Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment

Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infections. Here, we report that bladder catheterization initiated a persistent sterile inflammatory reaction within minutes of catheter implantation. Catheterization resulted in increased expression of gene...

Full description

Saved in:
Bibliographic Details
Main Authors: Rousseau, Matthieu, Goh, Hwee Mian Sharon, Holec, Sarah, Albert, Matthew L., Williams, Rohan B.H., Ingersoll, Molly A., Kline, Kimberly A.
Other Authors: School of Biological Sciences
Format: Article
Language:English
Published: 2017
Subjects:
Online Access:https://hdl.handle.net/10356/84078
http://hdl.handle.net/10220/42943
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-84078
record_format dspace
spelling sg-ntu-dr.10356-840782022-02-16T16:25:56Z Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment Rousseau, Matthieu Goh, Hwee Mian Sharon Holec, Sarah Albert, Matthew L. Williams, Rohan B.H. Ingersoll, Molly A. Kline, Kimberly A. School of Biological Sciences Singapore Centre for Environmental Life Sciences Engineering Catheterization Infections Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infections. Here, we report that bladder catheterization initiated a persistent sterile inflammatory reaction within minutes of catheter implantation. Catheterization resulted in increased expression of genes associated with defense responses and cellular migration, with ensuing rapid and sustained innate immune cell infiltration into the bladder. Catheterization also resulted in hypersensitivity to Enterococcus faecalis and uropathogenic Escherichia coli (UPEC) infection, in which colonization was achieved using an inoculum 100-fold lower than the ID90 for infection of an undamaged urothelium with the same uropathogens. As the time of catheterization increased, however, colonization by the Gram-positive uropathogen E. faecalis was reduced, whereas catheterization created a sustained window of vulnerability to infection for Gram-negative UPEC over time. As CAUTI contributes to poorer patient outcomes and increased health care expenditures, we tested whether a single prophylactic antibiotic treatment, concurrent with catheterization, would prevent infection. We observed that antibiotic treatment protected against UPEC and E. faecalis bladder and catheter colonization as late as 6 hours after implantation. Thus, our study has revealed a simple, safe, and immediately employable intervention, with the potential to decrease one of the most costly hospital-incurred infections, thereby improving patient and health care economic outcome. NRF (Natl Research Foundation, S’pore) MOE (Min. of Education, S’pore) Published version 2017-07-19T06:33:16Z 2019-12-06T15:37:50Z 2017-07-19T06:33:16Z 2019-12-06T15:37:50Z 2016 Journal Article Rousseau, M., Goh, H. M. S., Holec, S., Albert, M. L., Williams, R. B. H., Ingersoll, M. A., et al. (2016). Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment. JCI Insight, 1(15), e88178-. https://hdl.handle.net/10356/84078 http://hdl.handle.net/10220/42943 10.1172/jci.insight.88178 27699248 en JCI Insight © 2016 American Society for Clinical Investigation (ASCI). This paper was published in JCI Insight and is made available as an electronic reprint (preprint) with permission of American Society for Clinical Investigation (ASCI). The published version is available at: [http://dx.doi.org/10.1172/jci.insight.88178]. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper is prohibited and is subject to penalties under law. 13 p. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Catheterization
Infections
spellingShingle Catheterization
Infections
Rousseau, Matthieu
Goh, Hwee Mian Sharon
Holec, Sarah
Albert, Matthew L.
Williams, Rohan B.H.
Ingersoll, Molly A.
Kline, Kimberly A.
Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
description Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infections. Here, we report that bladder catheterization initiated a persistent sterile inflammatory reaction within minutes of catheter implantation. Catheterization resulted in increased expression of genes associated with defense responses and cellular migration, with ensuing rapid and sustained innate immune cell infiltration into the bladder. Catheterization also resulted in hypersensitivity to Enterococcus faecalis and uropathogenic Escherichia coli (UPEC) infection, in which colonization was achieved using an inoculum 100-fold lower than the ID90 for infection of an undamaged urothelium with the same uropathogens. As the time of catheterization increased, however, colonization by the Gram-positive uropathogen E. faecalis was reduced, whereas catheterization created a sustained window of vulnerability to infection for Gram-negative UPEC over time. As CAUTI contributes to poorer patient outcomes and increased health care expenditures, we tested whether a single prophylactic antibiotic treatment, concurrent with catheterization, would prevent infection. We observed that antibiotic treatment protected against UPEC and E. faecalis bladder and catheter colonization as late as 6 hours after implantation. Thus, our study has revealed a simple, safe, and immediately employable intervention, with the potential to decrease one of the most costly hospital-incurred infections, thereby improving patient and health care economic outcome.
author2 School of Biological Sciences
author_facet School of Biological Sciences
Rousseau, Matthieu
Goh, Hwee Mian Sharon
Holec, Sarah
Albert, Matthew L.
Williams, Rohan B.H.
Ingersoll, Molly A.
Kline, Kimberly A.
format Article
author Rousseau, Matthieu
Goh, Hwee Mian Sharon
Holec, Sarah
Albert, Matthew L.
Williams, Rohan B.H.
Ingersoll, Molly A.
Kline, Kimberly A.
author_sort Rousseau, Matthieu
title Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
title_short Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
title_full Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
title_fullStr Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
title_full_unstemmed Bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
title_sort bladder catheterization increases susceptibility to infection that can be prevented by prophylactic antibiotic treatment
publishDate 2017
url https://hdl.handle.net/10356/84078
http://hdl.handle.net/10220/42943
_version_ 1725985578126671872