Researchers identify factors that heighten risk for catheter-associated urinary tract infections and sepsis
Urinary catheters are required for nearly every surgical procedure. However, a major challenge for the health care industry is predicting who may develop catheter-associated urinary tract infections (CAUTIs) and when these infections may lead to death.
Now, a study from the University of Notre Dame has identified a population that is more susceptible to developing a CAUTI.
Researchers showed that models with fibrinolytic deficiencies, or conditions that cause overactivation of the protein fibrin, had increased risk for developing severe and persistent CAUTIs. Additionally, they found these same models were more likely to develop sepsis.
Fibrin is vital in the formation of blood clots when the body attempts to repair injuries. When injured, the body calls on a process that uses fibrin to repair a wound, creating a fibrous structure to prevent bleeding during the healing process.
Ana Lidia Flores-Mireles, the Hawk Assistant Professor of Biological Sciences at Notre Dame, studied how this healing process could promote infection during urinary catheterization in animal models.
“A urinary catheter is constantly rubbing against bladder tissue, causing continuous inflammation and mechanical damage,” Flores-Mireles said. “The body will activate healing for the damaged bladder by recruiting the protein fibrinogen from the bloodstream. Fibrinogen will convert into fibrin, which creates net-like structures that accumulate where pathogens then colonize and promote persistent infection.”
The study published in Nature Communications found that the more fibrin “nets” the body creates, the more susceptible the model was to high pathogen colonization and the more fibrinogen was found in the circulatory system. As the amount of fibrinogen or fibrin increases in the bloodstream, the more likely a CAUTI is to spread to other organs and tissue.
However, when the researchers blocked fibrinogen recruitment or accumulation, it reduced CAUTIs because the pathogens needed the fibrin net-like structure to survive and persist.
The research suggests that catheterized patients given antifibrinolytic medications, or drugs that discourage bleeding, could be at a higher risk for developing a CAUTI. Antifibrinolytic medications are often used to treat postpartum hemorrhages, traumatic injuries and other surgical procedures — all of which could require catheters when treated.
Flores-Mireles believes that this study can be applied to better prevent and manage human CAUTI, especially due to the current lack of consensus on best practices for CAUTI treatment.
“We strongly believe these findings provide key data to inform urinary catheterization guidelines in health care facilities and intensive care units, which will provide a higher quality of life to patients and minimize risk for complications,” Flores-Mireles said.
To help prevent CAUTIs, Flores-Mireles and her lab are developing a novel catheter that minimizes the inflammation and mechanical damage caused by typical catheters, preventing fibrin structures from forming and pathogens from causing infection.
In addition to Flores-Mireles, the study, “Fibrinolytic-deficiencies predispose hosts to septicemia from a catheter-associated UTI,” was co-authored by Notre Dame’s Francis Castellino, Deborah Donahue, Victoria Ploplis, Jonathan Molina, Andrew Paik, Kurt Kohler, Christopher Gager, Marissa Andersen, Ellsa Wongso and Elizabeth Lucas; Washington University’s Wei Xu, Michael Caparon, Scott J. Hultgren, Karla Bergeron, Aleksandra Klim and Alana Desai; and the University of North Carolina’s Matthew Flick. Mireles, Castellino, Donahue and Ploplis are affiliated with Notre Dame’s W.M. Keck Center for Transgene Research.
Contact: Brandi Wampler, associate director of media relations, 574-631-2632, brandiwampler@nd.edu
Originally published by news.nd.edu on May 30, 2024.
atLatest Research
- Ecological Society of America awards honors for research papers from Rohr, McLachlan labsResearchers in the Department of Biological Sciences at the University of Notre Dame have been honored with awards from the Ecological Society of America (ESA) for their research. …
- A New Era for Notre DameFor only the third time in 72 years, the University of Notre Dame has a new president, Rev. Robert A. Dowd, C.S.C. This transition in leadership heralds the beginning of a new era for Notre Dame, one marked by tremendous optimism and opportunity. In this episode of For Good, Father…
- Overburdened caseworkers put foster youths’ online safety on the back burnerFoster parents and caseworkers believe sexual-related risks are the top concern for online safety for youths in the U.S. child welfare system. But how these two groups approach technology access and other online risks is conflicted, according to research from the University of Notre Dame.
- 2024 International Frontiers Prize awarded to Notre Dame’s Jason Rohr for innovative public health and sustainability researchJason Rohr, Galla Professor and Chair of the Department of Biological Sciences at the University of Notre Dame, is one of three international winners of the 2024 Frontiers Planet Prize for his research that helps improve public health, agriculture,…
- U.S. states impact foreign policy amid national China unease, research showsState-level officials such as governors, state legislators, and attorneys general are shaping U.S.-China relations as the two countries navigate a strained geopolitical relationship, according to new research by political scientist Kyle…
- CI Compass leads archiving, long-term data preservation conversation at 2024 NSF Research Infrastructure WorkshopAs scientific data at U.S. National Science Foundation (NSF)-funded mid-scale and major facilities continues to grow exponentially with the help of advanced instrumentation and increased computing power, the challenge of preserving, archiving, and keeping that data accessible grows with it. In March,…