Ta. Wollin et al., BACTERIAL BIOFILM FORMATION, ENCRUSTATION, AND ANTIBIOTIC ADSORPTION TO URETERAL STENTS INDWELLING IN HUMANS, Journal of endourology, 12(2), 1998, pp. 101-111
Encrustation and urinary tract infection are problematic complications
of ureteral stent usage. The objective of our first study was to use
surface science techniques to examine three ureteral stent types for e
ncrustation, biofilm formation, and antibiotic adsorption after use in
patients. Black Beauty (N = 16), LSe (N = 16), and SofFlex (N = 32) u
reteral stents were recovered from patients who had received trimethop
rim or ciprofloxacin while the stent was indwelling. These stents were
examined with X-ray photoelectron spectroscopy (XPS) and scanning ele
ctron microscopy/energy-dispersive X-ray analysis (SEM/EDX) for the pr
esence and composition of encrustation or biofilm, Conditioning films
and encrustations were found on all stents, Encrustation elements (Ca,
Mg, P) were identified on 11 of 16 Black Beauty (69%), 7 of 16 LSe (4
4%), and 12 of 32 SofFlex (38%) stents, The stent type, duration of in
sertion, and age or sex of the patient did not correlate significantly
with the amount of encrustation, Bacterial biofilms were found on 1 o
f 7 Black Beauty stents (14%) and 7 of 32 SofFlex stents (22%), In a s
econd study, an additional 28 patients with SofFlex stents mere treate
d with ciprofloxacin (N = 16) or ofloxacin (N = 12), Their stents were
subjected to high-performance liquid chromatography to determine if o
ral antibiotic therapy can lead to drug adsorption to the stent. Analy
sis showed that both ciprofloxacin and ofloxacin adsorbed to the stent
surfaces. The mean concentrations of the two antibiotics within the c
onditioning film of the stents were 0.99 mu g/mL and 0.34 mu g/mL, res
pectively. These surface science techniques provide a comprehensive me
thod of evaluating ureteral stents and other prosthetic devices in viv
o.