BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN

Amr Abdu Mohammed Saleh; Hassan A. Al-Shamahy; Roqiaa Mohammed Ahmed Al-Hrazi; Bushra Mohammed Jaadan; Rahma Taher Farea AL-Magrami; Amani Abdulhakeem Al-Sharani

doi:10.22270/ujpr.v4i6.329

Amr Abdu Mohammed Saleh Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen. Laboratory Department, Faculty of Medicine and Health Sciences University of Science and Technology, Yemen.
Hassan A. Al-Shamahy Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Roqiaa Mohammed Ahmed Al-Hrazi Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Bushra Mohammed Jaadan Medicinal Chemistry, Faculty of Pharmacy, Sana’a University, Republic of Yemen.
Rahma Taher Farea AL-Magrami Medical Microbiology and Clinical Immunology Department, Faculty of Medicine and Health Sciences, Sana’a University, Republic of Yemen.
Amani Abdulhakeem Al-Sharani Oral Medicine and Periodontology Department, College of Dentistry, University of Sciences and Technology, Yemen.

DOI https://doi.org/10.22270/ujpr.v4i6.329

Abstract

Objective: Biofilm formation by uropathogens on the surface of indwelling medical devices can inflict obstinate or recurring infection, thought-provoking antimicrobial therapy. This study included 227 patients with indwelling urinary catheters and suffering from CAUTI. They were analyzed for biofilm formation and antibiogram susceptibility, 59.4% were males and 40.6% were females.

Methods: Ensuing phenotypic identification of isolated bacteria, antibiotic sensitivity test was performed by modified Kirby–Bauer disc diffusion method following the Clinical and Laboratory Standards Institute (CLSI 2015) guidelines; Biofilm-forming uropathogens were detected by the tissue culture plate (TCA) method.

Results: The predominant uropathogen in catheter-associated UTIs (CAUTIs) was Escherichia coli 46.3%, followed by K. pneumoniae18.5%, P. aeruginosa 11.9%,7%, S. coagulase negative 5.7%, S. aureus 4.8%, Enterobacter spp. 4.4%, E. faecalis 1.3%. The total rate of biofilm producer bacteria was 49.3% (21.1% high producers, 28.2% moderate producers). Prime biofilm producers were E. coli 60% with OR=8.6 (p=0.002), followed by K. pneumoniae 57.1% with OR=10.1 (p=0.002), and P. aeruginosa 37% with OR=6.6 (p=0.02). Gram-negative biofilm producers found 100%, 100%, 88.6%, 82.9%, 81.9%, 80.9%, and 72.4%, 40%, 33% resistant to ampicillin , amoxyclave, cotrimoxazole, ceftraxone, nalidixic acid, ciprofloxacin, cefotaxime, nitrofurantoin and amikacin respectively.

Conclusion: In conclusion, a high antimicrobial resistance was observed in biofilm producers than non-biofilm producers. Of recommended antimicrobial therapies for CAUTIs, ampicillin and amoxicillin-clavulanate were the least active antibiotics, whereas imipenem and amikacin were found as the most effectual for gram-negative biofilm producer. Likewise, penicillin and erythromycin were the least active antibiotics, whereas vancomycin, and rifampicin were found as the most effective antibiotic for Gram-positive biofilm producer.

Peer Review History:

Received 10 December 2019; Revised 26 December; Accepted 4 January, Available online 15 January 2020

Academic Editor: Rola Jadallah, Arab American University, Palestine, rola@aauj.edu

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