One of the cause of nosocomial urinary tract infection is urinary catheter usage (CAUTI). CAUTI is usually caused by Uropathogenic Eschericia coli (UPEC) that can produce biofilm and causes persistent infection, resistant to antibiotic.
Biofilm production on catheter happens on the 3rd day of hospitalization , it is usually caused by E.coli, which is a normal flora. The existence of virulence gene fimA and papC on E.coli can predict the production of biofilm and papC gene is statistically significant. E.coli’s sensitivity is not influenced by its ability to produce biofilm, but it is influenced by the existence of biofilm. Antibiotic does not reduce the production of biofilm, it is suspected that biofilm can increase antibiotic resistance and increase the number of normal flora in human’s body.
To detect biofilm producing bacteria’s resistance status, there are 2 tests that can be done, minimal biofilm inhibitory concentration (MBIC) and minimal biofilm eradication concentration (MBEC). For planktonic bacteria minimal inhibitory concentration can be tested. Antibiotics commonly used in nosocomial infection caused by urinary catheter placement are phosphomycin, ciprofloxacin, cefixime, amoxicilline clauvulanic acid, ceftriaxone, meropenem, and amykacine. Those antibiotics needed to be tested on their MIC and MBIC, therefore we can recommend which antibiotic have the best MIC and MBIC for planktonic bacteria and bacteria inside the biofilm.
Based on that background, research is needed to predict biofilm production on urinary catheter, to prevent CAUTI. The research was done with cross sectional design to assess genotype fimA, papC, hlyA, and sfaS with PCR method, and phenotype MIC, MBIC and risk factors influencing biofilms production in >48 hours catheter usage.
The research shows that phosphomycine is the most effective antibiotic for biofilm related infection. Women, catheter usage length, and bacteriuria is the predictor of biofilm production on urinary catheter. Foley catheter is usually replaced after 7 days. This study’s result recommends Foley catheter to be replaced after 5 days because biofilm production on catheter usually happens after 3 days and bacteria is released from the biofilm after 5 days.
The result was presented by dr. Wani Devita Gunardi, SpMK(K) on his doctoral hearing, Monday, July 1st 2019, in IMERI Auditorium. The dissertation is titled “Biofilm Production on Urinary Catheter Predictor: virulence genotype, and antibiotic resistance phenotype on Escherecia coli”.
Head examiner Prof. Dr. dr. Suhendro, SpPD-KPTI along with other examiner Prof. Dr. dr. Saptawati Bardosono, MSc; dr. Aida Lydia, SpPD-KGH, PhD; Dodi Safari, PhD; and Prof. Dr. dr. Kuntaman, MS, SpMK(K) can be seen on the hearing. At the end of the hearing Prof. dr. Saleha Sungkat, DAP&E, MS, SpParK as the head of the hearing inaugurated dr. Wani Devita Gunardi, SpMK(K) as a Doctor in Medical science FMUI.
On their closing speech, promotor Prof. dr. Amin Soebandrio, PhD, SpMK(K) along with co-promotor Prof. dr. Rainy Umbas, SpU(K), PhD and dr. Anis Karuniawati, SpMK(K), PhD, hoped that this research can be made into information guideline saying catheter user for more than 3 days should be checked for bacteriuria as the sign of biofilm production on catheter.
(Public Relations FKUI)