Factors affecting in vitro adherence of ureteral stent biofilm isolates to polyurethane

Adherence of bacteria to biomaterials is the first stage in the development of a device-related infection. The adherence of bacterial cells to biomaterials may be influenced by surface characteristics of the cell, its growth conditions and the biomaterial surface chemistry. Following growth in human urine, the cell surface,hydrophobicity and zeta potential of two ureteral stent biofilm isolates, Enterococcus faecalis and Escherichia coli, were significantly altered. In addition, the adherence of human urine-grown Enterococcus faecalis and Escherichia coli to polyurethane was significantly increased by up to 52.1% and 58.6%, respectively. Treatment of the polyurethane with human urine rendered the polymer surface more hydrophilic (mean advancing water contact angle reduced from 97.59 degrees to 26.37 degrees). However, organisms grown in human urine showed less adherence (up to 90.4%) to the treated polymer than those grown in Mueller-Hinton broth. The results presented in this study indicate that in vivo conditions should be simulated as far as possible when carrying out in vitro bacterial adherence assays, especially if assessing novel methods for reduction of adherence. (C) 1997 Elsevier Science B.V.