Approaches to control infection, encrustation, and blockage of urinary catheters

The overall aim of this project is to determine if chemical inhibition of efflux systems in P. mirabilis can prevent or reduce catheter blockage. The impact of efflux inhibition on susceptibility to antibiotics commonly used to treat UTI, and the potential for synergistic EPI: antibiotic treatment will also be explored, as well as the use of EPIs for prevention of biofilm formation in a range of other common uropathogens.

In the UK alone, around 3.2 million individuals over the age of 65 are incontinent. It is estimated that as many as 200,000 may undergo long-term help to manage this condition, and up to 40 per cent of older people in residential care undergo long-term urethral catheterisation. As the aged population grows this figure will continue to rise.

Associated infections are linked with increased morbidity and mortality as well as spread of antibiotic resistance, and a significant financial burden to the NHS (~£123 million p.a.). Proteus mirabilis is a particular problem in this regard, implicated in over 40 per cent of cases, and leads to chronic infections with serious complications.

The development of effective countermeasures against such infections will have a considerable positive impact on the wellbeing of many older people, and provide substantial savings for the NHS. Because many drugs already in clinical use are potential inhibitors of bacterial efflux systems (EPIs), confirming the efficacy of such EPIs for controlling catheter infections has clear potential to provide an effective intervention within 5-10 years.