Bacterial biofilm dependent catheter associated urinary tract infections: Characterization, antibiotic resistance pattern and risk factors

Abstract

Biofilms cause recurrent and resistant device-related infections. We aimed to detect the prevalence of biofilm-dependent catheter-associated urinary tract infections (CAUTI) among catheterized patients, identify bacterial pathogens, antibiotic resistance pattern and risk factors associated with biofilm production. Adult and pediatric patients admitted to Mansoura University Urology and Nephrology Center and fulfilling the criteria of CAUTI were enrolled in this study. urine sample and a part of urinary catheter were collected for microbiological testing and assessment of biofilm formation using tube method (TM) and scanning electron microscope (SEM). The prevalence of biofilm-dependent CAUTI was 82.85%, in which Klebsiella pneuomoniae had the highest biofilm-forming potential. Biofilm producers uropathogens are more resistant to antibiotics. Extremes of age and prolonged duration of catheterization were significantly associated with biofilm formation. TM showed good correlation with SEM regarding degree of biofilm production, sensitivity (100%) and specificity (100%). Prevalence of biofilm-dependent CAUTI was high. Minimizing the duration of catheterization and usage of silicone catheter are recommended. Using carbapenems in treatment of biofilm-dependent CAUTI should be considered. TM can be implemented for biofilm detection as it is cheap, rapid, easy and showed good correlation with SEM.

Microbial Profile and Antibiotic Resistance Pattern of Urine and Biofilm Pathogens Isolated from Catheterized Patients at Komfo Anokye Teaching Hospital, Kumasi, Ghana

“…Regarding resistance to the biofilm isolates, this study is true for other studies that showed higher resistance among the biofilm isolates than the non-biofilm isolates [7] [21] [30]. High resistance to Ciprofloxacin was observed in similar studies which agree with this study revealing trimethoprim and ciprofloxacin as higher resistance to biofilm pathogens [21].…”

“…Nitrofurantoin had lower resistance rates and can be considered for CAUTI treatment contrary to similar studies elsewhere [7] [31]. Generally, in concordant with Qayoom, K. pneumoniae isolated from biofilm exhibited higher resistance levels than the other isolates [32] and these could be attributed to K. pneumoniae's high potential to producing biofilm [7].…”

“…Most of them are the host's own microflora or microflora from health personnel, other patients, or the environment. Bacteria usually encountered in CAUTI include Escherichia coli, Klebsiella pneumoniae, other Enterobactericeae and Staphylococcus species [5] [6] [7].…”

Phenotypic and genomic characterization ofPseudomonas aeruginosaisolates recovered from catheter-associated urinary tract infections in an Egyptian hospital

“…Moreover, the prevalence of biofilm-dependent CAUTIs was about 82 %. The majority (81.25 %) of patients with catheters inserted for ≤14 days suffered from mono-bacterial colonization inside the catheter, and 42.11 % of patients with catheters inserted for one month had poly-microbial colonization (Ramadan et al, 2021).…”

Drug-resistant, biofilm-producing uropathogens isolated and characterized from urinary tract infected patients in Chattogram, Bangladesh

“…Between 50% and 60% of adult women have faced at least one UTI in their life, and close to 10% of postmenopausal women suggest that they had a UTI in the previous year (Alos, 2005). A biofilm can be defined as microorganisms bound to a surface of each other with the existence of an extracellular matrix made of secreted elements of the organisms and/or of components of the microorganisms themselves and it causes frequent and resistant device-related infections (Ramadan et al, 2021). Biofilms provide an environment for poor antibiotic penetration and horizontal transfer of virulence genes which favors the progression of Multidrug-resistant organisms (MDRO) (Katongole, 2020).…”