Analysis of Proteus mirabilis distribution in multi-species biofilms on urinary catheters and determination of bacteria resistance to antimicrobial agents.

The objectives of the investigation presented in this paper were: to examine the frequency of P. mirabilis isolation from catheters and assess the complexity of multi-species biofilms which these bacteria form, as well as to determine the vulnerability of planktonic and sessile P. mirabilis populations to popular antibiotics and compare it to the susceptibility of other Gram-negative bacteria isolated as associated flora from multi-species biofilm. 88 urological catheters, collected from long-term catheterized patients were examined. Uropathogens were recovered from the catheter surface by sonication, and identified on standard diagnostic media. The broth-microdilution method and the MBEC High-throughput Screening assay were used to determine the bacterial resistance to antibiotics. 279 microorganisms were isolated from 88 urinary catheter biofilms. The Enterobacteriaceae family were the most frequently detected bacteria (53.2% of isolates), whereas Proteus spp. isolation accounted for 17.9%, which placed these bacilli on the third position in the Enterobacteraceae family. Among all the tested drugs, amikacin and cephalosporins (ceftriaxone, cefotaxime and cefaclor) exhibited the highest activity against P. mirabilis planktonic cells, 86% and 73% of strains were susceptible to these antibiotics, respectively. 100% of P. mirabilis sessile forms were resistant to cefepime, ciprofloxacin, gatifloxacin, and norfloxacin. Amikacin and ceftriaxone affected only 5% of sessile forms. The planktonic cells of the other studied uropathogens were mostly vulnerable to the all tested drugs (exception P. aeruginosa strains), the most effective of which occurred to be amikacin and cefepime. Obtained MBECs values were 2-512-fold higher than MICs assessed for planktonic forms.