Mahgoub Mohamed Anwar, Abbass Aleya Abdel Gawad, Abaza Amani Farouk, Shoukry Mohamed Shafik
Department of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Egypt Public Health Assoc. 2023 Jan 3;97(1):30. doi: 10.1186/s42506-022-00124-2.
Catheter-associated urinary tract infections (CAUTIs) are the most common infections found in healthcare facilities. Urinary catheters predispose the development of CAUTIs by destroying natural barriers and providing a source for infection and biofilm formation (BF). This study aimed to evaluate probiotic lactic acid bacteria (LAB) as a means of preventing in vitro urinary catheter colonization and BF.
Cross-sectional screening, followed by an experimental study, was conducted on 120 catheterized patients admitted to the urology department in a tertiary care hospital for 7 months. The isolated and identified uropathogens were tested for their antimicrobial susceptibility patterns by the disk diffusion method according to Clinical and Laboratory Standards Institute recommendations and examined for their ability to produce biofilms using a microtiter plate (MtP) assay. Five LAB (Lactobacillus acidophilus (L. acidophilus), Bifidobacterium bifidum (B. bifidum), L. paracasei, L. pentosus, and L. plantarum) were identified and examined for preventing in vitro colonization and BF of some isolated uropathogens on Foley urinary catheter surfaces.
Of the 120 samples collected, 32.5% were found to be associated with CAUTIs. Of isolated organisms, 74.4% were gram-negative bacilli, while gram-positive cocci represented 14%, and only 11.6% were of the Candida species. About two-thirds of isolated uropathogens were biofilm formers. All five probiotic strains had inhibitory effects on the growth of all the uropathogens tested but with varying intensities according to the duration of application after 2, 4, and 6 days.
The prevalence of CAUTIs was high, and the predominant bacterial isolates were gram-negative bacilli. Many of the studied uropathogens were biofilm formers. The bacterial isolates had a higher prevalence of resistance to commonly prescribed antimicrobial agents. Probiotics have the potential to prevent in vitro urinary catheter colonization and inhibit BF. Pre-coating urinary catheters with probiotics is recommended after ensuring the safety of probiotics' use in vivo by carrying out further large-scale studies.
导尿管相关尿路感染（CAUTIs）是医疗机构中最常见的感染类型。导尿管通过破坏天然屏障并为感染和生物膜形成（BF）提供来源，从而易引发CAUTIs。本研究旨在评估益生菌乳酸菌（LAB）作为预防体外导尿管定植和BF的一种手段。
对一家三级护理医院泌尿外科收治的120例留置导尿管患者进行了为期7个月的横断面筛查，随后开展了一项实验研究。根据临床和实验室标准协会的建议，采用纸片扩散法对分离鉴定出的尿路病原体进行抗菌药物敏感性模式检测，并使用微量滴定板（MtP）分析法检测其产生生物膜的能力。鉴定出5种LAB（嗜酸乳杆菌、两歧双歧杆菌、副干酪乳杆菌、戊糖乳杆菌和植物乳杆菌），并检测它们对一些分离出的尿路病原体在Foley导尿管表面的体外定植和BF的预防作用。
在收集的120份样本中，发现32.5%与CAUTIs有关。在分离出的微生物中，74.4%为革兰氏阴性杆菌，革兰氏阳性球菌占14%，只有11.6%为念珠菌属。约三分之二分离出的尿路病原体是生物膜形成菌。所有5种益生菌菌株对所有测试的尿路病原体的生长均有抑制作用，但根据应用2、4和6天后的持续时间，抑制强度有所不同。
CAUTIs的患病率较高，主要分离出的细菌是革兰氏阴性杆菌。许多研究的尿路病原体是生物膜形成菌。分离出的细菌对常用抗菌药物的耐药率较高。益生菌有预防体外导尿管定植和抑制BF的潜力。在通过进一步大规模研究确保益生菌在体内使用的安全性后，建议用益生菌预涂导尿管。
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