Multiple antibiotic resistance and biofilm formation of catheter associated urinary tract infection (CAUTI) causing microorganisms

Abstract

Urinary Tract Infection (UTI) is the most common infection acquired in both hospitals and nursing homes and those UTI usually associated with catheterization are referred to as catheter associated urinary tract infection (CAUTI). Catheters provide entry along external and internal surface of catheters and organism contained within form biofilm. Biofilms are community based growth of infectious organisms encompassed in an exopolymeric matrix that protects the inhabitants from the immune response and antibiotics. In this study, 14 isolates were obtained from the catheter bag of UTI patients and their microbiological and biochemical characterization performed. The isolates isolated are E. coli (5), Klebsiella (4), Pseudomonas (2), Proteus (2) and Enterococcus fecalis (01). The isolates were differentiated based on Hi Chrome media and biochemical tests. Isolates were tested for antibiotic resistance using Kirby Bauer disk diffusion assay as per CLSI norms. 13 isolates are MDR (multiple drug resistant) and 3 NDR (non drug resistant). Based on Congo Red agar assay for biofilm formation all 13 MDR were found to be biofilm formers. Biofilm formation was confirmed using latex and silicone catheter tubes as adherent substrates. All the CAUTI isolates except for E. coli were found to be inhibited by Silicone catheters in comparison to those made of latex. E. coli isolates showed significantly lower biofilm formation in comparison to the other isolates. However, successful control strategies for UTI patients may be customized by including anti-biofilm forming measures along with alternatives to antibiotic treatments.