Faculty Bibliography

PURPOSE/OBJECTIVE:To determine the composition and site of initiation of bacterial biofilm location on indwelling urinary catheters, and to track biofilm progression over time. MATERIALS & METHODS/METHODS:Indwelling urinary catheters were collected from two tertiary care centers following removal from patients. Indwelling time was noted, and catheters were de-identified. Catheters were sectioned, stained for biofilms, and analyzed using spectrophotometry and visualization. Biofilm colonization patterns were analyzed using descriptive statistical analyses and bacterial composition was determined using next-generation sequencing. RESULTS:33 catheters from 26 males and 7 females were collected with indwelling times ranging from 15 minutes to 43 days and analyzed. Biofilm colonization was consistently high on the region of the balloon throughout indwelling times. After week 1, the distal third of the catheter had higher biofilm colonization than the proximal third (week 2: p=0.034). At all indwelling times, the intraluminal surface of the catheter had greater biofilm colonization than the outer surface. Next-generation sequencing detected potential uropathogenic bacteria in 10 of 10 analyzed samples. CONCLUSIONS:The catheter balloon, its distal aspect, and its lumen were the predominant locations of biofilms, comprised of uropathogenic bacteria. Strategies to prevent or treat biofilms should be targeted to these areas.

CONTEXT/BACKGROUND:In recent years, focal therapy has emerged as a treatment option for a selected group of men with localized prostate cancer. Cryotherapy and high-intensity focused ultrasound (HIFU) are the most investigated types of focal treatment with other options currently under evaluation. OBJECTIVE:The objective of the study was to give a comprehensive overview of six available focal treatment options for prostate cancer with their rationale, delivery mechanism, and outcomes. INFORMATION ACQUISITION/UNASSIGNED:The SIU ICUD chapter on available Energies to Treat Prostate Cancer was used as a guide to describe the different technologies. For outcomes, a literature search was conducted using PubMed key words including focal therapy, HIFU, cryotherapy, irreversible electroporation, vascular-targeted photodynamic therapy, laser interstitial therapy, radiofrequency ablation, microwave therapy, and their synonyms in MeSH terms. CONCLUSION/CONCLUSIONS:Focal therapy appears to have encouraging outcomes on quality of life and urinary and erectile function. For oncological outcomes, it is challenging to fully interpret the outcomes due to heterogeneity in patient selection and short-term follow-up.