Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation

Background. A catheter-associated urinary tract infection (CA-UTI) is preceded by biofilm formation, which is related to several risk factors such as gender, age, diabetic status, duration of catheterization, bacteriuria before catheterization, virulence gene factor, and antibiotic usage. Aims. This...

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Main Authors: Wani Devita Gunardi, Anis Karuniawati, Rainy Umbas, Saptawati Bardosono, Aida Lydia, Amin Soebandrio, Dodi Safari
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Microbiology
Online Access:http://dx.doi.org/10.1155/2021/8869275
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author Wani Devita Gunardi
Anis Karuniawati
Rainy Umbas
Saptawati Bardosono
Aida Lydia
Amin Soebandrio
Dodi Safari
author_facet Wani Devita Gunardi
Anis Karuniawati
Rainy Umbas
Saptawati Bardosono
Aida Lydia
Amin Soebandrio
Dodi Safari
author_sort Wani Devita Gunardi
collection DOAJ
description Background. A catheter-associated urinary tract infection (CA-UTI) is preceded by biofilm formation, which is related to several risk factors such as gender, age, diabetic status, duration of catheterization, bacteriuria before catheterization, virulence gene factor, and antibiotic usage. Aims. This study aims to identify the microbial composition of catheter samples, including its corresponding comparison with urine samples, to determine the most important risk factors of biofilm formation and characterize the virulence gene factors that correlate with biofilm formation. Methods. A longitudinal cross-sectional study was conducted on 109 catheterized patients from September 2017 to January 2018. The risk factors were obtained from the patients’ medical records. All catheter and urine samples were cultured after removal, followed by biomass quantification. Isolate identification and antimicrobial susceptibility testing were performed using the Vitex2 system. Biofilm-producing bacteria were identified by the Congo Red Agar (CRA) method. A PCR test characterized the virulence genes of dominant bacteria (E. coli). All data were collected and processed for statistical analysis. Results. Out of 109 catheterized patients, 78% of the catheters were culture positive, which was higher than those of the urine samples (37.62%). The most common species isolated from the catheter cultures were Escherichia coli (28.1%), Candida sp. (17.8%), Klebsiella pneumoniae (15.9%), and Enterococcus faecalis (13.1%). E. coli (83.3%) and E. faecalis (78.6%) were the main isolates with a positive CRA. A statistical analysis showed that gender and duration prior to catheterization were associated with an increased risk of biofilm formation p<0.05. Conclusion. E. coli and E. faecalis were the most common biofilm-producing bacteria isolated from the urinary catheter. Gender and duration are two risk factors associated with biofilm formation, therefore determining the risk of CAUTI. The presence of PapC as a virulence gene encoding pili correlates with the biofilm formation. Biofilm-producing bacteria, female gender, duration of catheterization (more than five days), and PapC gene presence have strong correlation with the biofilm formation. To prevent CAUTI, patients with risk factors should be monitored by urinalysis tests to detect earlier the risk of biofilm formation.
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spelling doaj-art-74ca53f68c814529ac3f65927c6e324c2025-02-03T06:06:27ZengWileyInternational Journal of Microbiology1687-918X1687-91982021-01-01202110.1155/2021/88692758869275Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm FormationWani Devita Gunardi0Anis Karuniawati1Rainy Umbas2Saptawati Bardosono3Aida Lydia4Amin Soebandrio5Dodi Safari6Department of Clinical Microbiology, Faculty of Medicine, Krida Wacana Christian University, Jakarta 1151, IndonesiaDepartment of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta 10320, IndonesiaDepartment of Urology, FMUI-CMH, Jakarta 10430, IndonesiaDepartment of Nutrition, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaDepartment of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaEijkman Institute for Molecular Biology, Jakarta 10430, IndonesiaEijkman Institute for Molecular Biology, Jakarta 10430, IndonesiaBackground. A catheter-associated urinary tract infection (CA-UTI) is preceded by biofilm formation, which is related to several risk factors such as gender, age, diabetic status, duration of catheterization, bacteriuria before catheterization, virulence gene factor, and antibiotic usage. Aims. This study aims to identify the microbial composition of catheter samples, including its corresponding comparison with urine samples, to determine the most important risk factors of biofilm formation and characterize the virulence gene factors that correlate with biofilm formation. Methods. A longitudinal cross-sectional study was conducted on 109 catheterized patients from September 2017 to January 2018. The risk factors were obtained from the patients’ medical records. All catheter and urine samples were cultured after removal, followed by biomass quantification. Isolate identification and antimicrobial susceptibility testing were performed using the Vitex2 system. Biofilm-producing bacteria were identified by the Congo Red Agar (CRA) method. A PCR test characterized the virulence genes of dominant bacteria (E. coli). All data were collected and processed for statistical analysis. Results. Out of 109 catheterized patients, 78% of the catheters were culture positive, which was higher than those of the urine samples (37.62%). The most common species isolated from the catheter cultures were Escherichia coli (28.1%), Candida sp. (17.8%), Klebsiella pneumoniae (15.9%), and Enterococcus faecalis (13.1%). E. coli (83.3%) and E. faecalis (78.6%) were the main isolates with a positive CRA. A statistical analysis showed that gender and duration prior to catheterization were associated with an increased risk of biofilm formation p<0.05. Conclusion. E. coli and E. faecalis were the most common biofilm-producing bacteria isolated from the urinary catheter. Gender and duration are two risk factors associated with biofilm formation, therefore determining the risk of CAUTI. The presence of PapC as a virulence gene encoding pili correlates with the biofilm formation. Biofilm-producing bacteria, female gender, duration of catheterization (more than five days), and PapC gene presence have strong correlation with the biofilm formation. To prevent CAUTI, patients with risk factors should be monitored by urinalysis tests to detect earlier the risk of biofilm formation.http://dx.doi.org/10.1155/2021/8869275
spellingShingle Wani Devita Gunardi
Anis Karuniawati
Rainy Umbas
Saptawati Bardosono
Aida Lydia
Amin Soebandrio
Dodi Safari
Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation
International Journal of Microbiology
title Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation
title_full Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation
title_fullStr Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation
title_full_unstemmed Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation
title_short Biofilm-Producing Bacteria and Risk Factors (Gender and Duration of Catheterization) Characterized as Catheter-Associated Biofilm Formation
title_sort biofilm producing bacteria and risk factors gender and duration of catheterization characterized as catheter associated biofilm formation
url http://dx.doi.org/10.1155/2021/8869275
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