Effectiveness of Chitosan Coating Catheter in Preventing Catheter- Associated Urinary Tract Infection (CAUTI)

Abstract

Catheter-associated urinary tract infection (CAUTI) is a serious health issue that develops in hospitalized patients. The number of CAUTI cases could be reduced by preventing microbial adhesion and biofilm formation. Chitosan demonstrates antimicrobial activity against a variety of microorganisms. Coating the surfaces of silicon catheters has been shown to minimize or prevent bacterial adhesion and biofilm formation. In this study, we investigated the efficacy of chitosan, in different molecular sizes, as a polymer-coated silicon catheter. Chitosan of a high (HMw), medium (MMw), and low (LMw) molecular weight, at a pH value of 5.0-6.0, used to coat catheters, was examined using two methods, namely the crystal violet and sonication methods. The first method showed that clinical Klebsiella pneumoniae had a significantly (p<0.05) lower level of bacterial adhesion with MMw chitosan, and Klebsiella pneumoniae ATCC 13883 with LMw of chitosan. Using the sonication method, the MMw chitosan showed a decrease in bacterial viability for the Escherichia coli clinical isolate, Klebsiella pneumoniae reference strain, and Escherichia coli reference strain at to a greater extent than the HMw and LMw. Chitosan with three molecular weights (Mw) showed some antibacterial activity when the time-kill assay was applied. However, overall, HMw chitosan grades were not found to be effective as an antibacterial coating agent, although the MMw and LMw presented a potential antiadhesive polymer material to reduce CAUTI.