Unraveling Biofilm-Forming Uropathogens: Isolation and Antimicrobial Resistance Patterns at Nepal Police Hospital, Kathmandu

揭示形成生物膜的泌尿道病原体:尼泊尔加德满都警察医院的分离和抗菌素耐药模式

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Abstract

BACKGROUND: Urinary Tract Infections (UTIs) are common bacterial infections with growing treatment challenges due to the rise of antimicrobial resistance. Additionally, the characteristics of the pathogens responsible for UTIs are changing, primarily due to the emergence of biofilms. Biofilms, which are structured microbial communities, pose a significant public health threat because of their inherent resistance to antimicrobial treatments. Hence, this cross-sectional study aimed to isolate and characterize uropathogenic bacteria capable of forming biofilm and exhibiting antimicrobial resistance among patients seeking microbiology laboratory services at the Nepal Police Hospital. METHODS: Uropathogens were isolated from midstream urine samples using CLED, Blood, and MacConkey agar. Standard microbiological techniques were employed for identification of pathogen. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disc diffusion method, and biofilm formation was assessed using the microtiter plate method. RESULTS: Of the 2081 samples analyzed, significant bacterial growth was observed in 184 (8.84%) of the samples. The predominant pathogens were Escherichia coli (39.7%), followed by Klebsiella pneumoniae (26.6%) and Pseudomonas aeruginosa (7.8%). Amikacin, levofloxacin, and tigecycline were the most effective antibiotics. Among the isolates, 32 (17.39%) were confirmed as MDR. Biofilm production was confirmed in six isolates (3.26%), with two Enterococcus faecalis and one Klebsiella oxytoca identified as strong biofilm producers, while two Klebsiella pneumoniae and one Acinetobacter spp. exhibited weak biofilm production. Statistical analysis showed no significant correlation between antibiotic resistance and biofilm production (p > 0.05). CONCLUSION: Biofilm-forming uropathogens present substantial challenges in UTI treatment. Importantly, our study did not find a correlation between antibiotic resistance and biofilm production, suggesting that these traits may be independent or influenced by different pathogenic mechanisms.

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