1887

Abstract

A group of biofilm-producing bacteria isolated from patients with urinary tract infections was evaluated, identifying the main factors contributing to biofilm formation. Among the 156 isolates, 58 (37.2 %) were biofilm producers. The bacterial species (<0.001), together with patient’s gender ( = 0.022), were the factors with the highest influence for biofilm production. There was also a strong correlation of catheterization with biofilm formation, despite being less significant ( = 0.070) than species or gender. In fact, some of the bacteria isolated were biofilm producers in all cases. With regard to resistance profile among bacterial isolates, β-lactam antibiotics presented the highest number of cases/percentages – ampicillin (32/55.2 %), cephalothin (30/51.7 %), amoxicillin/clavulanic acid (22/37.9 %) – although the carbapenem group still represented a good therapeutic option (2/3.4 %). Quinolones (nucleic acid synthesis inhibitors) also showed high resistance percentages. Furthermore, biofilm production clearly increases bacterial resistance. Almost half of the biofilm-producing bacteria showed resistance against at least three different groups of antibiotics. Bacterial resistance is often associated with catheterization. Accordingly, intrinsic (age and gender) and extrinsic (hospital unit, bacterial isolate and catheterization) factors were used to build a predictive model, by evaluating the contribution of each factor to biofilm production. In this way, it is possible to anticipate biofilm occurrence immediately after bacterial identification, allowing selection of a more effective antibiotic (among the susceptibility options suggested by the antibiogram) against biofilm-producing bacteria. This approach reduces the putative bacterial resistance during treatment, and the consequent need to adjust antibiotherapy.

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2014-03-01
2020-01-24
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References

  1. Al-Mathkhury H. J. F. , Ali A. S. , Ghafil J. A. . ( 2011; ). Antagonistic effect of bacteriocin against urinary catheter associated Pseudomonas aeruginosa biofilm. . N Am J Med Sci 3:, 367–370. [CrossRef] [PubMed]
    [Google Scholar]
  2. Bonkat G. , Widmer A. F. , Rieken M. , van der Merwe A. , Braissant O. , Müller G. , Wyler S. , Frei R. , Gasser T. C. , Bachmann A. . ( 2013; ). Microbial biofilm formation and catheter-associated bacteriuria in patients with suprapubic catheterisation. . World J Urol 31:, 565–571. [CrossRef] [PubMed]
    [Google Scholar]
  3. Christensen G. D. , Simpson W. A. , Bisno A. L. , Beachey E. H. . ( 1982; ). Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. . Infect Immun 37:, 318–326.[PubMed]
    [Google Scholar]
  4. Christensen G. D. , Simpson W. A. , Younger J. J. , Baddour L. M. , Barrett F. F. , Melton D. M. , Beachey E. H. . ( 1985; ). Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. . J Clin Microbiol 22:, 996–1006.[PubMed]
    [Google Scholar]
  5. CLSI ( 2008; ) Performance Standards for Antimicrobial Susceptibility Testing; M100-S18. . Wayne, PA:: Clinical and Laboratory Standards Institute;.
  6. Comité de l’Antibiogramme de la Société Française de Microbiologie ( 2008; ). Paris:: Société Française de Microbiologie;.
  7. Dohnt K. , Sauer M. , Müller M. , Atallah K. , Weidemann M. , Gronemeyer P. , Rasch D. , Tielen P. , Krull R. . ( 2011; ). An in vitro urinary tract catheter system to investigate biofilm development in catheter-associated urinary tract infections. . J Microbiol Methods 87:, 302–308. [CrossRef] [PubMed]
    [Google Scholar]
  8. Donlan R. M. , Costerton J. W. . ( 2002; ). Biofilms: survival mechanisms of clinically relevant microorganisms. . Clin Microbiol Rev 15:, 167–193. [CrossRef] [PubMed]
    [Google Scholar]
  9. Eshwarappa M. , Dosegowda R. , Aprameya I. V. , Khan M. W. , Kumar P. S. , Kempegowda P. . ( 2011; ). Clinico-microbiological profile of urinary tract infection in south India. . Indian J Nephrol 21:, 30–36. [CrossRef] [PubMed]
    [Google Scholar]
  10. Foxman B. , Wu J. , Farrer E. C. , Goldberg D. E. , Younger J. G. , Xi C. . ( 2012; ). Early development of bacterial community diversity in emergently placed urinary catheters. . BMC Res Notes 5:, 332. [CrossRef] [PubMed]
    [Google Scholar]
  11. Guggenbichler J. P. , Assadian O. , Boeswald M. , Kramer A. . ( 2011; ). Incidence and clinical implication of nosocomial infections associated with implantable biomaterials – catheters, ventilator-associated pneumonia, urinary tract infections. . GMS Krankenhhyg Interdiszip 6:, 18.[PubMed]
    [Google Scholar]
  12. Guiton P. S. , Hung C. S. , Hancock L. E. , Caparon M. G. , Hultgren S. J. . ( 2010; ). Enterococcal biofilm formation and virulence in an optimized murine model of foreign body-associated urinary tract infections. . Infect Immun 78:, 4166–4175. [CrossRef] [PubMed]
    [Google Scholar]
  13. Hassan A. , Usman J. , Kaleem F. , Omair M. , Khalid A. , Iqbal M. . ( 2011; ). Evaluation of different detection methods of biofilm formation in the clinical isolates. . Braz J Infect Dis 15:, 305–311.[PubMed] [CrossRef]
    [Google Scholar]
  14. Hoyle B. D. , Wong C. K. , Costerton J. W. . ( 1992; ). Disparate efficacy of tobramycin on Ca2+-, Mg2+-, and HEPES-treated Pseudomonas aeruginosa biofilms. . Can J Microbiol 38:, 1214–1218. [CrossRef] [PubMed]
    [Google Scholar]
  15. Lynch A. S. , Robertson G. T. . ( 2008; ). Bacterial infections and fungal biofilm infections. . Annu Rev Med 59:, 415–428. [CrossRef] [PubMed]
    [Google Scholar]
  16. National Nosocomial Infections Surveillance System ( 2002; ). National Nosocomial Infections Surveillance System Report (NNIS), data summary from January 1992 through June. . Am J Infect Control 30:, 458–475. [CrossRef] [PubMed]
    [Google Scholar]
  17. Niveditha S. , Pramodhini S. , Umadevi S. , Kumar S. , Stephen S. . ( 2012; ). The isolation and the biofilm formation of uropathogens in the patients with catheter associated urinary tract infections (UTIs). . J Clin Diagn Res 6:, 1478–1482.[PubMed]
    [Google Scholar]
  18. Ponnusamy P. , Natarajan V. , Sevanan M. . ( 2012; ). In vitro biofilm formation by uropathogenic Escherichia coli and their antimicrobial susceptibility pattern. . Asian Pacific J Trop Med 5:, 210–213. [CrossRef] [PubMed]
    [Google Scholar]
  19. PPCIRA ( 2013; ). Programa de Prevenção e Controlo de Infeções e de Resistência aos Antimicrobianos, Orientações Programáticas. Direção Geral de Saúde, Ministério da Saúde;, Lisboa, Portugal:.
    [Google Scholar]
  20. Regev-Shoshani G. , Ko M. , Crowe A. , Av-Gay Y. . ( 2011; ). Comparative efficacy of commercially available and emerging antimicrobial urinary catheters against bacteriuria caused by E. coli in vitro. . Urology 78:, 334–339. [CrossRef] [PubMed]
    [Google Scholar]
  21. Reid G. , Charbonneau-Smith R. , Lam D. , Kang Y. S. , Lacerte M. , Hayes K. C. . ( 1992; ). Bacterial biofilm formation in the urinary bladder of spinal cord injured patients. . Paraplegia 30:, 711–717. [CrossRef] [PubMed]
    [Google Scholar]
  22. Ronald A. . ( 2002; ). The etiology of urinary tract infection: traditional and emerging pathogens. . Am J Med 113: (Suppl. 1A), 14S–19S. [CrossRef] [PubMed]
    [Google Scholar]
  23. Sanchez C. J. Jr , Mende K. , Beckius M. L. , Akers K. S. , Romano D. R. , Wenke J. C. , Murray C. K. . ( 2013; ). Biofilm formation by clinical isolates and the implications in chronic infections. . BMC Infect Dis 13:, 47. [CrossRef] [PubMed]
    [Google Scholar]
  24. Singhai M. , Malik A. , Shahid M. , Malik M. A. , Goyal R. . ( 2012; ). A study on device-related infections with special reference to biofilm production and antibiotic resistance. . J Global Infect Dis 4:, 193–198. [CrossRef] [PubMed]
    [Google Scholar]
  25. Soto S. M. , Smithson A. , Martinez J. A. , Horcajada J. P. , Mensa J. , Vila J. . ( 2007; ). Biofilm formation in uropathogenic Escherichia coli strains: relationship with prostatitis, urovirulence factors and antimicrobial resistance. . J Urol 177:, 365–368. [CrossRef] [PubMed]
    [Google Scholar]
  26. Stahlhut S. G. , Struve C. , Krogfelt K. A. , Reisner A. . ( 2012; ). Biofilm formation of Klebsiella pneumoniae on urethral catheters requires either type 1 or type 3 fimbriae. . FEMS Immunol Med Microbiol 65:, 350–359. [CrossRef] [PubMed]
    [Google Scholar]
  27. Stickler D. J. . ( 1996; ). Bacterial biofilms and the encrustation of urethral catheters. . Biofouling 9:, 293–305. [CrossRef]
    [Google Scholar]
  28. Stickler D. J. , King J. , Nettleton J. , Winters C. . ( 1993a; ). The structure of urinary catheter encrusting bacterial biofilms. . Cells Materials 3:, 315–319.
    [Google Scholar]
  29. Stickler D. , Ganderton L. , King J. , Nettleton J. , Winters C. . ( 1993b; ). Proteus mirabilis biofilms and the encrustation of urethral catheters. . Urol Res 21:, 407–411. [CrossRef] [PubMed]
    [Google Scholar]
  30. Suci P. A. , Mittelman M. W. , Yu F. P. , Geesey G. G. . ( 1994; ). Investigation of ciprofloxacin penetration into Pseudomonas aeruginosa biofilms. . Antimicrob Agents Chemother 38:, 2125–2133. [CrossRef] [PubMed]
    [Google Scholar]
  31. Tamilvanan S. , Venkateshan N. , Ludwig A. . ( 2008; ). The potential of lipid- and polymer-based drug delivery carriers for eradicating biofilm consortia on device-related nosocomial infections. . J Control Release 128:, 2–22. [CrossRef] [PubMed]
    [Google Scholar]
  32. Tenke P. , Kovacs B. , Jäckel M. , Nagy E. . ( 2006; ). The role of biofilm infection in urology. . World J Urol 24:, 13–20. [CrossRef] [PubMed]
    [Google Scholar]
  33. Tenke P. , Köves B. , Nagy K. , Hultgren S. J. , Mendling W. , Wullt B. , Grabe M. , Wagenlehner F. M. , Cek M. . & other authors ( 2012; ). Update on biofilm infections in the urinary tract. . World J Urol 30:, 51–57. [CrossRef] [PubMed]
    [Google Scholar]
  34. Tielen P. , Narten M. , Rosin N. , Biegler I. , Haddad I. , Hogardt M. , Neubauer R. , Schobert M. , Wiehlmann L. , Jahn D. . ( 2011; ). Genotypic and phenotypic characterization of Pseudomonas aeruginosa isolates from urinary tract infections. . Int J Med Microbiol 301:, 282–292. [CrossRef] [PubMed]
    [Google Scholar]
  35. Tunney M. M. , Jones D. S. , Gorman S. P. . ( 1999; ). Biofilm and biofilm-related encrustation of urinary tract devices. . Methods Enzymol 310:, 558–566. [CrossRef] [PubMed]
    [Google Scholar]
  36. Wasfi R. , Abd El-Rahman O. A. , Mansour L. E. , Hanora A. S. , Hashem A. M. , Ashour M. S. . ( 2012; ). Antimicrobial activities against biofilm formed by Proteus mirabilis isolates from wound and urinary tract infections. . Indian J Med Microbiol 30:, 76–80. [CrossRef] [PubMed]
    [Google Scholar]
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