Bacteriology and Antibiotic Sensitivity Patterns of Urine and Biofilm in Patients with Indwelling Urinary Catheter in a Tertiary Hospital in Bangladesh

Abstract

Catheter-Associated Urinary Tract Infection (CAUTI) is a common health care associated infection worldwide and is result of wide spread use of urinary catheter and inappropriate antibiotics use. Cause of CAUTI is formation of pathogenic biofilm in the inner surface of indwelling urinary catheters and its early detection prevents various hazards as well as economic impact.This observational prospective study was done to see relationship between the pattern of microorganism in urine and biofilm and their antibiotic sensitivity patterns in 100 patients in Comilla medical college hospital, Comilla, Bangladesh. Selected patients had undergone catheterization for urinary retention or incontinence. The urine collected by suprapubic puncture and biofilm from indwelling catheter for culture and sensitivity.90% of urine samples and 100% biofilm showed growth of uropathogens. E.coli was the most frequently isolated pathogen (60%), followed by Klebsiella spp (14%). Multibacterial isolates was found from biofilm in 15 samples with long term catheterization. Biofilm strains displayed relatively high resistance against tested antibiotics. Highest sensitivity pattern found for E.coli in urine and biofilm for imipenem (95% vs. 92%), lowest for ciprofloxacin (20% vs. 16%). Catheter biofilm resistant to all tested drugs were found for E.coli in 6.95% and klebsiella in 5.55%. Urine samples resistant to all tested antibiotics only in E.coli 3.33%.E.coli was the most frequent isolate which showed the higher sensitivity to carbapenems, and lowest to the quinolones. Correlation was observed between biofilm production and multidrug resistance. A large-scale prospective studies suggested to make a guideline to manage UTI specially CAUTI.

Antibiotic Resistance in Urinary Tract Infection in a Tertiary Care Hospital in Bangladesh-A Follow-up Study

“…Urological pathogens shows very low degree of resistance (0-1%) against meropenem, imipenem, tazobactum and amikacin which was similar to our previous study on 2011 14 . Bacteria shows higher degree of resistance against most of the remaining antibiotics used for sensitivity due to irrational consumption of most of the antibiotics during the past decade in our region 13,23,24 .…”

“…The present study was undertaken to find the current urological pathogens and their antibiotic resistance pattern in a tertiary hospital in Bangladesh to compare with previous pattern of study in 2011 14 . It will be helpful for awareness and antibiotic use in UTI in this tertiary level hospital and country level.…”

Nutritional Immunity and Antibiotic Drug Treatments Influence Microbial Composition but Fail to Eliminate Urethral Catheter Biofilms in Recurrently Catheterized Patients

“…, Proteus and Providencia spp. ) dominate microbial communities that form on catheter surfaces (3, 5, 6). Urea degradation alkalinizes the pH of urine and triggers the precipitation of phosphate salt crystals in this milieu, thus increasing the risk of luminal occlusion and complications such as urinary stones and kidney infections (3).…”

“…Culture-based methods have shown that CBs typically harbor more than a single microbial organism (5, 6, 21). Culture-independent metagenomic surveys have identified fastidious microbes including genera such as Actinomyces , Stenotrophomonas , Corynebacterium , and Finegoldia spp .…”

A Study on Biofilm Phenotype and Antimicrobial Resistance Pattern of Clinical Isolates from Catheter Associated Urinary Tract Infection

“…Catheter associated urinary tract infection (CAUTI) is a common health care associated infection throughout the world, occurring due to one common reason of magnanimous usage of indwelling urinary catheters teamed with inappropriate antibiotic use (Majumder et al, 2014). The mechanism of such infections is mostly due to the inert nature of the catheter material which is susceptible to microbial colonization and formation of biofilm, thus enhancing the pathogenic effects (Trautner and Darouiche, 2004).…”