Prevention of encrustation and blockage of urinary catheters by:Proteus mirabilis via pH-triggered release of bacteriophage


The crystalline biofilms of Proteus mirabilis can seriously complicate the care of patients undergoing long-term indwelling urinary catheterisation. Expression of bacterial urease causes a significant increase in urinary pH, leading to the supersaturation and precipitation of struvite and apatite crystals. These crystals become lodged within the biofilm, resulting in the blockage of urine flow through the catheter. Here, we describe an infection-responsive surface coating for urinary catheters, which releases a therapeutic dose of bacteriophage in response to elevated urinary pH, in order to delay catheter blockage. The coating employs a dual-layered system comprising of a lower hydrogel 'reservoir' layer impregnated with bacteriophage, capped by a 'trigger' layer of the pH-responsive polymer poly(methyl methacrylate-co-methacrylic acid) (EUDRAGIT®S 100). Evaluation of prototype coatings using a clinically reflective in vitro bladder model system showed that catheter blockage time was doubled (13 h to 26 h (P < 0.05)) under conditions of established infection (108 CFU ml-1) in response to a 'burst-release' of bacteriophage (108 PFU ml-1). Coatings were stable both in the absence of infection, and in the presence of urease-negative bacteria. Quantitative and visual analysis of crystalline biofilm reduction show that bacteriophage constitute a promising strategy for the prevention of catheter blockage, a clinical problem for which there is currently no effective control method.

Publication DOI:
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > School of Biosciences > Cell & Tissue Biomedical Research
Additional Information: This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.
Uncontrolled Keywords: Chemistry(all),Biomedical Engineering,Materials Science(all)
Publication ISSN: 2050-7518
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
http://pubs.rsc ... 2G#!divAbstract (Publisher URL)
PURE Output Type: Article
Published Date: 2017-06-22
Accepted Date: 2017-06-22
Authors: Milo, Scarlet
Hathaway, Hollie
Nzakizwanayo, Jonathan
Alves, Diana R.
Perez Esteban, Patricia (ORCID Profile 0000-0001-7084-1065)
Jones, Brian V.
Jenkins, A. Toby A.



Version: Published Version

License: Creative Commons Attribution

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