surfaces was observed in some devices, raising concerns as to what actually happens to medical devices when exposed to the host urinary tract. Bacteria were recovered from the urine of three patients and the stents of four patients treated with trimethoprim. Five stents had bacterial biofilms detected by SEM. The actual clinical end-point was not the focus of this study, but no patients became septic. Our goal was to demonstrate conclusively in humans that medical devices do develop conditioning films upon implantation, and that they can be susceptible to bacterial colonization even during antibiotic treatments. The kidneys of stented patients are clearly at risk of infection, and only by proper selection of a stent type and appropriate antibiotic coverage can this risk be significantly reduced. References 1 : The development of synthetic polymers that resist encrustation on exposure to urine. Br. J. Urol.1992; 69: 651. Crossref, Medline, Google Scholar 2 : The binding of urinary components and uropathogens to a silicone latex urethral catheter. Cells Mater.1992; 2: 253. Google Scholar 3 : Comparison of in vitro encrustation on silicone and hydrogel coated latex catheters. Br. J. Urol.1988; 61: 156. Crossref, Medline, Google Scholar 4 : Biomedical polymers: bacterial adhesins, colonization, and infection. CRC Crit. Revs. Biocompat.1986; 2: 219. Google Scholar 5 : XPS, SEM and EDX analysis of conditioning film deposition onto ureteral stents. Surf. Interf. Anal.1994; 21: 581. Crossref, Google Scholar 6 : Bacterial adhesion and biofilm formation on ureteral stents in vitro and in vivo. J. Urol.1992; 148: 1592. Link, Google Scholar 7 : Use of quinolones in treatment of prostatitis and lower urinary tract infection. Eur. J. Clin. Microb. Infect. Dis.1991; 10: 342. Crossref, Medline, Google Scholar 8 : Use of quinolones in urinary tract infections and prostatitis. Rev. Infect. Dis.1989; 11: 1321. Crossref, Google Scholar 9 : Pharmacokinetics of ciprofloxacin after oral and parenteral administration. Antimicrob. Agents Chemother.1985; 27: 375. Crossref, Medline, Google Scholar 10 : Fluoroquinolone antimicrobial agents. N. Engl. J. Med.1991; 324: 384. Crossref, Medline, Google Scholar 11 : Ciprofloxacin: an overview and prospective appraisal. Am. J. Med.1987; 82: 395. Medline, Google Scholar 12 : Effects of ciprofloxacin, norfloxacin, and ofloxacin on in vitro adhesion and survival of Pseudomonas aeruginosa AK1 on urinary catheters. Antimicrob. Agents Chemother.1994; 38: 1490. Crossref, Medline, Google Scholar 13 : Adsorption of ciprofloxacin to urinary catheters and effect on subsequent bacterial adhesion and survival. Coll. Surf. B: Biointerfaces1993; 1: 9. Crossref, Google Scholar 14 : Surface thermodynamics of bacterial adhesion. Appl. Environ. Microbiol.1983; 46: 90. Crossref, Medline, Google Scholar 15 : Crystallization studies in a urothelial-lined living test tube (the catheterized female rat bladder): calcium oxalate crystal adhesion to the chemically injured rat bladder. Invest. Urol.1979; 17: 257. Medline, Google Scholar 16 : Urothelial reaction to uretic intubation. Br. J. Urol.1987; 66: 66. Google Scholar 17 : Effect of bacterial, urine and substratum surface tension properties on bacterial adhesion to biomaterials. Biofoul.1991; 4: 171. Crossref, Google Scholar 18 : Infection of catheterized patients: bacterial colonization of encrusted Foley catheters shown by scanning electron microscopy. Urol. Res.1989; 17: 349. Crossref, Medline, Google Scholar 19 : The ecology and pathogenicity of urease-producing bacteria in the urinary tract. Crit. Rev. Microbiol.1988; 16: 37. Crossref, Medline, Google Scholar 20 : Encrustation of intraprostatic stents-a comparative study. Br. J. Urol.1992; 69: 383. Crossref, Medline, Google Scholar 21 : Bacterial and crystal adherence to the surfaces of indwelling catheters. J. Urol.1990; 143: 717. Link, Google Scholar 22 : Biodeterioration of medical-grade silicone rubber used for voice prostheses: a SEM study. Biomater.1993; 14: 459. Crossref, Medline, Google Scholar From the Department of Microbiology and Immunology and Department of Surgery, Division of Urology, The University of Western Ontario, and the Lawson Research Institute, London, Ontario, Canada© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Samir M, Mahmoud M and Tawfick A (2023) Does bacterial colonization influence ureteral stent-associated morbidity? A prospective studyArab Journal of Urology, 10.1080/2090598X.2022.2164124, (1-6) Kar M, Dubey A, Patel S, Siddiqui T, Ghoshal U and Sahu C (2022) Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent and percutaneous nephrostomy tubeJournal of Global Infectious Diseases, 10.4103/jgid.jgid_276_21, VOL. 14, NO. 2, (75), . Tofail S (2022) A Dynamically Degradable Surface: Can We ‘Fool’ Bacteria to Delay Biofouling in Urinary Stents? Urinary Stents, 10.1007/978-3-031-04484-7_16, (187-195), . Beysens M and Tailly T (2018) Ureteral stents in urolithiasisAsian Journal of Urology, 10.1016/j.ajur.2018.07.002, VOL. 5, NO. 4, (274-286), Online publication date: 1-Oct-2018. Lange D, Bidnur S, Hoag N and Chew B (2014) Ureteral stent-associated complications—where we are and where we are goingNature Reviews Urology, 10.1038/nrurol.2014.340, VOL. 12, NO. 1, (17-25), Online publication date: 1-Jan-2015. Bonkat G, Braissant O, Rieken M, Müller G, Frei R, van der Merwe A, Siegel F, Gasser T, Wyler S, Bachmann A and Widmer A (2012) Comparison of the roll-plate and sonication techniques in the diagnosis of microbial ureteral stent colonisation: results of the first prospective randomised studyWorld Journal of Urology, 10.1007/s00345-012-0963-5, VOL. 31, NO. 3, (579-584), Online publication date: 1-Jun-2013. Bonkat G, Rieken M, Müller G, Roosen A, Siegel F, Frei R, Wyler S, Gasser T, Bachmann A and Widmer A (2012) Microbial colonization and ureteral stent-associated storage lower urinary tract symptoms: the forgotten piece of the puzzle?World Journal of Urology, 10.1007/s00345-012-0849-6, VOL. 31, NO. 3, (541-546), Online publication date: 1-Jun-2013. Williams G (2012) Antimicrobial Surfaces Russell, Hugo & Ayliffe's, 10.1002/9781118425831.ch20a, (485-499) Janssen C, Lange D and Chew B (2012) Ureteral stents – future developmentsBritish Journal of Medical and Surgical Urology, 10.1016/S1875-9742(12)60004-4, VOL. 5, (S11-S17), Online publication date: 1-Dec-2012. Newton M and Brown J (2011) Full-Length Metallic Double J Stents: A Review of Resonance® StentsClinical Medicine Insights: Urology, 10.4137/CMU.S6604, VOL. 5, (CMU.S6604), Online publication date: 1-Jan-2011. Al-Ghazo M, Ghalayini I, Matani Y, El-Radaideh K and Haddad H (2009) The risk of bacteriuria and ureteric stent colonization in immune-compromised patients with double J stent insertionInternational Urology and Nephrology, 10.1007/s11255-009-9607-0, VOL. 42, NO. 2, (343-347), Online publication date: 1-Jun-2010. Lange D, Elwood C, Choi K, Hendlin K, Monga M and Chew B (2009) Uropathogen Interaction With the Surface of Urological Stents Using Different Surface PropertiesJournal of Urology, VOL. 182, NO. 3, (1194-1200), Online publication date: 1-Sep-2009. GILMORE B, JONES D, GORMAN S and CERI H (2009) Models for the assessment of biofilm and encrustation formation on urological materials Biomaterials and Tissue Engineering in Urology, 10.1533/9781845696375.1.59, (59-81), . Vejborg R and Klemm P (2008) Blocking of Bacterial Biofilm Formation by a Fish Protein CoatingApplied and Environmental Microbiology, 10.1128/AEM.00279-08, VOL. 74, NO. 11, (3551-3558), Online publication date: 1-Jun-2008. Goller C and Romeo T (2008) Environmental Influences on Biofilm Development Bacterial Biofilms, 10.1007/978-3-540-75418-3_3, (37-66), . Lam J and Gupta M Ureteral Stents Urinary Stone Disease, 10.1007/978-1-59259-972-1_25, (465-493) Lojanapiwat B (2006) Colonization of internal ureteral stent and bacteriuriaWorld Journal of Urology, 10.1007/s00345-006-0135-6, VOL. 24, NO. 6, (681-683), Online publication date: 1-Dec-2006. Cadieux P, Chew B, Knudsen B, DeJong K, Rowe E, Reid G and Denstedt J (2018) Triclosan Loaded Ureteral Stents Decrease Proteus Mirabilis 296 Infection in a Rabbit Urinary Tract Infection ModelJournal of Urology, VOL. 175, NO. 6, (2331-2335), Online publication date: 1-Jun-2006. Chew B, Duvdevani M and Denstedt J (2014) New developments in ureteral stent design, materials and coatingsExpert Review of Medical Devices, 10.1586/17434440.3.3.395, VOL. 3, NO. 3, (395-403), Online publication date: 1-May-2006. Halachmi S and Meretyk S (2009) Shock wave lithotripsy for ureteral stones in elderly male patientsThe Aging Male, 10.1080/13685530600907985, VOL. 9, NO. 3, (171-174), Online publication date: 1-Jan-2006. Jones D and Gorman S (2005) Medical Device Composition and Biological Secretion Influences on Biofilm Formation Biofilms, Infection, and Antimicrobial Therapy, 10.1201/9781420028232.ch4, (51-70), Online publication date: 29-Aug-2005. Chew B and Denstedt J (2004) Technology Insight: novel ureteral stent materials and designsNature Clinical Practice Urology, 10.1038/ncpuro0014, VOL. 1, NO. 1, (44-48), Online publication date: 1-Nov-2004. Bithelis G, Bouropoulos N, Liatsikos E, Perimenis P, Koutsoukos P and Barbalias G (2004) Assessment of Encrustations on Polyurethane Ureteral StentsJournal of Endourology, 10.1089/end.2004.18.550, VOL. 18, NO. 6, (550-556), Online publication date: 1-Aug-2004. Gallardo-Moreno A, Luisa González-Martín M, Bruque J and Pérez-Giraldo C (2004) Changes on the physico-chemical surface properties and adhesion behaviour of Enterococcus faecalis by the addition of serum or urine to the growth mediumPhys. Chem. Chem. Phys., 10.1039/B314609J, VOL. 6, NO. 7, (1512-1517) Schauersberger J, Amon M, Aichinger D and Georgopoulos A (2003) Bacterial adhesion to rigid and foldable posterior chamber intraocular lensesJournal of Cataract and Refractive Surgery, 10.1016/S0886-3350(02)01741-8, VOL. 29, NO. 2, (361-366), Online publication date: 1-Feb-2003. Gallardo-Moreno A, González-Martín M, Bruque J, Pérez-Giraldo C and Gómez-García A (2003) The effects of urine and temperature on the physicochemical surface properties and adhesion behaviour of uropathogenic bacteriaJournal of Adhesion Science and Technology, 10.1163/156856103322114552, VOL. 17, NO. 9, (1223-1233), Online publication date: 1-Jan-2003. Stickler D, Evans A, Morris N and Hughes G (2002) Strategies for the control of catheter encrustationInternational Journal of Antimicrobial Agents, 10.1016/S0924-8579(02)00091-2, VOL. 19, NO. 6, (499-506), Online publication date: 1-Jun-2002. Auge B and Preminger G (2002) Ureteral stents and their use in endourologyCurrent Opinion in Urology, 10.1097/00042307-200205000-00007, VOL. 12, NO. 3, (217-222), Online publication date: 1-May-2002. Bruinsma G, van der Mei H and Busscher H (2001) Bacterial adhesion to surface hydrophilic and hydrophobic contact lensesBiomaterials, 10.1016/S0142-9612(01)00159-4, VOL. 22, NO. 24, (3217-3224), Online publication date: 1-Dec-2001. Blumstein H (2001) INFECTION IN THE PATIENT WITH INDWELLING DEVICES AND OSTOMIESEmergency Medicine Clinics of North America, 10.1016/S0733-8627(05)70211-X, VOL. 19, NO. 3, (709-721), Online publication date: 1-Aug-2001. Sofer M and Denstedt J (2000) Encrustation of biomaterials in the urinary tractCurrent Opinion in Urology, 10.1097/00042307-200011000-00005, VOL. 10, NO. 6, (563-569), Online publication date: 1-Nov-2000. Hessen M, Zuckerman J and Kaye D (2014) Infections Associated with Foreign Bodies in the Urinary Tract Infections Associated with Indwelling Medical Devices, 10.1128/9781555818067.ch16, (325-344) Volume 160Issue 3 Part 1September 1998Page: 876-881 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.Metrics Author Information CHRISTINA TIESZER More articles by this author GREGOR REID More articles by this author JOHN DENSTEDT More articles by this author Expand All Advertisement PDF downloadLoading ...