The urinary catheter microflora: a longitudinal study of the lumens and balloons of urinary catheters from a single volunteer

Indwelling urinary catheters place the user at risk of catheter-associated urinary tract infections. Catheters in place 28 days or greater are universally colonised, but only a relatively small proportion of patients develop symptoms indicative of infection. To further understand the micro-environment, indwelling urinary catheters were collected prospectively and longitudinally over one year from one donor. Microbiological contents of the lumen and balloon of the catheters were analysed and correlated with clinical details.In total 9 suprapubic urinary catheters were collected from the volunteer over the year. From 8/9 catheters collected Pseudomonas aeruginosa was isolated. The genetic relationship of these 8 Pseudomonas isolates was originally assessed by Pulsed-Field Gel Electrophoresis. The P. aeruginosa isolates from catheters 2-6 had indistinguishable DNA restriction patterns. The DNA restriction patterns of isolates from catheters 7-9 differ by 2-3 bands, suggesting they are closely related but that a genetic event has occurred. Between catheters 6 and 7 there was a significant clinical event for the volunteer, which was a surgical intervention to the bladder. To investigate the genetic evolution that occurred alongside a clinical event, we aim to identify genomic changes by whole genome sequencing and relate this to the clinical scenario.