A Strategy for the Control of Catheter Blockage by Crystalline Proteus mirabilis Biofilm Using the Antibacterial Agent Triclosan  G.Ll. Jones, A.D. Russell, Z. Caliskan, D.J. Stickler  European Urology  Volume 48, Issue 5, Pages 838-845 (November 2005) DOI: 10.1016/j.eururo.2005.07.004 Copyright © 2005 Elsevier B.V. Terms and Conditions

Fig. 1 The effect of triclosan on the pH of the urine. The pH of the residual urine in the bladder model was measured at blockage or at seven days in those cases where the catheter drained freely for the full experimental period. The pH of the urine supplied to the model was 6.1. () Indicates all-silicone catheters; () hydrogel-coated latex catheters; () silicone-coated latex catheters. European Urology 2005 48, 838-845DOI: (10.1016/j.eururo.2005.07.004) Copyright © 2005 Elsevier B.V. Terms and Conditions

Fig. 2 The effect of triclosan on the viable cell numbers of Pr. mirabilis in urine. The viable cell count (log10cfu/ml+1) of bacteria in the residual urine was performed at catheter blockage or at seven days in those models where the catheter drained freely for the full experimental period. () Indicates all-silicone catheters; () hydrogel-coated latex catheters and () silicone-coated latex catheters. European Urology 2005 48, 838-845DOI: (10.1016/j.eururo.2005.07.004) Copyright © 2005 Elsevier B.V. Terms and Conditions

Fig. 3 Scanning electron-micrographs of a control hydrogel-coated latex catheter inflated with water and a test catheter inflated with 10mg/ml triclosan in 5% PEG that had been removed from Pr. mirabilis infected bladder models. (A) is of the eye-hole and (B) shows a cross-section taken just below the eye-hole of a control catheter that blocked at 30h. (C and D) show the same views of a test catheter removed from the model after seven days. European Urology 2005 48, 838-845DOI: (10.1016/j.eururo.2005.07.004) Copyright © 2005 Elsevier B.V. Terms and Conditions

Fig. 4 The three types of catheter were inserted into bladder models, inflated with triclosan and the models supplied with artificial urine. After 48h catheters were removed and washed thoroughly. Sections cut from these catheters were then placed on the surface of TSA plates that had been seeded with a lawn of the test strain of Pr. mirabilis B2. On incubation a large zone of inhibition of bacterial growth is visible around the section of all-silicone catheter but not around the latex-based catheters. European Urology 2005 48, 838-845DOI: (10.1016/j.eururo.2005.07.004) Copyright © 2005 Elsevier B.V. Terms and Conditions

Fig. 5 The effect of triclosan on catheter encrustation in models supplied with human urine. Sets of models fitted with all-silicone catheters that had been inflated with water or triclosan (10mg/ml in PEG) were supplied with human urine for 48h. (A) presents the mean pH values of urine in the bladder chambers at 48h. The mean viable cell counts (log10cfu/ml+1) of bacteria in the residual urine in control and test models are presented in (B). The amounts of encrustation recovered from catheters removed from the models at 48h, expressed as mg of calcium and magnesium per catheter are recorded in (C). The mean values were calculated from four replicated experiments for A and B and three replicates for C. European Urology 2005 48, 838-845DOI: (10.1016/j.eururo.2005.07.004) Copyright © 2005 Elsevier B.V. Terms and Conditions

Fig. 6 Scanning electron-micrographs of a control all-silicone catheter inflated with water and a test catheter inflated with 10mg/ml triclosan in 5% PEG from Pr. mirabilis infected bladder models supplied with human urine after 48h. (A) is of the eye-hole and (B) shows a cross-section taken just below the eye-hole of a control catheter. (C and D) show the same views of a test catheter. European Urology 2005 48, 838-845DOI: (10.1016/j.eururo.2005.07.004) Copyright © 2005 Elsevier B.V. Terms and Conditions