Multiple drug resistant bacterial biofilms on implanted catheters - a reservoir of infection.
BACKGROUND
Medical devices are an essential part of modern health-care, but its usage has led to the emergence of medical device associated infections otherwise known as Foreign-Body related infections (FBRIs). This is caused by bacterial adhesion and biofilm formation on their surfaces which act as a nidus of infection. These biofilms are resistant to antibacterial agents and host immune response. The antibiotics which are useful in treating planktonic forms cannot clear the biofilm and the device must usually be removed to resolve the infection.


OBJECTIVE
The main objective of the study was to identify the prevalence of bacterial biofilms on retrieved catheters which included vascular catheters (141) and Foley catheters (86) from patients and understand the nature of antibiotic resistant strains in these biofilms. MATERIALS USED :227 numbers of retrieved catheters which included vascular catheters (141nos) and Foley catheters (86 nos) were used in the study.These retrieved implants were from patients from neurosurgery ward of SCTIMST who had undergone selective neurosurgical procedures. Patients with pre-existing infections including brain abscess were not included in the study.These patients had no clinical infection or pyrexia. Skin swabs were taken from patients using intravascular devices after retrieval of catheter.


CONCLUSIONS
Among vascular catheters Staphylococcus species were the major isolate and among the isolates many of the strains were Methicillin and some were Vancomycin resistant. Among the Foley catheter isolates E. faecalis was the major isolate followed by E. coli, Staphylococcus species, Klebsiella species, Pseudomonas species, Citrobacter etc. Most of the strains were resistant to multiple antibiotics. Although the patients selected did not have any clinical symptoms of infection, the presence of multiple-drug resistant organisms as biofilm points to this niche which can constitute a threat for HAls and its resultant complications. This suggests that catheters should be removed as early as possible to prevent Biofilm development on them.
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SS
Pradeep Kumar
H V
HV
Easwer
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A
Maya Nandkumar
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001422:Bacterial Adhesion; D018441:Biofilms / Q000187:drug effects*; D057785:Catheters / Q000382:microbiology*; D015169:Colony Count, Microbial; D004352:Drug Resistance, Microbial; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D019635:Neurosurgical Procedures; D015995:Prevalence
D000900:Anti-Bacterial Agents