In terms of biofilm inhibitory concentration and minimal biofilm eradication concentrations, the role of microbial biofilm in upper versus lowers urinary tract infections.

Abstract

. This study has been undertaken for detection the most common microorganisms isolated from infected JJ stents and infected calculi in upper urinary tract and their representative urine samples from lower urinary tract and their ability to produce biofilm quantitatively. Furthermore, depending on Biofilm inhibitory concentration (BICs) and Minimal biofilm inhibitory concentration (MBECs) for determine the biofilm antibiogram for biofilm producer study isolates to the selected antimicrobial agents. One hundred and thirty specimens obtained from Sixty five patients admitted to Urology Department in Al-Ramadi Teaching Hospital during the period from April through December 2008. They include 94 specimens taken from 47indwelling double J ureteric stents in addition to renal stones and representative urine samples obtained from 18 patients with renal calculi. Quantitative biofilm formation assay and biofilm antimicrobial susceptibility test was achieved.Out of 47 upper end of JJ stent, 19 (40.4%) were positive for culture. Out of 24 yield microorganisms 19 (79.2%) were biofilm producer isolates. Out of 47 lower ends of JJ stent, 16 (34%) were positive for culture. Of these, 16 microorganisms were biofilm producer isolates. Also, 5 renal stones were positive for culture and all the yielded bacterial isolates were biofilm producers. The biofilm cells were required 50-100 times the MIC values for ciprofloxacin in both of JJ stent and infection stones while with cefotaxime, the study sessile were required 50-500 X, 50-100 X MICs valuefor JJ stents and infection stones respectively. Further, the biofilm producer isolates cells were required 10- 100 times the MIC values for amikacin in both of two specimens. The study concluded that Klebsiella pneumonia and Candida albicans were the most common microorganisms isolated from infected JJ stent while Klebsiella pneumoniawas the predominant in struvite stone followed by Proteus mirabilis. No significant difference observed between upper and lower urinary tract infections regarding biofilm formation. Further, with the increase in duration of insertion, double J stent will be more predisposing to microbial colonization. Furthermore, the biofilm producer study isolates were required lower concentration of amikacin to remove bacterial biofilm from JJ stents and infection stones in comparison with ciprofloxacin and cefotaxime.