Magnitude of Biofilm Formation and Antimicrobial Resistance Pattern of Bacteria Isolated from Urinary Catheterized Inpatients of Jimma University Medical Center, Southwest Ethiopia.

Netsanet Awoke,Lule Teshager,Tesfaye Kassa

doi:10.1155/2019/5729568

Netsanet Awoke, Lule Teshager + Show 1 more

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https://doi.org/10.1155/2019/5729568

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Abstract

Biofilm formation is one of the features of most bacteria. Catheterization in medicine is a source of highly resistant bacterial infections, and those bacteria respond poorly to antimicrobial therapy. Bacterial biofilm features were not described from catheterized inpatients in Ethiopia as its formation is known to afford antimicrobial resistance and challenge patient management. The aim of this study was to isolate catheter-associated urinary bacterial pathogens, their biofilm formation, and antimicrobial susceptibility pattern among inpatients of Jimma University Medical Center (JUMC) in Southwest Ethiopia. A prospective cross-sectional study was conducted among urinary catheterized inpatients of JUMC from February to August 2016. A total of 143 study participants were enrolled consecutively in this study. Urine samples were collected from catheterized patients and processed using a standard bacteriological protocol for isolation and identification. Evaluation of in vitro biofilm formation and antimicrobial susceptibility pattern of uropathogenic bacteria was done using microtiter plates and disk diffusion method, respectively. Data were cleaned, coded, and entered into SPSS version 20 for analysis. All statistical test values of p < 0.05 were considered statistically significant. From all study participants, mean age was 44 years. Sixty bacterial strains were recovered from 57 urinary catheterized inpatients among which 54 of them were monomicrobial (94.7%). The remaining six bacterial strains were recovered from three study participants each with two bacterial isolates. The predominant bacterial isolates were Gram-negative bacteria with E. coli turning out first. About 80% of bacterial isolates were biofilm formers. The majority of the bacteria were resistant to commonly prescribed antimicrobial agents. In conclusion, the majority of bacterial uropathogen isolates were Gram-negative, biofilm formers, and resistant to commonly prescribed antimicrobial agents. Relatively ciprofloxacin, nitrofurantoin, and amikacin were highly effective against most isolated bacteria.

Highlights

Urinary tract infections (UTIs) account up to 40% of all hospital acquired infections around the globe, and more than 80% of nosocomial UTIs are usually associated with catheterization [1,2,3]
Despite catheter is generally critical indwelling medical device and indispensable in medicine, its prolonged use in hospitalized patients expose them to infection. is process allows bacteria to enter to the bladder and form biofilm either through migrating along the intra- or extraluminal parts of the catheter surface [11, 12]. is bacterial feature of biofilm production is very important in contributing to catheter-associated UTIs in hospital setting
Six isolates were recovered from three catheterized inpatients each with the following isolates as a mixed infection: S. aureus and Enterobacter spp.; E. coli and Klebssiella spp.; and Klebssiella spp. and S. aureus

Summary

Introduction

Urinary tract infections (UTIs) account up to 40% of all hospital acquired infections around the globe, and more than 80% of nosocomial UTIs are usually associated with catheterization [1,2,3]. High prevalence of catheterization in a hospital setup leads to a large cumulative burden of catheterassociated UTIs with the resultant rise in morbidity and mortality [4]. Bacterial biofilm is a complex community of microorganisms with production of extracellular polysaccharide matrix on damaged tissue and surface of indwelling medical devices including urinary catheter. Is bacterial feature of biofilm production is very important in contributing to catheter-associated UTIs in hospital setting. On the other hand, is highly associated with the bacteria to afford inherent antimicrobial resistance such as the host’s defense mechanisms and exogenous antimicrobial agents. It has been determined that biofilm-forming bacteria have shown resistance to antimicrobials as much as 1000 times more than their planktonic counterparts [1, 13]. Chronic and complicated UTIs can result in discomfort to the patient and prolonged hospital stay. is in turn increases hospital burdens, health care costs for diagnosis and treatment as well as higher morbidity and mortality of patients [1, 14,15,16]

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