Pseudomonas aeruginosa biofilm and Gentamicin

Q: 82 years old male is admitted to ICU from Nursing Home with severe urosepsis. The indwelling urinary catheter on arrival tends to show blue-green biofilm. Gentamicin is the drug of choice?

A) True

B) False

Answer: B

Escherichia coli, Enterococcus spp., and Pseudomonas aeruginosa are leading causes of institution-acquired Urinary Tract Infections (UTIs) when prolonged indwelling catheters are kept.

Pseudomonas aeruginosa causing catheter-associated UTIs produce biofilms. The majority of the isolates are multidrug-resistant. Gentamicin resistance correlated with increased biofilm production. Other risk factors for P. aeruginosa urosepsis are

• male sex
• longer hospitalization
• prior use of antibiotics

Outbreaks of P. aeruginosa urosepsis have been reported from contaminated urologic equipment or facilities due to Urodynamic equipment, a cystoscopy room via an unsealed drain, and a urology unit with a contaminated sink, scope, and bedside table.

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References:

1. Suman E, Varghese S, Jose J. Gentamicin resistance in biofilm producing Pseudomonas aeruginosa causing catheter associated urinary tract infections. Indian J Med Sci 2005; 59:214.

2. Bilavsky E, Pfeffer I, Tarabeia J, et al. Outbreak of multidrug-resistant Pseudomonas aeruginosa infection following urodynamic studies traced to contaminated transducer. J Hosp Infect 2013; 83:344.

3. Boutiba-Ben Boubaker I, Boukadida J, Triki O, et al. [Outbreak of nosocomial urinary tract infections due to a multidrug resistant Pseudomonas aeruginosa]. Pathol Biol (Paris) 2003; 51:147.