Detection of catheter related blood stream infections in an ICU of a tertiary care center in Northern India

Abstract

Introduction: Indwelling medical devices are frequently used in all health setting with critical care units of hospitals for treatment and intervention in patient care.Microorganisms attach to surfaces resulting in the formation of a biofilm which pose a serious public health issue because of its increased resistance to antimicrobial agents and the potential to cause infections. Aims and Objectives: To determine the proportion of bacterial Biofilms in patients with central venous line and to find out the organisms most commonly associated with it. Materials and Methods: The study was carried out from January 2019 to September 2020. Positive cultures were obtained from 58 of these 102 samples. The isolates were then tested for in vitro production of biofilm using a microtitre plate assay. All the isolates were subjected to antimicrobial susceptibility tests on Muller-Hinton agar by Kirby Bauer disc diffusion method based on CLSI guidelines. Results: Demographic characteristics of the study subjects showed that among 102 catheterized patients isolated with males 58.82% and 41.1% females. Out of 58 isolates, 62.06% were gram negative bacteria (GNB) and 37.93% were gram positive. Staphylococcus aureus was most common isolate 27.58% followed by Klebsiella spp. 20.68%, Acinetobacter 15.5%, Coagulase negative Staphylococci 6.8% respectively. The total number of positive slime producers, in this study, was 23(39.6%). The highest number of strong slime producer strains was observed in case of Pseudomonas (2 out of 5), Klebsiella pneumonia (4 out of 12) and Staphylococcus(3 out of 16)Antibiotic susceptibility patterns showed increased resistance towards penicillin and beta-lactum group of antibiotics, increased sensitivity to linezolid and vancomycin among gram positive organisms. Among gram negative bacteria increased resistance was seen for cephalosporins and aminigylycosides and least resistance for colistin. Conclusion: Colonization of indwelling medical devices with consequent biofilm production is a likely contributory factor to infections. The microorganisms survive in the hospital environment despite unfavourable conditions such as desiccation, nutrient starvation, and antimicrobial treatment. Resistance to antibiotics ladder is increasing and it’s necessary to take actions to reduce its hindrance in the future. Advanced studies in biofilm will help to prevent the more virulent factors which protect the bacteria from host immunity and to get rid of critical complications in therapy.