1350. Pilot Trial of Bacterial Interference in Patients with Indwelling Catheters
Session: Poster Abstract Session: Clinical Trials
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Slide1.PNG (419.0 kB)
  • Background:

    Persons who require long-term urinary catheter use for bladder drainage are at high risk for recurrent catheter-associated urinary tract infection (CAUTI).  No CAUTI preventive strategy has yet been effective in this population.  We are investigating bacterial interference, or deliberate bladder colonization with benign E. coli HU2117 (83972), in a pilot trial.

    Methods:

    Participants in the E. coli coated catheter trial are adults over age 50, with history of long-term indwelling urinary catheters and pre-existing bladder colonization.  Subjects receive baseline urine cultures, 7-10 days of targeted antibiotics, and standard catheter change during antibiotic treatment. After a 2-4 day washout period, subjects receive a study catheter pre-coated with E. coli HU2117. Catheters are left in place up to 28 days, and subjects are followed with serial urine cultures and symptom assessment.

    Results:

    Of the 7 subjects enrolled to date (6 male, 1 female), average age is 71.9 years (range 58-89). ) 0% of subjects had sterile urine immediately prior to study catheter insertion. In 5 of 7, at least 1 of the original bladder organisms reappeared.  All 7 subjects became colonized with E. coli HU2117, with a mean duration of 56.4 days (median 43, range 11-141), but all 7 also had co-colonization with pathogens.  3 subjects suffered invasive disease from the co-colonizing pathogens (1 febrile UTI with obstruction, 2 urosepsis). All 3 cases were associated with an overgrowth of another urinary pathogen, while the two cases of urosepsis were associated temporally with loss of E. coli HU2117 from the urine. 

    Conclusion:

    Our patient population is at high risk for invasive UTI. Pre-insertion antibiotics are not effective at sterilizing the urine or preventing subsequent invasive disease. It is unclear if E. coli HU2117 is providing a protective effect in this patient population while present in the bladder.   

    Barbara W. Trautner, MD, PhD, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX and Deborah Horwitz, MS, PA-C, Baylor College of Medicine, Houston, TX

    Disclosures:

    B. W. Trautner, None

    D. Horwitz, None

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