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Research

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Submitted By EricaSJ89
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November 21, 2015,

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Fisher, L. E., Hook, A. L., Ashraf, W., Yousef, A., Barrett, D. A., Scurr, D. J., … Bayston, R. (2015). Biomaterial modification of urinary catheters with antimicrobials to give long-term broadspectrum antibiofilm activity. Journal of Controlled Release, 202, 57-64. doi:10.1016/j.jconrel.2015.01.037.Epub Retrieved November 15,2015, from ncbi.nlm.nih.gov

Since urinary catheter infections are so prevalent in hospitalized patients; short-term bladder drainage or long-term management of bladder dysfunction can posed serious infections. The purpose of this research is to see, if applying Biomaterial modification to urinary catheters such as anti-microbial agents will prevent foley catheters related infections. The aim is to try to keep the indwelling catheter as long as possible without the development of catheter related infection.(Fisher et.al,2015). The questions to keep in mind are that is it effective to apply the Biomaterial agent in reducing catheter related infection? What is the objective of patients who has an indwelling catheter with anti-microbial agent?

Applicability
The variables used in this study are silicone catheters. The independent variable used to run this test are pathogens such as Esherichia Coli, Proteus Mirabis, and Klebsiella Pneumaniae and anti-microbial agents are 0.2% Rifampin, 1% Triclosan, and 1% Sparloxacin.(Fisher et al,2015)
In this study, there were no actual people samples, but the specimens of fresh sterile urine were obtained from a Urology clinic. The catheters used are from manufacture, which were purchased as a testing agent. The catheters were divided into two groups. The first sample was untouched which means the package was tested with no antimicrobial agent. The other groups of catheters were from the same purchased manufacture but antimicrobial agents were added to them.
The study design is an experimental type of study. The catheters in as a receive state were left with no agents on them while other half of receive state catheters were primed with anti-microbial agents. Both samples were placed in actual patient’s sterile urine to remain there for 12 weeks. The purpose was to analyze the state of the catheters; would these catheters resist breakage and tearing? Further if the catheters have anti-microbial agents on the tips would that possibly prevent infection? (Fisher et. Al, 2015) Credibility
The intervention used in this study is to test whether having a catheter with anti-microbial agents will prevent infection in patients requiring an indwelling catheter for prolonged time.
The samples of anti-microbial agents are Rifampin, Triclosan, and Sparfloxacin. The targets bacteria are Escherichia Coli, Proteus Mirablis, Klebsiella Pnuemoniae from isolated patient’s urine. 1/ 2 of the received catheters were labelled (control) and the other ½ of the received catheters were labelled (anti-microbial agent). The control and the antimicrobial agent samples were placed in sterile urine for 72 hours. This test is called the TK 100 test which means that the time the sampling will take to have 100% bacteria attached to the catheters would be one hour. This process also called a conditioning film where the film would attach itself to the catheter and creates a barrier. (Fisher et al, 2015
The instrument used is an Instrom 5985 with 5kn load cell connected to a video extesometer. Data collected by using blue hill two software. A force of 100mm/min to the catheter is tested to determine how strong the catheter is. This test was done at room temperature and three replicates of each analysis were done. Another test involved using Atomic force microscopy; this one was done to evaluate the roughness of the tip and surrounding area of the catheter. The stimulated drug add to the catheter creates a roughness. The roughness of the catheter can cause the patient discomfort. This test was performed in triplicates and 2x2 segments of the catheter were mounted onto stubs for analysis along with a nanoscope v controller. The test uses a silicone nitride cantilever with 0.1n/m; the nominal springs constantly in order to determine the roughness of the catheter. The third test used a serial plate transfer test. This test use fresh sample urine from patients in a Urology clinic. Isa Agar plates with seeded bacteria are part of the testing process. The silicon discs were placed on triplicates fashion and left overnight. The inhibition zones were measures with calipers and the discs were placed in fresh seeded plates and left for incubation period a total of 100 days. (Fisher et al, 2015). The samples were segmented Foley catheters and Silicon test discs 1mm x 6mm. Antimicrobial solution dissolved in chloroform to yield a concentrated of 0.2% Rifampin, 1% Triclosan and 1% Sparfloxacin. A series of silicone test discs and segmented Foleys, along with using the anti-microbial agents were used. (Fisher et al., 2015)
Summary
According to the article reviewed, applying anti-microbial agents to the foley catheter shows that wasn’t effective in the reduction of infection in laboratory tested and in clinical studies. The studies done on these anti-microbial catheters further shows that new growth of Pseudomonas or Candida bacteria is related to overused of antibiotics. Further study is needed in order to launch these catheters in the healthcare market. The article was written by multiple authors contributed to multiple inputs into the research experiment. The problem and clinical study along with result was clearly stated. The research problem statement, which was how applying biofilm agent such as an antibacterial to the foley catheter would inhibit bacteria growth, was clearly addressed not only in the beginning statement but throughout the research paper it was constantly reminded what the research is about. The instruments used for the experimental test were use in a laboratory setting as well as was tested in actual clinical setting on actual foley catheters in urine specimen. However, I felt the article could have stated number of urine sample used for the testing which I felt didn’t give me enough evidenced that the result was reliable enough.
The amount of time the study was ran for and the finding support the require testing time. The study was relevant to the expectation of the research. I would of like the research to be done on real people. The study does examine my perception of intervention; from reading about foley catheter risks of infection. This study did intrigue me somewhat in thinking that might help patients’ decreased infection through applications of antibacterial biofilm agent. It was hard to tell what gender, age or ethnicity the population tested, since no real people were used only urine samples. Somewhat the intervention of interest was interesting since the results if it were effective can be applicable to healthcare facility.

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