European Journal of Molecular & Clinical Medicine

Abstract

Background & Method: Biofilm production is considered to be a major virulence factor associated with health care associated infections particularly with Catheter associated urinary tract infection (CAUTI) pathogens. This study is done to find out prevalence of antimicrobial resistance and biofilm production capacity in CAUTI pathogens in patients admitted to various ICUs of Shree Krishna Hospital, Karamsad, and diagnosed to be suffering with CAUTI based on NHSN definitions were included in study and subjected for antimicrobial susceptibility testing and in-vitro biofilm production test using micro-titre plate method. On the basis of same criteria 55 patients were included in this study. The clinical history of the patients and other details taken for various patient variable factors like age, gender, co-morbid conditions, indoor days, device days, final patient outcome and other lab based investigations done as indicator of active infection or sepsis from the electronic hospital database available on hospital information system, to determine the incidence of antimicrobial resistance, biofilm forming capacity, to determine risk factors associated and final patient outcome with biofilm formation in CAUTI pathogens isolated from ICU patients. Chi-square test was used to check the relation between the categorical variables while t test was applied in case of continuous variables. A p value less than 0.05 was considered as statistically significant.
Result: Among total 61 isolates recovered from 55 patients, 52.4% were biofilm producer. Most common isolates were pseudomonas aeruginosa (22.95%) followed by Enterococcus faecium (13.11%). Candida tropicalis and Klebsiella pneumoniae were seen among 11.47% each. Among gram negative organisms, most common resistant drug was ciprofloxacin (95.12%), followed by cefipime (87.80%), meropenam, piperacillin-tazobactem (85.37%).  Deaths were seen more in biofilm negative patients (14.29%) as compared to biofilm positive (7.41%).
Conclusion: It is evident that the CAUTI remains major indwelling device associated infection in ICU patients. The biofilm production is associated with 32 (52.4%) out of total 61 isolates of CAUTI in present study.