PURPOSE Catheter-associated urinary tract infections (CAUTIs) are a significant cause of morbidity worldwide, as they account for 40% of all hospital-associated infections. Microbial biofilm formation on urinary catheters (UCs) limits antibiotic efficacy, making CAUTI extremely difficult to treat. To gain insight into the spatiotemporal microbe interactions on the catheter surface we sought to determine how the presence or absence of bacteriuria prior to catheterization affects the organism that ultimately forms a biofilm on the UC and how long after catheterization they emerge. METHODS Thirty UCs were collected from patients who received a urine culture prior to catheterization, a UC, and antibiotics as part of standard of care. Immunofluorescence imaging and scanning electron microscopy were used to visualize patient UCs. RESULTS Most patients did not have bacteria in their urine (based on standard urinalysis) prior to catheterization, yet microbes were detected on the majority of UCs, even with dwell times of < 3 days. The most frequently identified microbes were Staphylococcus epidermidis, Enterococcus faecalis, and Escherichia coli. CONCLUSIONS This study indicates that despite patients having negative urine cultures and receiving antibiotics prior to catheter placement, microbes, including uropathogens associated with causing CAUTI, could be readily detected on UCs with short dwell times. This suggests that a potential microbial catheter reservoir can form soon after placement, even in the presence of antibiotics, which may serve to facilitate the development of CAUTI. Thus, removing and/or replacing UCs as soon as possible is of critical importance to reduce the risk of developing CAUTI.

中文翻译：

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尽管使用抗生素，高分辨率成像仍显示患者导尿管上的微生物生物膜。

目的 导管相关尿路感染 (CAUTI) 是全球发病率的重要原因，因为它们占所有医院相关感染的 40%。导尿管 (UC) 上的微生物生物膜形成限制了抗生素的功效，使 CAUTI 极难治疗。为了深入了解导管表面上的时空微生物相互作用，我们试图确定导管插入术前菌尿的存在与否如何影响最终在 UC 上形成生物膜的生物体，以及它们在导管插入术后出现的时间。方法 从在导管插入术、UC 和抗生素作为标准护理的一部分之前接受尿培养的患者中收集了 30 个 UC。免疫荧光成像和扫描电子显微镜用于可视化患者 UC。结果 大多数患者在导尿前尿液中没有细菌（基于标准尿液分析），但在大多数 UC 上检测到微生物，即使停留时间小于 3 天。最常见的微生物是表皮葡萄球菌、粪肠球菌和大肠杆菌。结论 本研究表明，尽管患者尿培养阴性并在置管前接受了抗生素治疗，但微生物，包括与引起 CAUTI 相关的尿路病原体，可以在停留时间短的 UC 上轻松检测到。这表明放置后很快就会形成潜在的微生物导管储库，即使存在抗生素，这可能有助于促进 CAUTI 的发展。因此，