Isolation of Uropathogensin Catheterized Patients and Their Biofilm Formation Capacity and Comparison of Biofilm Formation by Two Different Methods in a Tertiary Care Hospital of North India

Abstract

Introduction: Urinary tract infections (UTIs) account for 30% of all hospital acquired infections (HAI). Of these 30% infections, 80% of them are estimated to be catheter-associated. According to the CDC, Catheter associated urinary tract infections (CAUTIs) are defined as an UTI developing in a patient after 48 hours of implantation of an indwelling urinary catheter. In most of the cases, the underlying cause of CAUTI is formation of a pathogenic biofilm on the surface of the indwelling urinary catheter.Most important medical significance of biofilm is decrease in susceptibility of antimicrobial agents. Materials and Methods: The present study was a cross sectional study, conducted over a period of one year.A total of 468 subjects (patients) were included in this study.After taking informed written consent from each patient, Urine samples of catheterized patients were received and sentfor bacterial culture and sensitivity in the Microbiology section of Central laboratory (an ISO 15189:2012 certified, NABL accredited Laboratory) of SMIH, Patel Nagar, Dehradun. Samples were collected taking all aseptic precautions, out of which 100 samples were processed and reported as per the standard methods. Results: Taking Tissue culture plate (TCP) as gold standard, sensitivity of Tube method (TM) method was found to be 76.4%; specificity 71.5%.64.1% of Escherichia coli isolates were positive by both tube method and tissue culture plate method; However, 75% of Klebsiella pneumonia isolates were positive by tissue culture plate method. Pseudomonas aeruginosa showed a positivity of 88.8% by tissue culture plate method. Conclusion: Based on this study, we conclude that Catheter associated urinary tract infections are the most common nosocomial infections. Most aspects of the diagnosis, treatment, and prevention of CAUTI are influenced by the tenacity of biofilm-associated uropathogens. Based on our study results, we can conclude that TCP is a quantitative and reliable method to detect biofilm forming micro-organisms. When compared to TM, the TCP can be recommended as a general screening method for detection of biofilm producing bacteria in laboratories.