Probiotics. Some evidence of their effectiveness
Cells and Materials
The ability of uropathogens to adhere to catheters and subsequently colonize the urinary mucosa leads to urinary tract infections which afflict a large patient population. In vitro studies were carried out whereby Escherichia coli Hu734 (water contact angle 12°) and Enterococcus faecalis (19°) were found to be highly adhesive to silicone latex urinary catheters. The addition of one of four Lactobacillus sp., with water contact angles ranging from 19-105°, to the suspending fluid caused a 60-86% reduction in pathogen adhesion with a significant effect against E. coli, the organism most commonly found to infect the urinary tract. Lactobacilli were significantly effective at displacing uropathogens and preventing their adhesion. Hydrophobic lactobacilli (105°) were particularly effective at preventing enterococci from adhering from the surface, while more hydrophilic lactobacilli (19-54°) were most effective at displacing enterococci. The effective competition with four strains of lactobacilli was achieved even when they only comprised 0.1% -7% of the total organisms on the surfaces. These studies demonstrate the important role which the indigenous urethral flora could play in inhibiting the initial attachment of pathogens to catheter surfaces.