CA1232809A - Articles and compositions providing antimicrobial effect during urinary drainage - Google Patents

Articles and compositions providing antimicrobial effect during urinary drainage

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Publication number
CA1232809A
CA1232809A CA000449796A CA449796A CA1232809A CA 1232809 A CA1232809 A CA 1232809A CA 000449796 A CA000449796 A CA 000449796A CA 449796 A CA449796 A CA 449796A CA 1232809 A CA1232809 A CA 1232809A
Authority
CA
Canada
Prior art keywords
recited
collection device
urine collection
urine
agent
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA000449796A
Other languages
French (fr)
Inventor
James A. Stupar
Dean Laurin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Allegiance Corp
Original Assignee
James A. Stupar
Dean Laurin
Baxter Travenol Laboratories, Inc.
Allegiance Corporation
Baxter International Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by James A. Stupar, Dean Laurin, Baxter Travenol Laboratories, Inc., Allegiance Corporation, Baxter International Inc. filed Critical James A. Stupar
Application granted granted Critical
Publication of CA1232809A publication Critical patent/CA1232809A/en
Expired legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2/00Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
    • A61L2/16Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor using chemical substances
    • A61L2/20Gaseous substances, e.g. vapours
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • A61F5/441Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices having venting or deodorant means, e.g. filters ; having antiseptic means, e.g. bacterial barriers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2/00Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
    • A61L2/26Accessories or devices or components used for biocidal treatment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/08Materials for coatings
    • A61L29/085Macromolecular materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/14Materials characterised by their function or physical properties, e.g. lubricating compositions
    • A61L29/16Biologically active materials, e.g. therapeutic substances
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/14Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L31/16Biologically active materials, e.g. therapeutic substances
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/88Draining devices having means for processing the drained fluid, e.g. an absorber
    • A61M1/882Draining devices provided with means for releasing antimicrobial or gelation agents in the drained fluid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/10Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing inorganic materials
    • A61L2300/106Halogens or compounds thereof, e.g. iodine, chlorite
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/20Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
    • A61L2300/202Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials with halogen atoms, e.g. triclosan, povidone-iodine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/404Biocides, antimicrobial agents, antiseptic agents

Abstract

ARTICLES AND COMPOSITIONS PROVIDING ANTIMICROBIAL
EFFECT DURING URINARY DRAINAGE
Abstract of the Disclosure Compositions and an article of manufacture intended for introduction into a urinary drainage bag to provide antimicrobial effect to the interior of the urinary drainage bag and the urine contained therein are the province of this invention. The composition can be placed directly into the urinary drainage bag and may be used as part of a urinary drainage system having a urinary drainage bag, a urinary catheter, and a catheter adapter on the end of catheter tubing providing flow communication from catheter to bag. The article of manufacture also can be used as part of a similar system. Antimicrobial effect is provided to the interior of the urinary drainage bag, and the catheter and catheter adapter provide levels of antimicrobial effect as well.

Description

12328(:~9 ARTICLES AND COMPOSITIONS PROVIDING ANTIMICROBIAL
EFFECT DURING URINARY DRAINAGE

yield of the Invention Compositions and methods useful in providing antimicrobial effect to medical devices are numerous. This invention generally relates to articles of manufacture providing antimicrobial effect to urinary drainage systems. The specific province of this in-mention resides in compositions and an article of manufacture, generally for insertion into a urinary drainage bag, which pro-vise antimicrobial effect to the interior of the urinary drainage bag and the urine contained therein. The article can be used as part of a urinary drainage system having a urinary drainage bag, a urinary catheter, and a catheter adapter on the end of catheter tubing providing flow communication from catheter to bag. When placed directly in the urinary drainage bag, the compositions also can be used as part of a similar system. The article, catheter and catheter adapter of the system all would provide levels of antimicrobial effect.

Background of the Invention Indwelling urethral catheterization is performed in approxi-mutely 10 to 15 percent of hospitalized patients. About 25 percent of these patients contract bacterial infections of the urinary tract. Two studies of note are, Garibaldi, R. A.; Burke, J. P.;
Pickman, M. L.; and Smith, C. B., "Factors Predisposing to Bacteriuria During Indwelling Urethral Catheterization". New England Journal of Medicine, 291:215, 1974, and Quinine, C. M.
and McCormick, R. C., "Prevention of Catheter-Induced Urinary-Tract Infections by Sterile Closed Drainage". New England Journal of Medicine, 274-1155, 1966.

.. .. . ... .. . .. . . ... . . ... . ..... ..

~;~32~
- 2 -The incidence of catheter-induced urinary tract infections still remains a problem despite various prophylactic measures that have been tried. Attempts to reduce the incidence of urinary tract infections have included the application of antibiotic ointments or other bactericidal agents to the surface of the catheters, frequent bladder irrigation with concomitant trophy-lactic administration of antibiotics, or inhibition of the growth of bacteria in urine drainage containers. See, Akiyama, H. and Okamoto, S., "Prophylaxis of Indwelling Urethral Catheter Infection:
Clinical Experience with a Modified Foley Catheter and Drainage System". The Journal of Urology, 121:40, 1979.
Urinary drainage bags have been cited as one of the contami-nation routes through which a patient may obtain a urinary tract infection when catheterized. Two other predominant sites suscep-lo title to contamination which can contribute to urinary tract infections are the catheter adapter at the end of a catheter drainage tube which connects the urinary drainage bag with a catheter and the catheter itself. Microorganisms which have been introduced into the urinary drainage bag through the drainage conduit when the bag is emptied can colonize in the bag and mix grate up the catheter drainage tubing and catheter and thereafter into a patient's bladder. Furthermore, microorganisms from an infected patient may proliferate in the urinary drainage bag and, when emptied, can lead to cross-contamination of other areas of the body, other patients, or both.
The patent literature is illustrative of attempts to eliminate the urinary drainage bag as a source of contamination leading to urinary tract infection. US. Patent 4,193,403, Patient-Care Apparatus Housing Device for Controlling Presence of Pathogens, to Langston, et at. and US. Patent 4,241,733, Patient-Care Appear-tusk With Device for Dispensing Anti-pathogenic Agent, to Langston, et at. describe a urinary drainage bag system where an antimicrobial agent is continuously released into the catheter drainage tubing ~;~328~9 and the urinary drainage bag. The mode of release of the anytime-crabbily agent involves the depolymerization of paraformaldehyde into formaldehyde in the presence of moisture. Formaldehyde is not a preferred antimicrobial agent because it is believed to be a mutagen and a carcinogen.
Introducing 3 percent US hydrogen peroxide solution into a urinary drainage bag prior to each period of urine collection significantly reduces the risk of urinary tract infection. This discovery is the subject of US. Patent 4,233,263, Method of Maintaining Bacterial Sterility in Urine Drainage Bags, to Schaefer [hereinafter cited as Schaefer]. The key to the effectiveness of the Schaefer method is user compliance. Each time urine is drained from the urinary drainage bag, hydrogen peroxide must be reintroduced. Practical experience teaches that the hydrogen peroxide of the Schaefer system must be actively mixed or agitated to disperse throughout the urine in the bag. Also, several urinary tract infection organisms are resistant to hydrogen peroxide.
US. Patent 3,312,221, Urinary Drainage Apparatus, to Averment describes a urinary drainage bag having a porous plastic pouch containing an antimicrobial agent. The pouch is suspended so that incoming urine cascades over and through the pouch so that the antimicrobial agent will dissolve in the urine. Adequate dwell time of antimicrobial agent in the urine is not always assured, however. Under saturation of the urine is a possibility when there is a high flow rate of urine. Also, potential exists for restrict-in the flow of urine into the bag by the placement of the pouch in the urine flow path. This situation may become critical espy-Shelley when there is high flow of urine or when a patient drains bloody or viscous urine.
It would be advantageous to have an article of manufacture for a urinary drainage bag which releases antimicrobial agent only when wet or humidified and not necessarily on a continuous basis.

;~3281~9 Such selective release of antimicrobial agent would insure effect tiveness for longer periods of time without excessively high con-cent rations or pressures of antimicrobial vapors.
A desirable antimicrobial agent would be less toxic than formaldehyde. The agent desirably would have high enough volubility in urine to exert antimicrobial effect, and it desirably would provide antimicrobial effect to those portions of the interior of the urinary drainage bag not contacting the urine.
Good dispersion qualities of the antimicrobial agent and an adequate dwell time in urine would be desirable. Under saturation of the urine in high flow rate conditions would be obviated.
Also, it would be expedient to have a system which did not require introduction of antimicrobial agent into the urinary drainage bag each time after a bag is emptied. Placement of the antimicrobial agent desirably would be away from urine flow to avoid restricting urine flow.

~2328C~9 Summary of the Invention various aspects of this invention are as follows:
A urine collection device for collecting urine from a patient, comprising:
a urinary drainage bag having inner walls; and antimicrobial means for disinfecting urine in said bag and said inner walls, said means including a water-vapor activated halogenating agent taken from the group consisting of trichlororisocyanuric acid, trichloroisocyanuric acid and their alkali metal salts, said agent being contained in a hydrophobic gas permeable pouch, said agent being activated by exposure to water-vapor from urine in said bag permeating through said pouch to cause said agent to produce a gas having an antimicrobial effect on urine in said bag and said inner walls of said bag.
A urine collection device for collecting urine from a patient, comprising:
a urinary drainage bag; and antimicrobial means for disinfecting urine, said means having a water-activated halogenating agent for producing a gas having an antimicrobial effect when said agent is humidified by exposure to urine in said bag.

-4b- ~L~3~2~3~9 A method of providing antimicrobial effect in a urinary drainage bag wherein urine is collected in said bag for a period of time and then emptied therefrom, consisting essentially of introducing into said bag for each period of urine collection a halogen compound-releasing agent.

1232~309 Description of the Invention An antimicrobial urinary drainage system and an article of manufacture having antimicrobial effect constitute this invention.
A method of this invention comprises introducing a halogenating agent into a urinary drainage bag in order to provide antimicrobial effect to the urinary drainage bag interior and to urine in the bag. The article of manufacture comprises an antimicrobial gas-generating agent, for example, trichloroisocyanuric acid (TCCA), contained within a gas permeable material. The general configure-lion may be that of a pouch, a coated solid, a solid mixture or the like. A preferred embodiment is a pouch which may be sex-minted into compartments. The article also may be variously shaped as sheets, rods, tubes or the like. When the article, for example the pouch, is placed in a urinary drainage bag, it is exposed to humidity or wetness when urine is present. Water vapor diffuses through the material forming the pouch walls to activate the anti-microbial gas-generating agent. Chlorine gas or other vapor having antimicrobial effect is thus released through the pouch walls into the urine which contacts the pouch and is thus released into the drainage bag.
The material forming the pouch walls is permeable to at least water vapor and chlorine gas. Preferably it is a hydra-phobic material permeable to gases but impermeable to fluids such as urine. When urine is drained from the urinary drainage bag, the pouch containing the antimicrobial agent remains in the bag. Chlorine gas or other vapor having antimicrobial effect is again released into the urine and drainage bag when fresh urine enters the bag. By pouch we also contemplate an agent coated by a gas permeable material and a solid mixture of antimicrobial agent and gas permeable material.
Solid, halogenating agents providing antimicrobial effect and suitable for direct introduction into the urinary drainage bag as a step in the method of this invention include, but are not limited to, the classes of N-halo-amines, N-halo-amides, N-halo-sulfonamides and hypochlorites, such as the following:

- 6 - ~LX32~309 trichloroisocyanuric acid (TCCA), dichloroisocyanuric acid (DCCA) and alkali metal salts thereof, such as ~(monotrichloro)-tetra-(monopotassium dichloro)] penta-isocyanurate, sodium dichloro-isocyanurate, sodium dichloroisocyanurate dehydrate and potassium dichloroisocyanurate; N-chlorinated-hydantoins, N-brominated-hydantoins and ~-chlorinated-N-brominated-hydantoins, such as 1,3-dichloro-5, 5-dimenthyl hydantoin; chlorinated mailmen, brominated mailmen, and chlorobromomelamines, such as in-chloromelamine, dichloromelamine and monochloromelamine;
N, N'-dichloroazodicarbonamidine; sodium p-toluenesulfonchloramide;
p-toluenesulfondichloramides; sodium benzenesulfonchloramide;
succinchlorimide; p-sulfondichloramidobenzoid acid; calcium hypochlorite; chlorinated trisodium phosphate. Quantities of these agents, not contained within a gas permeable material,-are introduced into a urinary drainage bag before each period of urine collection in the method of this invention.
Liquid antimicrobial halogenating agents suitable for direct introduction into the urinary drainage bag as a step in the method of this invention are aqueous solutions of hypochlorous acid, sodium hypochlorite, calcium hypochlorite or the agents listed in the paragraph above Also, these liquid agents may be contained in non-porous, gas permeable containers made from, for example, polyethylenevinylacetate or silicone rubber.
One embodiment of the urinary drainage system of the present invention comprises a urinary drainage bag, catheter drainage tubing connected to the urinary drainage bag and terminating at one end in a catheter adapter, a catheter connected to the catheter adapter, and an antimicrobial agent contained by material to form a pouch or the like. The pouch easily can provide antimicrobial effect to the urinary drainage bag interior and urine collected therein. Portions of the catheter adapter, urinary catheter, or both are coated with 7 LO ~3~8(~3 the antimicrobial composition of Canadian Patent Application Serial No. 439,002, Antimicrobial Compositions, to Laurie and Stupor, filed October 14, 1983 [hereinafter cited as the '002 application], commonly owned with this application by Baxter Travenol Laboratories, Inc.
Another embodiment of the urinary drainage system of the present invention is similar to the embodiment just described except that quantities of the solid halogenating agents or liquid halogenating agents, not contained within a material, are lo directly introduced into the urinary drainage bag before each period of urine collection.
The material forming the article, for example the pouch, of the present invention preferably is a hydrophobic, gas permeable material. The pouch is closed so that an antimicrobial agent contained therein is prevented from spilling out. TYVEK~
non-woven, spun wound, micro porous polyolefin fabric (TYVEKæ is a registered trade mark of E. I. duo Pont de Numerous and Company), a hydrophobic, polyolefin paper material or the like, may be used as the material for the pouch or the like. Also, the material for containing the agent may be polyethylene vinyl-acetate or silicone rubber. Indeed, useful hydrophilic gas permeable materials may be used for containing the antimicrobial agent, for example, cellophane and polyvinyl alcohol. Anti micro-blat agent may be contained directly between layers of the material to form a closed pouch or the like. The agent may be contained in elongated gas barrier capsules in the pouch which protect the agent during storage and which can be broken later to expose the antimicrobial agent during urine collection use.
The antimicrobial agent also may be coated by the material or formed into a solid mixture with the material. The solid mixture then can be formed into configurations desired.
Alternatively, the urinary drainage bag may be manufactured with a polyolefin paper material window or other gas permeable mat-trial. An antimicrobial agent-containing pouch then may be attached 12~ 9 at the window area. This embodiment pouch preferably would have one side covered with metal foil or other gas impermeable material while the edges of the opposite face would contain an adhesive.
This layered pouch then would seal in face-to-face engagement with the window on the urinary drainage bag.
An antimicrobial agent which preferably is contained in a TYVEK~ material pouch is trichloroisocyanuric acid (TCCA). The other solid halogenating agents listed hereinabove also can be contained in the TYVEK~ pouch. Gaseous chlorinating compounds from the TCCA or halogen gases from the other antimicrobial agent, would be released only in the presence of humidity or wetness.
A sufficient quantity of agent to release antimicrobial gas for 10 to 14 days could be contained in the pouch.
One benefit of the present invention is that halogenati~g gases, such as chlorine, and hypochlorous acid, as the antimicrobial agent, are released only in the presence of humidity or wetness and not necessarily continuously released. It is contemplated that gaseous chlorinating compounds released in this way are less toxic than other antimicrobial agents introduced into urine.
Another benefit achieved by the present invention is thaw the volubility of the antimicrobial agent in urine is high enough to render the urine antimicrobial. Gas generated can render interior surfaces, not in contact with urine, antimicrobial as well.
Impediments to urine flow from the catheter drainage tube are not present because the pouch or article does not reside in the urine flow path. Flow of urine is not restricted, and urine need not contact the pouch to render it antimicrobial.
An additional benefit of the present invention is that a pouch or article containing the antimicrobial agent need be in-traduced into the urine drainage bag only once. Treatment with additional antimicrobial agent after every emptying of the bag is not necessary with the pouch embodiment.

~2328(:~9 g Brief Description of the Drawings For a more complete understanding of this invention, reference should now be had to the embodiments illustrated in greater detail in the accompanying drawings.
In the drawings:
Figure 1 is a plan view of a urinary drainage bag, partially broken away, showing the antimicrobial agent-containing article in the form of a pouch inside the drainage bag.
Figure 2 is a partial plan view illustrating the pouch of the present invention being inserted into a urinary drainage bag.
Figure 3 is a plan view showing a urinary drainage bag with a gas permeable window and antimicrobial agent-containing pouch being affixed thereto.
Figure 4 illustrates, in perspective, an embodiment of the antimicrobial agent-containing pouch.
Figure S is a plan view of another embodiment of an anti micro-blat agent-containing pouch having breakable, gas-impermeable ampules therein for containing the antimicrobial agent prior to use.
Figure 6 is a cross-section taken at 6--6 of Figure S, showing the breakable ampules contained in the pouch.
Figure 7 illustrates, in a plan view, the urinary drainage system of this invention comprising a urinary drainage bag contain-in an antimicrobial agent-containing pouch, a catheter drain tube, a catheter adapter coated with an antimicrobial compound and a catheter coated with an antimicrobial compound.

- 10- lZ3Z~ 9 Detailed Description of the Drawings Turning now to the drawings, Figure 1 illustrates urinary drainage bag 10 of generally conventional configuration. Catheter drainage tubing 12 drains urine from an indwelling catheter to drainage bag 10. Drainage conduit 14, residing in the bottom of drainage bag 10, allows urine periodically to be emptied from bag 10. Port 16 is provided for insertion of an article, a pouch or the like comprised of material which contains an antimicrobial agent. Port 16 can be capped at its end 18 by a cap of appear-private configuration.
Pouch 20, containing an antimicrobial agent, is shown in the interior of urinary drainage bag 10. Pouch 20 is generally of rectangular configuration tapering to a pointed end 22.
Pouch 20 is comprised of opposing layers of a gas permeable;
urine impermeable, material. The material forming the layers is permeable to at least water vapor and chlorine gas. Prefer-ably, pouch 20 is constructed of a hydrophobic material permeable to gases but impermeable to fluids such as urine. A preferred material for the layers is a non-woven, spun wound, micro porous polyolefin material such as TYVEK~ fabric. Pouch 20 is shown having two separate compartments 24, 26 each containing an antimicrobial, gas-generating agent, preferably trichloroiso-cyan uric acid (TCCA).
Other materials, both hydrophobic and hydrophilic, can be used to contain antimicrobial, gas-generating agents. These materials include polyethylenevinylacetate, silicone rubber, cellophane and polyvinyl alcohol. Solid halogenating agents also can be coated by or mixed with these materials.
Other antimicrobial agents which release gases having anti-microbial effect at the bag interior can be contained within pouch 20 or coated or mixed with the gas permeable, urine imp permeable materials. For example, the solid halogenating agents earlier identified can be used.

~2328(~9 Urine from a patient drains through catheter drainage tubing 12 into urinary drainage bag 70. In the presence of humidity or wetness, a gas having antimicrobial effect at the bag interior is released. When TCCA is contained in pouch 20, chlorine gas and vaporous hypochlorous acid are released.
As earlier mentioned, pouch 20 may be made from a micro porous, hydrophobic, polyolefin paper material such as TYVEK~ fabric or nonporous highly gas permeable material such as polyethylene-vinyl acetate or silicone rubber. Pouch 20 may be closed using conventional heat sealing techniques to form seal 28 at its periphery and to form seal 30 which separates pouch 20 into compartments 24, 26.
Pouch 20 is inserted into urinary drainage bag 10 as shown in Figure 2. Opposing layers of material 27, 29 comprise pouch 20. Pouch 20 conveniently can be folded along sealing line 30.
Angled front portion 22 of pouch 20 allows its easy insertion through port 16. Pouch 20 can be packaged in aluminum or other metal foil, polymers of vinylidene chloride or the like to provide a vapor barrier for pouch 20 prior to use. Also, pouch 20 can be coated with a dissolvable material functioning as a vapor barrier; gelatins, polyvinyl alcohol, inorganic salts or the like which dissolve in urine would be preferable.
Figure 3 illustrates another embodiment of the present invent lion. Urinary drainage bag lo is substantially similar to urinary drainage bag 10 except as herein noted. The back 11 of urinary drainage bag lo is illustrated in Figure 3. Window portion 32, of generally rectangular configuration, has been removed from back 11 of bag loan The bag material has been replaced by panel 34 generally made from a gas permeable, hydrophobic material such as a polyolefin paper, TYVEK~ fabric or the like. Panel 34 is sealed along line 36 to the bag material.
Figure 4 illustrates an antimicrobial agent-containing pouch aye substantially similar to pouch 20 except as hereinafter noted.
Pouch aye can be made from the same layers of opposing material I, ~Z32~3~39 as pouch 20 with the exception that side 38 is backed with a gas and water impermeable material such as a metal foil. polyvinylidene chloride or the like. Also pouch aye can be made from one layer of gas permeable, hydrophobic material and an opposing layer of gas and water impermeable material. Pouch aye is of generally rectangular configuration and is shown with two compartments aye, aye. Compartments aye, aye are filled with an antimicrobial agent such as TCCA or the like which can release an antimicrobial gas such as chlorine gas into the interior of bag lo through gas permeable panel 34.
Still another embodiment of the antimicrobial agent-containing pouch 20b is illustrated in Figure 5. Pouch 20b is substantially similar to pouch 20 except as hereinafter noted. Compartments 24b, 26b of pouch 20b are shown separated by sealing line ion.
Elongated, breakable gas-impermeable ampules 40 are contained in compartments 24b, 26b. Ampules 40 contain an antimicrobial agent such as TCCA, or the like. When ready for use, ampules 40 in pouch 20b can be broken thereby providing the intended antimicrobial effect. Figure 6 illustrates a cross-section taken at 6--6 in Figure 5 showing ampules 40 containing anti-microbial agent 42. Ampules 40 can be made of glass, polymers of acrylonitrile or vinylidene chloride, other brittle plastics or metal foil-plastic laminates.
A particular advantage in using the embodiment of pouch 20b resides in its ease of storage. inn antimicrobial agent 42 is TCCA or another chlorine gas releasing agent which functions in the presence of humidity or wetness, the agent 42 can be stored indefinitely. Chlorine gas will be released only when the ampules are shattered thereby exposing the antimicrobial agent to the atmosphere. Furthermore, pouch 20b conveniently may be placed in a urinary drainage bag at a manufacturing facility, prior to sterilization of the urinary drainage bag. Insertion of an anti-microbial agent-containing pouch into the urinary drainage bag .~, - 13 - lZ32~3(~9 at a hospital by a nurse or other trained individual is obviated.
All that needs to be done is the shattering of ampules 40.
Similarly, other problems are obviated by containing TCCA
in ampules in pouch 20 before use. Chlorine gas released from TCCA reacts with polyvinyl chloride in urinary drainage bags causing yellowing in 7 to 10 days and a more severe tackiness over a period of months. Ethylene oxide sterilization of the urinary drainage bag could involve a vigorous reaction with TCCA
and the production of toxic ethylene chlorohydrin. Encapsulated 10 TCCA in a pouch would overcome these disadvantages thereby allowing pouches to be inserted as a manufacturing step.
Antimicrobial urinary drainage System 44 is illustrated in Figure 7. System 44 comprises urinary drainage bag 10, anti micro-blat agent-containing pouch 20, catheter drainage tubing 12, catheter adapter 46 and urinary catheter 48. Urinary catheter 48 communicates with catheter adapter 46 which communicates with urinary drainage bag 10 through urinary drainage tube 12. Catheter 48 and catheter adapter 46 are shown having surfaces coated with a composition having antimicrobial effect. The antimicrobial composition preferably is chosen from among the compositions disclosed in our prior patent application, the '002 patent apt placation. In System 44, either catheter adapter 46, catheter 48 or both may have surfaces coated with an antimicrobial composition.
A method of this invention involves directly introducing an uncoated solid or aqueous halo~enating agent into the urinary drainage bag. Referring again to Figure 1, instead of intro-during a pouch into the interior of urinary drainage bag 10, a halogenating agent is introduced into bag 10 through port 16 prior to each period of urine collection. For example, the solid and liquid antimicrobial agents earlier identified can 1~32~0 be used. Antimicrobial effect is provided to urine contained therein and to interior portions of bag 10 not directly contacting urine.
The examples below are offered for illustrative purposes only and are not intended to limit the scope of the invention of this application, which is defined in the claims below.

A urinary drainage bag of conventional configuration was opened and a pouch made from TYVEK~ polyolefin fabric material was placed whereinto. The pouch measured 8-1/2 inches by 4 inches and was segmented into 12 equally sized compartments.
Each of the 12 compartments contain approximately 1 gram of powdered trichloroisocyanuric acid. The drainage was sealed closed. Over an 8-hour period, 500 milliliters of urine con-lo twining 105_106 Equal per milliliter was infused into the bag Urine drained from the bag was filtered, and the filter was gut-lured for bacterial growth. No organisms grew on the filter after 16 of the 8-hour challenges described above.

A TYVEK3 polyolefin fabric material pouch measuring approxi-mutely 8 inches by 3 inches and divided into two compartments containing a total of 20 grams of TCCA was inserted into a urinary drainage bag. 500 milliliters of urine containing 105-106 Equal per milliliter was then infused into the bag over an 8-hour period.
Urine drained from the bag was filtered and cultured for bacterial growth. No bacteria grew on the filters after six such challenges.

A tablet, approximately 1 inch diameter and 1 1/2 inch thick, .. . . .

~:32~30~

made from one part powdered TCCA (less than 100 mesh size part-eels) and one part silicone rubber (alkoxy-cured REV) was placed into a urinary drainage bag. One ml. of urine challenge contain-in 105 organisms (Equal or candid albicans) was added through the drainage port at the bottom of the bag. Urine was added to the bag at a rate of 500 ml. per 8 hours. After 8 hours of got-section, urine was drained and filtered. The filters were gut-lured. No growth of bacteria occurred on the filters after 14 of these challenges and bag fillings.

Quantities of various halogen-releasing agents were added to 50 ml. of urine. Prior to the addition of the agents, the urine was sterilized by micro porous filtration. Samples were left at room temperature for more than 8 hours. The samples then were contaminated with microorganisms to the level of 104 organisms per milliliter. Periodically, urine from the samples was streaked on ajar plates and incubated to detect the amount of surviving organisms compared to urine with no antimicrobial agents added thereto. Separate populations of microorganisms introduced into the samples were Equal, Candid albicans, Pseudomonas aeruginosa, and Staphylococcus Ayers.
Results of the separate challenges were generally identical and are tabulated in Table 1 below. As used below, tidal means no surviving organisms detectable, and static means no organisms multiplied in the treated urine.

.. .,, ........... , .. .. ,.,,, ........ .. .. ,.. Jo . ,.. , ... I... .. .... . .. . ...

~32~309 Agent Concentration Appearance Activity Appearance in Urine Initially Against After (wax) all 1-2 days Organisms TCCA 0.02 Clear 30 min. Clear - Tidal Br3Cl- 1.0 Slightly Less than Slightly dim ethyl turbid Seedier turbid hydantoin Chloramine 1.0 Slightly Less than Slightly -T turbid 1 hr. - turbid Tidal Trichloro- 0.2 Clear, sly 30 min. - Clear, mailmen orange Tidal sly orange Coequal) 0,04 Clear 24 hr. - Clear 2 static no growth) Jo

Claims (35)

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A urine collection device for collecting urine from a patient, comprising:
a urinary drainage bag having inner walls; and antimicrobial means for disinfecting urine in said bag and said inner walls, said means including a water-vapor activated halogenating agent taken from the group consisting of trichlororisocyanuric acid, dichloroisocyanuric acid and their alkali metal salts, said agent being contained in a hydrophobic gas permeable pouch, said agent being activated by exposure to water-vapor from urine in said bag permeating through said pouch to cause said agent to produce a gas having an antimicrobial effect on urine in said bag and said inner walls of said bag.
2. A urine collection device for collecting urine from a patient, comprising:
a urinary drainage bag; and antimicrobial means for disinfecting urine, said means having a water-activated halogenating agent for producing a gas having an antimicrobial effect when said agent is humidified by exposure to urine in said bag.
3. A urine collection device as recited in claim 2, wherein said agent is a solid.
4. A urine collection device as recited in claim 2, wherein said agent is a liquid.
5. A urine collection device as recited in claim 2, wherein said antimicrobial means further comprises:
a pouch for containing said halogenating agent, said pouch being exposed to water-vapor from urine in said bag.
6. A urine collection device as recited in claim 5, wherein said pouch is formed of a hydrophobic gas permeable material.
7. A urine collection device as recited in claim 6, wherein said pouch is formed of a non-woven, spun-wound, microporous polyolefin fabric.
8. A urine collection device as recited in claim 5, wherein said pouch is formed of a material taken from the group consisting of:
polyethylenevinyl acetate and silicone rubber.
9. A urine collection device as recited in claim 2, wherein said antimicrobial means further includes:
an elongated gas barrier capsule for containing said halogenating agent, wherein said capsule may be broken to expose said agent to urine during urine collection.
10. A urine collection device as recited in claim 2, wherein said antimicrobial means includes a mixture of said halogenating agent and a material taken from the group consisting of polyethylenevinyl acetate, silicone rubber, cellophane and polyvinylalcohol to form a solid.
11. A urine collection device as recited in claim 1, wherein said antimicrobial means further includes a coating surrounding said halogenating agent, said coating being taken from the group consisting of polyethylenevinyl acetate, silicone rubber, cellophane and polyvinylalcohol to form a solid configuration.
12. A urine collection device as recited in claim 5, wherein said bag includes a gas permeable window, said pouch being attached to an outer surface of said bag at said window.
13. A urine collection device as recited in claim 5, wherein said pouch includes one side being formed of a gas impermeable material, an opposing side of said pouch having means for face-to-face engagement with said window on said bag.
14. A urine collection device as recited in claim 2, wherein said agent includes trichloroisocyanuric acid.
15. A urine collection device as recited in claim 5, wherein said agent includes trichloroisocyanuric acid.
16. A urine collection device as recited in claim 12, wherein said agent includes trichloroisocyanuric acid.
17. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of the classes of N-halo-amines, N-halo-amides, N-halo-sulfonamides and hypochlorites.
18. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: trichloroisocyanuric acid (TCCA), dichloroisocyanuric acid (DCCA), and their alkali metal salts.
19. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: [(monotrichloro)-tetra-(monopotassium dichloro)] penta-isocyanurate, sodium dichloroisocyanurate, sodium dichloroisocyanurate dihydrate, and potassium dichloroisocyanurate.
20. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: N-chlorinated-hydantoins, N-brominated-hydantoins, and N-chlorinated-N-brominated-hydantoins.
21. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: 1,3-dichloro-5,5-dimethyl hydantoin, and 1-chloro-3-bromo-5,5-dimethyl hydantoin.
22. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: chlorinated melamines, brominated melamines, and chlorobromomelamines.
23. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: trichloromelamine, dichloromelamine and monochloromelamine.
24. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: N,N'-dichloroazodicarbonamidine, sodium p-toluenesulfonchloramide, p-toluenesulfondi-chloramides, sodium benzenesulfonchloramide, succinchlorimide, p-sulfondichloamidobenzoic acid.
25. A urine collection device as recited in claim 2, wherein said agent includes a material taken from the group consisting of: calcium hypochlorite, sodium 19 .

hypochlorite, hypochlorous acid and chlorinated trisodium phosphate.
26. A urine collection device as recited in claim 2, wherein said agent releases gas only in the presence of humidity from said urine.
27. A urine collection device as recited in claim 2, wherein said gas from said agent renders interior surfaces of said bag as well as urine in said bag antimicrobial.
28. A urine collection device as recited in claim 5, wherein said bag includes a resealable port and said pouch includes an angled front portion for insertion of said pouch through said port.
29. A urine collection device as recited in claim 5, wherein said pouch is coated with a water dissolvable material which functions as a vapor barrier until dissolved.
30. A urine collection device as recited in claim 29, wherein said water dissolvable material is taken from the group consisting of: gelatins, polyvinylalcohol, and inorganic salts.
31. A urine collection device as recited in claim 9, wherein said capsule is formed of a material taken from the group consisting of: glass, polymers of acrylonitrile or vinylidene chloride, and metal foil-plastic laminates.
32. A urine collection device as recited in claim 2, wherein said antimicrobial means includes sufficient halogenating agent to provide an antimicrobial effect for a single period of urine collection.
33. A urine collection device as recited in claim 2, wherein said antimicrobial means includes sufficient halogenating agent to provide an antimicrobial effect for more than one period of urine collection.
34. A urine collection device as recited in claim 2, wherein said antimicrobial means includes sufficient halogentating agent to provide an antimicrobial effect for the life of the bag.
35. A urine collection device as recited in claim 2, wherein said antimicrobial means includes sufficient halogenating agent to provide an antimicrobial effect for ten to fourteen days of patient use.
CA000449796A 1983-04-18 1984-03-16 Articles and compositions providing antimicrobial effect during urinary drainage Expired CA1232809A (en)

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US485,681 1990-02-27

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EP0138851A4 (en) 1986-11-26

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