Related Experiment Video
Updated: Aug 6, 2026
An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
Pathogen Characteristic of Biofilm-Related CAUTI in the Intensive Care Unit
Sayyidah Auliany Aminy1,2, Abu Tholib Aman1, Ema Damayanti3,4
1Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, ugm.ac.id.
Insights
Catheter-associated urinary tract infections (CAUTI) in the ICU are frequently caused by resilient pathogens like E. coli, A. baumannii, and C. albicans. Most CAUTI isolates form biofilms, contributing to persistent infections despite varying antimicrobial and antifungal susceptibility.
Area of Science:
- Infectious Diseases
- Microbiology
- Healthcare Epidemiology
Background:
- Catheter-associated urinary tract infections (CAUTI) are a significant cause of healthcare-associated infections (HAIs) in intensive care units (ICUs).
- CAUTI contributes to increased patient morbidity, mortality, length of hospital stay, and healthcare costs.
- Antimicrobial resistance and biofilm formation by causative microorganisms complicate CAUTI management and treatment.
Purpose of the Study:
- To investigate the primary pathogens responsible for CAUTI in Indonesian ICUs.
- To analyze the antimicrobial and antifungal susceptibility patterns of CAUTI isolates.
- To evaluate the biofilm-forming capabilities of microorganisms causing CAUTI.
Main Methods:
- A cross-sectional study involving 71 patients with indwelling urinary catheters was conducted.
- Urine specimens were cultured, and isolates were identified using Vitek 2 and CHROMagar.
- Antimicrobial susceptibility was determined by broth microdilution, and biofilm formation was assessed via microtiter plate assay and scanning electron microscopy (SEM).
Main Results:
- Escherichia coli, Acinetobacter baumannii, and Candida albicans were the most prevalent pathogens identified.
- High rates of antimicrobial resistance were observed, including extended-spectrum β-lactamase (ESBL) production in Enterobacterales and carbapenem resistance in A. baumannii.
- Biofilm formation was detected in over 91% of bacterial isolates and all Candida isolates, confirmed by SEM.
Conclusions:
- E. coli, A. baumannii, and C. albicans are key pathogens in CAUTI, often exhibiting significant biofilm formation.
- While bacterial isolates demonstrate high antibiotic resistance, Candida species remain relatively susceptible to antifungals.
- The high prevalence of biofilm formation underscores its role in the persistence and recurrence of CAUTI.
Objectives:
Catheter-associated urinary tract infection (CAUTI) in the intensive care unit (ICU) is one of the healthcare-associated infections with increased length of stay, healthcare costs, morbidity, and mortality. CAUTI can be caused by antimicrobial-resistant and biofilm-forming microorganisms, resulting in recurrent and persistent infections. This study is aimed at analyzing the pathogens, antimicrobial sensitivity patterns, and biofilm-forming capabilities of CAUTI isolates in two referral hospitals in Yogyakarta, Indonesia.
Method:
A cross-sectional study was conducted on 71 patients with indwelling urinary catheters from October 2022 to March 2023. Urine specimens were collected aseptically and cultured. Microorganisms were identified and tested for antimicrobial susceptibility using Vitek 2, CHROMagar, and broth microdilution. Biofilm-producing bacteria were identified by microtiter plate assay (MTPA), and selected urinary catheters were examined by scanning electron microscopy (SEM).
Results:
A total of 71 urine specimens from patients with indwelling latex-urinary catheters resulted in 49 bacterial isolates and 28 yeasts identified. Escherichia coli, Acinetobacter baumannii, and Candida albicans were the most frequent pathogens. Among Enterobacterales, 62.5% were extended-spectrum β-lactamase (ESBL) producers, whereas 90% of A. baumannii and 20% of Pseudomonas aeruginosa isolates were carbapenem-resistant. In contrast, C. albicans and C. tropicalis showed a fairly good level of sensitivity to various antifungals. Biofilm formation was observed in 91.8% of bacterial and in all Candida isolates. SEM examination of urinary catheter segments and tips revealed biofilm structures and microbial morphologies consistent with urine culture findings.
Conclusion:
E. coli, A. baumannii, and C. albicans were the predominant CAUTI pathogens. Most isolates exhibited biofilm-forming ability. Although bacteria showed high antibiotic resistance, yeasts remained relatively susceptible to antifungals.
More Related Videos
07:16Development of a Polymicrobial Colony Biofilm Model to Test Antimicrobials in Cystic Fibrosis
Published on: September 20, 2024
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
Related Concept Videos
01:29Biofilms
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
01:25Colonisation of Pathogens
01:25Urinary Tract Infection II: Pathophysiology
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:25Clinical Significance of Antibiotic Resistance