Biofilm Formation, Antimicrobial Resistance and Biofilm-Related Genes among Uropathogens Isolated from Catheterized Uro-Oncology Patients

Abstract

Background & Objective: Despite the critical importance of catheter as an indwelling medical device, its prolonged utilization in hospitalized patients may lead to infection. This study aimed to identify distribution of uropathogenic bacteria isolated from catheterized uro-oncology patients, their biofilm production, and antimicrobial resistance patterns to generally used antibiotics. Materials & Methods: The urine samples of catheterized urology cancer patients were collected for urinalysis and urine culture. Then capability of biofilm production was detected by Congo red agar method, tube method, and microtiter plate assay. Antimicrobial susceptibility test was also performed using the Kirby–Bauer disc diffusion method on Muller–Hinton agar. Subsequently, polymerase chain reaction (PCR) assays were used to detect the biofilm encoding genes. Results: Of the 100 urinary catheter samples, 76 isolates were recovered from urinary catheters of 52 patients. Escherichia coli was established to be the most frequent pathogen isolated from the urine of patients followed by Pseudomonas and Staphylococcus. All of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) isolates were found to be biofilm producers. All studied isolates were found resistant to ampicillin, amoxicillin, and cephalexin. All biofilm- producer MRSA and Pseudomonas isolates were found to harbor the virulence genes studied. Both imipenem and fosfomycin were the most effective antibiotics against isolated bacteria. Conclusion: In our study virulent pathogens with highly- resistant profile and potential to form biofilm were isolated from uro-oncology patients. Therefore, the current study highlights the significance of antibiotic resistance which can lead to treatment failure.