Effects of shockwave treatment on bacterial biofilm eradication in urological tubular structures

Pseudomonas aeruginosa causes catheter-associated urinary tract infections (CAUTIs) through biofilm formation, where an extracellular polymeric substance (EPS) matrix limits antibiotic access. Shockwave technology has recently been proposed as a potential approach to disrupt the biofilm matrix and enhance antimicrobial access. The aim of the current study was to evaluate the effect of shockwave treatment on biofilm detachment and antibiotic efficacy against P. aeruginosa biofilms formed in tubular structures mimicking urinary catheters. Biofilms were established on silicone tubes, simulating the inner urinary catheter surface. The biofilms were treated with shockwaves (120 pulses at 2Hz) followed by exposure to ciprofloxacin (4μg/ml for 6h). To assess biofilm formation and detachment, crystal violet (CV) staining and SEM analysis were performed after each experiment. In addition, CFU counting and SYTO9/PI staining were conducted to evaluate bacterial viability after each treatment, and FTIR analysis was performed to examine EPSrelated signal changes following shockwave treatment. CV staining results showed a significant increase in biofilm detachment in the shockwave and antibiotic-treated group compared to the control group (P