Biofilm reduction potential of 0.02% polyhexanide irrigation solution in several types of urethral catheters

• Main Authors: Florian H. H. Brill, Julia Hambach, Christian Utpatel, Diana C. Mogrovejo, Henrik Gabriel, Jan-Hendrik Klock, Joerg Steinmann, Andreas Arndt
• Format: Article
• Language: English
• Published: BMC 2021-04-01
• Series: BMC Urology
• Subjects: Bacterial decolonization; Biofilm; Polyhexanide; Urinary catheter; Urinary tract infection; Transurethral catheter
• Online Access: https://doi.org/10.1186/s12894-021-00826-3

Abstract Background Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation. Methods Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution versus no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration. Results Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.002) or no treatment (p = 0.011). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.74). Conclusions A 0.02% polyhexanide solution is able to reduce bacterial biofilm from catheters artificially contaminated with clinically relevant bacteria in vitro. The data shows a reduction of the viability of thick bacterial biofilms in a variety of commercially available urinary catheters made from silicone, latex-free silicone, hydrogel-coated silicone and PVC. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.