Biofilms are one of the leading causes of Catheter-Associated Urinary Tract Infections (CAUTIs), but many people don’t understand what biofilms are and how they work. At UroShield, our ultrasound technology is developed based on how biofilms work, allowing us to create far more effective solutions to prevent the biofilm formation as a result. In this post, we share the details of what biofilms are and how they can affect your life if you are a catheter user.

What is a biofilm?

At home, you may have noticed a viscous layer in the dog bowl that simply will not rinse off, or a slimy shower stall floor that stubbornly resists any attempts of washing off. If you could inspect it under a microscope, however, you would find that this common household gunk is, in fact, a thriving bacterial colony that we call biofilms.

Biofilms are not just bacterial slime but complex biological systems; the bacteria organise into a coordinated functional community that can attach to surfaces both living and non-living, such as teeth, rocks, or the surfaces of medical equipment. They may comprise a single species or a diverse group of microorganisms that share nutrients and are resistant to outside threats.

How are they formed?

A biofilm usually begins to form when a free-swimming bacterium attaches to a hydrated surface. Once a free-floating cell starts a biofilm, or becomes part of an existing one, it produces a sticky mix of proteins and other substances that will help it attach better to the surface, and make it easier for other bacteria to join the colony. Known as extracellular polysaccharide substances or EPSs, these make up elaborate three-dimensional structures that hold the cells of a biofilm together, while protecting the colony from washing, desiccation, disinfectants, antibiotics, and a host body’s immune system.

Why biofilms are important

As previously mentioned, biofilms tend to form where it is wet and favourable for bacterial growth. Hospitals are often a rich habitat for bacteria, and patients with implanted medical devices are especially vulnerable. These can include:

  • Catheters inserted in the body to remove bodily fluids
  • Prosthetic joints
  • Mechanical heart valves
  • Pacemakers
  • Contact lenses
  • Endotracheal tubes, used to help breathing or administer anaesthesia
  • Intrauterine devices used as contraceptives

In relation to healthcare-associated infections (HCAI) and infection control, biofilms developing on medical device surfaces pose a significant risk for patients, especially those with disease-weakened immune systems. Furthermore, their resistance to antibiotics represents a grave threat to patients. This gives rise to the terrible dilemma that life-saving medical devices themselves become a significant contributor to infections because of their propensity to carrying biofilm. Biofilm accounts for as much as 80% of infectious diseases and adds up to billions of affected patients, billions of dollars and hundreds of thousands of deaths.

On the other hand, biofilms do have their positive benefits in nature. Underground microorganisms form a biofilm around the rhizosphere between roots and soil in plants. Chemical interactions in this symbiotic relationship allow both parties to access nutrients that are otherwise unavailable. They can also be potential tools for bioremediation when an environmental mess like an oil spill must be restored to its natural state. Biofilms are also used in mining to prevent toxic runoffs, as well as in waste-water treatment.

Dispersal, detection and prevention of biofilms

One reason why biofilms pose such a threat to healthcare is because of their propensity to propagate. Cells in a biofilm can detach when the colony reaches the end of its life cycle. They regain their mobility and continue life as floating microorganisms to start new colonies. The process known as biofilm dispersal poses a severe threat to the host when dispersed cells are able to attach to new surfaces and initiate biofilm growth.

To date, there are no detection methods available for the diagnosis of a biofilm in a clinical setting. Traditional culture methods to determine colonisation do not indicate biofilm growth, and negative results from swab samples may not necessarily imply the absence of an infection, but could possibly be due to the slow growth rate within a biofilm of species that cannot be detected within the usual detection range.

Depending on the species of microorganism, some biofilms can be scraped off gently, while others may be more firmly attached. Washing from a tap will not dislodge biofilms and will only remove some cells in the short run. At this time, as there is no universal treatment for medical biofilms, preventing biofilms from forming is the best option.

How UroShield can help to prevent biofilm formation

For catheter users who are threatened by biofilms and the risks associated, UroShield can help and is effective irrespective of the make, size, length or material of the catheter.

A small, external medical device, UroShield can prevent bacteria from sticking to the surface of the catheter by using low-frequency ultrasonic Surface Acoustic Waves (SAW). These minute vibrations can’t be heard or felt by humans, but the constant vibration of the surface makes it much more difficult for microorganisms to adhere, significantly reducing the possibility of infection. We have a substantial amount of clinical data showing that our system works well and even improves the quality of life of people at risk of CAUTI development.

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This post is not health advice and should not replace professional advice tailored to your specific circumstances. It is intended to provide information of general interest about current healthcare issues.