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<p>Catheter-associated urinary tract infections (CAUTIs) are a major healthcare challenge due to bacterial biofilm formation, which protects pathogens from antibiotics and host immune responses. Three phenotypic biofilm detection methods—Microplate assay, Tube Method, and Modified Congo Red Agar (MCRA)— were compared using bacterial isolates from catheter tips and urine samples. The Microplate assay, considered the reference standard, detected biofilm in 88.6% of catheter isolates and 78.6% of urine isolates. Notably, 44% of urine samples showed no microbial growth, likely due to prior antibiotic use. In catheter-derived samples, CRA showed higher sensitivity (81.8%) and specificity (61.5%) than the Tube method (72.7% and 46.2%, respectively). PPV and NPV were 87.0% and 46.2% for CRA, and 82.2% and 22.7% for Tube. Both methods performed less reliably in urine isolates. Strong biofilm formation was more prevalent in catheter isolates (62.5%) than in urine isolates (44.6%) and was associated with higher antimicrobial resistance. Gentamicin was most effective against urine isolates (85.7%), whereas Imipenem showed highest efficacy in catheter isolates (47.7%). These findings provide practical guidance for microbiology laboratories, especially in low-resource settings, by identifying reliable phenotypic methods for biofilm screening. Overall, sensitive biofilm detection combined with targeted antibiotic susceptibility testing is crucial for effective CAUTI management and antimicrobial stewardship.</p>

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Comparative analysis of biofilm detection methods and antibiotic resistance in catheter-associated uropathogens: a cross-sectional study from Syria

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月17日

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  • Walid Khaddam,
  • Bushra Durgham

摘要

Catheter-associated urinary tract infections (CAUTIs) are a major healthcare challenge due to bacterial biofilm formation, which protects pathogens from antibiotics and host immune responses. Three phenotypic biofilm detection methods—Microplate assay, Tube Method, and Modified Congo Red Agar (MCRA)— were compared using bacterial isolates from catheter tips and urine samples. The Microplate assay, considered the reference standard, detected biofilm in 88.6% of catheter isolates and 78.6% of urine isolates. Notably, 44% of urine samples showed no microbial growth, likely due to prior antibiotic use. In catheter-derived samples, CRA showed higher sensitivity (81.8%) and specificity (61.5%) than the Tube method (72.7% and 46.2%, respectively). PPV and NPV were 87.0% and 46.2% for CRA, and 82.2% and 22.7% for Tube. Both methods performed less reliably in urine isolates. Strong biofilm formation was more prevalent in catheter isolates (62.5%) than in urine isolates (44.6%) and was associated with higher antimicrobial resistance. Gentamicin was most effective against urine isolates (85.7%), whereas Imipenem showed highest efficacy in catheter isolates (47.7%). These findings provide practical guidance for microbiology laboratories, especially in low-resource settings, by identifying reliable phenotypic methods for biofilm screening. Overall, sensitive biofilm detection combined with targeted antibiotic susceptibility testing is crucial for effective CAUTI management and antimicrobial stewardship.