Document Type: Original Article


1 Ph.D. student, Chemical Engineering Department, Nikbakht Faculty, University of Sistan and Baluchestan, Zahedan, Iran

2 Associate Professor, Faculty member, Chemical Engineering Department, Nikbakht Faculty, University of Sistan and Baluchestan, Zahedan, Iran

3 Professor, Faculty member, Chemical Engineering Department, Nikbakht Faculty, University of Sistan and Baluchestan, Zahedan, Iran

4 Assistant Professor, Food Industry Department, Jahad Daneshgahi Faculty, Ferdowsi University of Mashhad, Mashhad, Iran


Introduction: One of the main causes of urinary infections is the use of urinary catheters. Over time, the overuse of chemical antibiotics has made urinary bacteria become resistant to chemical antibiotic treatments. Therefore, the major challenge in hospitals is preventing urinary infection and finding a suitable replacement for chemical antibiotics.  In recent years, researchers have been studying the use of herbal medicines to replace antibiotics.
Methods: In this study, green tea and ziziphora herbal extracts have been used as antibacterial agents for making silicone coated latex Foley catheters antibacterial and antibiofilm agents with inoculation. Various tests such as disc diffusion, broth penetration, contact angle, FE-SEM, AFM, ATR-FTIR, and elasticity were performed.
Results: After inoculation, disc diffusion test was performed on Staphylococcus aureus and Escherichia coli, urinary infection agents, and the antibacterial property of the silicone coated latex catheters was verified. In the penetration broth test, the herbal antibacterial catheters could eliminate the bacteria after 21 days (P˂0.0001). The contact angle test showed an increase in the hydrophilic property of the modified catheter (p˂0.0002). The mechanical test suggests an increase in Young module. SEM test indicates a decrease in bacteria adherence to the catheter surface. AFM test shows an increase in the roughness of the surface after impregnation. The presence of extracts in catheters was verified by ATR-FTIR.
Conclusion: It can be said from the obtained results that medicinal herbs can be appropriate agents for the inoculation of urinary catheters and the reduction of urinary infections in hospitals. In fact, modified catheters with herbal extracts could eliminate all bacteria. In addition, herbal extracts could be a good replacement for chemical antibiotics. Finally, herbal extracts could increase surface hydrophilicity,   prevent bacteria adherence, and they have antibiofilm properties.


  1. Darouiche RO, Hampel OZ, Boone TB, Raad II. Antimicrobial activity and durability of a novel antimicrobial-impregnated bladder catheter. International Journal of Antimicrob Agents. 1997;8:243-7.
  2. Haley RW, Hooton TM, Culver DH, Stanley RC, Emori TG, Hardison CD, etal. Nosocomial infections in US hospitals, 1975–1976: estimated frequency by selected characteristics of patients. The American journal of medicine. 1981;70:947-59.
  3. Abbo L, Hooton T. Antimicrobial stewardship and urinary tract infections.  Antibiotics. 2014;3:174-92.
  4. Kowalczuk D, Ginalska G, Golus J. Characterization of the developed antimicrobial urological catheters. International journal of pharmaceutics. 2010;402:175-83.
  5. Lawrence E, Turner I. Materials for urinary catheters: a review of their history and development in the UK. Medical engineering & physics. 2005;27:443-53.
  6. Tenke P, Mezei T, Bőde I, Köves B. Catheter-associated urinary tract infections. European urology supplements. 2017;16:138-43. 10.001.
  7. Donlan RM. Biofilms: microbial life on surfaces. Emerging infectious diseases. 2002;8:881.
    1. Branda SS, Vik Å, Friedman L, Kolter R. Biofilms: the matrix revisited. Trends in microbiology. 2005;13:20-6.
  8. Bjarnsholt T. Introduction to biofilms. Biofilm Infections: Springer; 2011. p. 1-9.
  9. Okada M, Sato I, Cho SJ, Iwata H, Nishio T, Dubnau D, et al. Structure of the bacillus subtilis quorum-sensing peptide pheromone comX. Nature chemical biology 2005;1:23-4.
  10. Vergidis P, Patel R. Novel approaches to the diagnosis, prevention, and treatment of medical device-associated infections.  Infectious disease clinics. 2012;26:173-86.
  11. Tenke P, Köves B, Nagy K, Hultgren SJ, Mendling W, Wullt B, et al. Update on biofilm infections in the urinary tract. World journal of urology. 2012;30:51-7.
  12. Lazãr V, Chifiriuc MC. Architecture and physiology of microbial biofilms. Romanian Archives of Microbiology and Immunology. 2010;69:95-07.
  13. Stickler DJ. Bacterial biofilms in patients with indwelling urinary catheters. Nature clinical practice urology. 2008;5:598-08.
  14. Tannock GW.The bowel microflora: an important source of urinary tract pathogens. World journal of urology. 1999;17:339-44.
  15. Stamm WE. Catheter-associated urinary tract infections: epidemiology, pathogenesis, and prevention.The American journal of medicine.1991;91:S65-S71.
  16. Galiczewski JM. Interventions for the prevention of catheter associated urinary tract infections in intensive care units: an integrative review. Intensive and Critical Care Nursing. 2016;32:1-11.
  17. Francolini I, Donelli G. Prevention and control of biofilm-based medical-device-related infections. FEMS Immunology & Medical Microbiology. 2010;59:227-38.
  18. Stepanović S, Vuković D, Ješić M, Ranin L. Influence of acetylsalicylic acid (aspirin) on biofilm production by Candida species. Journal of chemotherapy. 2004;16:134-8.
  19. Reid G, Habash M, Vachon D, Denstedt J, Riddell J, Beheshti  .Oral fluoroquinolone therapy results in drug adsorption on ureteral stents and prevention of biofilm formation. International journal of antimicrobial agents. 2001;17:317-20.
  20. Sofer M, Denstedt JD. Encrustation of biomaterials in the urinary tract. Current opinion in urology. 2000;10:563-9.
  21. Chao Y, Marks LR, Pettigrew MM, Hakansson AP. Streptococcus pneumoniae biofilm formation and dispersion during colonization and disease. Frontiers in cellular and infection microbiology. 2015;4:194.
  22. Moriarty TF, Zaat SA, Busscher H J. Biomaterials associated infection: immunological aspects and antimicrobial strategies: Springer Science & Business Media; 2012.
  23. Srinivasa Reddy P, Jamil K, Madhusudhan P, Anjani G, Das B. Antibacterial activity of isolates from Piper longum and Taxus baccata. Pharmaceutical biology. 2001;39:236-8.
  24. Pietta PG. Flavonoids as antioxidants. Journal of Natural Products. 2000;63:1035-42.
  25. Johnson R, Bryant S, Huntley AL. Green tea and green tea catechin extracts: an overview of the clinical evidence. Maturitas. 2012;73:280-7.
  26. Anzabi Y, Khaki A. Antibacterial activity of ziziphora tenuior lam extract and essential oil against bacteria isolated from urogenital tract infections. Medical Laboratory Journal. 2016;10:54-59.
  27. Amr S, Bollinger ME. Latex allergy and occupational asthma in health care workers: adverse outcomes. Environmental health perspectives. 2004;112:378-81.
  28. Seidel A. Encyclopedia of polymer science and technology: Wiley; 2014.
  29. Daniels CA. Polymers: structure and properties: CRC Press; 1989.
  30. Park J, Lakes RS. Biomaterials: an introduction: Springer; Science & Business Media; 2007.
  31. Rodrigues L. Van Der Mei H, Banat IM, Teixeira J, Oliveira R. Inhibition of microbial adhesion to silicone rubber treated with biosurfactant from Streptococcus thermophilus A. FEMS Immunology & Medical Microbiolog. 2006;46:107-12.
  32. Lee JN, Park C, Whitesides GM. Solvent compatibility of poly (dimethylsiloxane)-based microfluidic devices. Analytical chemistry. 2003;75:6544-54.
  33. Danese PN. Antibiofilm approaches: prevention of catheter colonization. Chemistry & biology. 2002;9:873-80.
  34. Bhalodia NR, Shukla V. Antibacterial and antifungal activities from leaf extracts of Cassia fistula l.: An ethnomedicinal plant. Journal of advanced pharmaceutical technology & research. 2011;2:104.
  35. Fisher LE, Hook.L, Ashraf W, Yousef A, Barrett DA, Scurr DJ, et al. Biomaterial modification of urinary catheters with antimicrobials to give long-term broadspectrum antibiofilm activity. Journal of Controlled Release. 2015;202:57-64.
  36. Wiegand I, Hilpert K, Hancock RE. Agar and broth dilution methods to determine the minimal inhibitory concentration (MIC) of antimicrobial substances. Journal of Nature protocols. 2008;3:163.
  37. Slane J, Vivanco J, Rose Ploeg HL, Squire M. Mechanical, material, and antimicrobial properties of acrylic bone cement impregnated with silver nanoparticles.           Materials Science and Engineering: C. 2015;48:188-96.
  38. Carberry BJ, Farrell J, Kennedy JE. Evaluation and characterisation of urinary catheter coating utilising Hansen solubility parameters and FEA analysis. Surface and Coatings Technology. 2015;276:456-63.
  39. Tenke P, Riedl CR, Jones GL, Williams GJ, Stickler D, Nagy E. Bacterial biofilm formation on urologic devices and heparin coating as preventive strategy. International journal of antimicrobial agents. 2004;23:67-74. http//
  40. Pollini M, Paladini F, Catalano M, Taurino A, Licciulli A, Maffezzoli A, et al. Antibacterial coatings on haemodialysis catheters by photochemical deposition of silver nanoparticles. Journal of Materials Science: Materials in Medicine. 2011;22:2005-12.
  41. Gadkari PV, Balaraman M.Catechins: Sources, extraction and encapsulation: A review. Food and Bioproducts Processing. 2015;93:122-38.
  42. Kim YW, Chun HJ, Kim IW, Liu HB, Ahn WS. Retracted Article: Antimicrobial and antifungal effects of green tea extracts against microorganisms causing vaginitis. Food Science and Biotechnology. 2013;22:713-9.
  43.  Aghamohammadi A, Azadbakht M, Hosseinimehr SJ. Quantification of thymol content in different extracts of Zataria multiflora by HPLC method. Pharmaceutical and Biomedical Research. 2016;8-13.
  44. Ignasimuthu K, Prakash R, Murthy PS, Subban N. Enhanced bioaccessibility of green tea polyphenols and lipophilic activity of EGCG octaacetate on gram-negative bacteria. L.W.T. 2019;105:103-9.
  45. Senthilkumar S, Sivakumar T. Green tea (Camellia sinensis) mediated synthesis of zinc oxide (ZnO) nanoparticles and studies on their antimicrobial activities International Journal of Pharmacy and Pharmaceutical Sciences. 2014;6:461-5.
  46. Oliveira RN, Mancini MC, Oliveira FCSd, Passos TM. Quilty B Thiré R M d S M et al. FTIR analysis and quantification of phenols and flavonoids of five commercially available plants extracts used in wound healing. FEMS Immunology & Medical Microbiology. 2016;21:767-79.
  47. Valderrama ACSDeGCR. Traceability of Active Compounds of Essential Oils in Antimicrobial Food Packaging Using a Chemometric Method by ATR-FTIR. American Journal of Analytical Chemistry. 2017;8:726-41.
  48. Miller-Chou BA, Koenig JL. A review of polymer dissolution. Progress in Polymer Science. 2003;28:1223-70.