RESUMO
PURPOSE: We investigated the effect of iontophoresis produced by passing an electric current through silver electrodes attached to catheters on catheter encrustation by crystalline Proteus mirabilis biofilm. MATERIALS AND METHODS: Four glass bladder models were catheterized with 16Fr silicone catheters, of which 3 had 0.25 mm silver wires running through and beside the lumen. Two wired catheters had the silver wires connected to a 9 V direct current source supplying a steady current of 150 microA via a self-regulating circuit. Artificial urine, which had been inoculated with a clinical strain of P. mirabilis isolated from an encrusted catheter, was instilled into the bladder model at 0.5 ml per minute. The models were operated until the test catheters became blocked. Mean blockage time was statistically analyzed by ANOVA. Bacterial colony count, silver ions and pH were assessed every 24 hours. RESULTS: The experiment was repeated 3 times. Time to blockage, colony count, pH and scanning electron microscopy was used to assess encrustation in electrified and control catheters. Time to blockage in electrified vs control catheters was 156 vs 22 hours. The difference in blockage times was statistically significant (p <0.002). The viable bacterial cell count in urine with test catheters vs that in controls was 1.12 x 10(4) vs 2.73 x 10(9) cfu/ml. The pH increased to 9 in control models, whereas it remained less than 6.5 in test models for about 100 hours. CONCLUSIONS: Electrified catheters released ions in urine that have the oligodynamic property of inhibiting bacterial growth. The application of electric current to catheters fitted with silver electrodes significantly decreased the rate at which these devices became encrusted by P. mirabilis. This principle could be used to prevent encrustation on long-term catheters.
