A prospective study of biofilm production among catheterized and non-catheterized urinary bacterial isolates along with their antimicrobial susceptibility pattern in tertiary care hospital, Nadiad, Gujarat

Abstract

Background: Urinary tract infections (UTIs) are one of the leading causes of morbidity, mortality, and health-care expenditure, affecting all age groups of people. Bacteria that are able to produce biofilm are more likely to cause recurrent UTI. Conversely, bacteria with higher biofilm-forming capacity are much more likely to cause recurrent UTI. Understanding biofilm formation and antimicrobial resistance determinants of uropathogenic organisms will provide insight into the development of treatment options for biofilm-associated UTIs. Aim and Objectives: The objectives of this study are to compare antimicrobial resistance patterns among biofilm-producing and non-biofilm-producing organisms isolated from catheterized and non-catheterized patients with UTIs. Hence, we can improve patient outcomes, reduce antimicrobial resistance, and decrease the spread of infections caused by multidrug-resistant organisms of biofilm-associated UTIs in all age groups of catheterized and non-catheterized patients visiting Dr. N. D. Desai Faculty of Medical Science and Research, Nadiad, Gujarat, during the study period. Materials and Methods: A prospective study was done to check the prevalence of biofilm production in catheterized and non-catheterized patients and their antimicrobial susceptibility pattern isolated from urine samples for a period of 1 year (from July 2022 to June 2023) at the Department of Microbiology, Dr. N. D. Desai Faculty of Medical Science and Research, Nadiad, Gujarat. The results of the microbiological profile and their susceptibility pattern were tabulated and statistically analyzed. Results: Out of 1360 urine samples, 370 samples grew pathogen. (GPC: 67, GNB: 319, and 16 of them grew 2 pathogens). Biofilm production was found in 78 (20.2%) of pathogens isolated from catheterized and non-catheterized patients. Commonly isolated pathogen was Gram-negative bacilli 82.6% followed by Gram-positive cocci 17.4%. Escherichia coli (67.4%) was the most common isolate found followed by Enterococcus spp. (13.5%), Klebsiella spp. (6.2%), Pseudomonas spp. (4.2%), Staphylococcus spp. (2.7%), Proteus spp. (2%), Enterobacter spp. (1.3%), Acinetobacter spp. (1.3%), Staphylococcus aureus (1.3%), and Citrobacter spp. (0.2%). Conclusion: UTIs are the most common infection in the community as well as health-care-associated infections. A biofilm-producing pathogen is more resistant to antimicrobial agents. Hence, it is necessary to detect biofilm formation at an early stage along with an antimicrobial susceptibility test to decrease the usage of last resort antimicrobial agents and the high costs of individual’s health as well as the health-care system around the world, particularly in developing countries.