Prevalence of Biofilm-forming and Carbapenemase-producing Gram-negative Bacilli Colonizing Indwelling Urinary Catheters of Patients

Authors

  • Ikemesit Udeme Peter Department of Microbiology, Faculty of Basic Medical Sciences, Federal University of Allied Health Sciences, Trans-Ekulu, Enugu, Nigeria Author
  • Onyedikachi Chijindu Obike Department of Clinical Pharmacy, Faculty of Pharmaceutical Science, University of Nigeria, Nsukka, Nigeria Author
  • Justina Nnenna Ngwu Department of Dental Therapy, Faculty of Dental Health, Federal University of Allied Health Science, Trans-Ekulu, Enugu, Nigeria Author
  • Akunna Perpetua Emeruwa Department of Microbiology and Parasitology, David Umahi Federal University of Health Science, Uburu, Ebonyi State, Nigeria & International Institute for Infectious Disease, Biosafety and Biosecurity, Uburu, Ebonyi State, Nigeria Author
  • Ijeoma Onyinye Okolo Department of Biochemistry, Faculty of Basic Medical Sciences, Federal University of Allied Health Science, Trans-Ekulu, Enugu, Nigeria Author
  • Ismaila Danjuma Mohammed Department of Nursing Sciences, Faculty of Health Sciences, Federal University of Lokoja, Kogi, Nigeria Author

DOI:

https://doi.org/10.56919/usci.2542.027

Keywords:

Gram-negative Bacilli (GNB), Biofilm forming, carbapenemase, Indwelling Urinary Catheters

Abstract

The increasing prevalence of biofilm-forming and carbapenemase-producing Gram-negative Bacilli (GNB) in catheterized patients is linked to significant clinical challenges, including persistent infections, prolonged hospital stays, and higher colonization rates.  To address these issues, establishing localized antimicrobial resistance (AMR) surveillance data is critical for guiding effective patient management and implementing robust infection prevention and control strategies.  This study analyzed 200 indwelling urinary catheters (IUCs) from hospitalized patients using standard microbiological techniques, with isolates characterized using the VITEK 2 system.  Phenotypic screening for biofilm production and carbapenem resistance was conducted using the Congo Red Assay and the Carba NP Test, respectively.  Carbapenemase genes were identified via Polymerase Chain Reaction (PCR) with specific primers.  Of the 200 samples, 164 (82.0%) were positive for GNB, with 87 (43.5%) identified as biofilm producers.  Carbapenem resistance was confirmed in 89 (44.5%) isolates using CRE agar and the Carba NP Test.  The distribution of carbapenemase genes among GNB isolates was as follows: blaKPC (29.5%), blaNDM (100%), blaVIM (13.5%), blaOXA (100%), and blaIMP (20.0%).  Antibiogram analysis revealed high resistance rates (54.5%-100%) to amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, ceftriaxone, meropenem, and ertapenem.  However, susceptibility was observed to nitrofurantoin, ciprofloxacin, and Gentamicin, suggesting their potential as empiric treatments for GNB infections in catheterized patients.  The study highlights the importance of adhering rigorously to structured catheter care protocols, including daily assessment of catheter necessity and strict adherence to aseptic techniques during insertion and maintenance.  Regular training for healthcare staff on best practices for catheter management is essential to reduce colonization rates and improve clinical outcomes for patients at risk of carbapenem-resistant GNB (CR-GNB) infections.  These findings highlight the urgent need for localized AMR surveillance and targeted infection control measures to mitigate the growing threat of multidrug-resistant GNB in healthcare settings.

References

Abouelfetouh, A., Torky, A. S., & Aboulmagd, E. (2019). Phenotypic and genotypic characterization of Carbapenem-resistant Acinetobacter baumannii isolates from Egypt. Antimicrobial Resistance and Infection Control, 8, 1–9. https://doi.org/10.1186/s13756-019-0611-6

Amer, W. H., Khalil, H. S., & Abd ELWahab, M. A. A. (2016). Characterization of carpabenem resistant Enterobacteriaceae in risk factors, phenotypic and genotypic characterization of carbapenem resistant Enterobacteriaceae in Tanta University Hospitals, Egypt. International Journal of Infection Control, 12, 1–11. https://doi.org/10.3396/IJIC.v12i2.012.16

Amisu, M. A., Awobusuyi, J., Salako, B. L., Mutiu, W. B., & Ojongbede, M. (2019). Localization of urinary tract infection in catheterized adults patients: Experience with the bladder washout technique. Tropical Journal of Nephrology, 14(2), 113–120.

Anane, Y. A., Apalata, T., Vasaikar, S., Okuthe, G. E., & Songca, S. (2020). Molecular detection of carbapenemase-encoding genes in multidrug-resistant Acinetobacter baumannii clinical isolates in South Africa. International Journal of Microbiology, 1, 10–23. https://doi.org/10.1155/2020/7380740

Asmare, Z., Awoke, T., Genet, C., Admas, A., Melese, A., & Mulu, W. (2024). Incidence of catheter-associated urinary tract infections by Gram-negative bacilli and their ESBL and carbapenemase production in specialized hospitals of Bahir Dar, northwest Ethiopia. Antimicrobial Resistance and Infection Control, 13, 10–21. https://doi.org/10.1186/s13756-024-01368-7

Atrissi, J., Milan, A., Bressan, R., Lucafò, M., Petix, V., & Busetti, M. (2021). Interplay of Opdp porin and chromosomal carbapenemases in the determination of carbapenem resistance/susceptibility in Pseudomonas aeruginosa. Microbiology Spectrum, 9, e01186-21. https://doi.org/10.1128/Spectrum.01186-21

Awoke, N., Kassa, T., & Teshager, L. (2019). Magnitude of biofilm formation and antimicrobial resistance pattern of bacteria isolated from urinary catheterized inpatients of Jimma University Medical Center, Southwest Ethiopia. International Journal of Microbiology, 20, 19–21. https://doi.org/10.1155/2019/5729568

Barceló, I. M., Jordana-Lluch, E., Escobar-Salom, M., Torrens, G., Fraile-Ribot, P. A., Cabot, G., Mulet, X., Zamorano, L., Juan, C., & Oliver, A. (2022). Role of enzymatic activity in the biological cost associated with the production of AmpC β-lactamases in Pseudomonas aeruginosa. Microbiology Spectrum, 10, e02700-22. https://doi.org/10.1128/spectrum.02700-22

Bashir, M., Umar, A. B., & Bilyaminu, M. (2020). Determination of bacteria associated with urinary catheters from patients suffering from urinary tract infections. Dr. Sulaiman Al-Habib Medical Journal, 2(1), 20–23. https://doi.org/10.2991/dsahmj.k.200220.001

Bebell, L. M., Ngonzi, J., Bazira, J., Fajardo, Y., Boatin, A. A., & Siedner, M. J. (2017). Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital. PLOS ONE, 12(4), e0175456. https://doi.org/10.1371/journal.pone.0175456

Bouslah, Z. (2020). Carba NP test for the detection of carbapenemase-producing Pseudomonas aeruginosa. Médecine et Maladies Infectieuses, 50, 466–479. https://doi.org/10.1016/j.medmal.2019.12.002

Chetri, S., Bhowmik, D., Paul, D., Pandey, P., Chanda, D. D., Chakravarty, A., Bora, D., & Bhattacharjee, A. (2019). AcrAB-TolC efflux pump system plays a role in carbapenem non-susceptibility in Escherichia coli. BMC Microbiology, 19, 210. https://doi.org/10.1186/s12866-019-1589-1

Clinical and Laboratory Standards Institute. (2021). Performance standards for antimicrobial susceptibility testing (31st ed.). CLSI.

Clinical and Laboratory Standards Institute. (2022). Performance standards for antimicrobial susceptibility testing (32nd ed.). CLSI Supplement M100.

Deshpande, P., Rodrigues, C., Shetty, A., Kapadia, F., Hedge, A., & Soman, R. (2010). New Delhi Metallo-beta lactamase (NDM-1) in Enterobacteriaceae: Treatment options with carbapenems compromised. Journal of Association of Physicians of India, 58, 147–149.

Drake, M. J., Clavica, F., Murphy, C., & Fader, M. J. (2024). Innovating indwelling catheter design to counteract urinary tract infection. European Urology Focus, 10, 713–719. https://doi.org/10.1016/j.euf.2024.09.015

Edemekong, C. I., Chukwujekwu, A. G., Okorie, M. E., Udenweze, E., Obodoechi, I. F., Ogbonna, I. P., & Livinus, N. P. (2025). Evaluation of antibacterial activity of selected medicinal plant on extended spectrum β-lactamase producing Salmonella enterica serovar Typhimurium. UMYU Scientifica, 4(1), 28–36. https://doi.org/10.56919/usci.2541.003

Elbadawi, H. S., Elhag, K. M., Mahgoub, E., Altayb, H. N., Ntoumi, F., Elton, L., McHugh, T. D., Tembo, J., Ippolito, G., Osman, A. Y., Zumla, A., & Abdel Hamid, M. M. (2021). Detection and characterization of carbapenem resistant Gram‐negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan. BMC Microbiology, 21, 136. https://doi.org/10.1186/s12866-021-02133-1

Flores-Mireles, A., Hreha, T. N., & Hunstad, D. (2019). Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Topics in Spinal Cord Injury Rehabilitation, 25(3), 228–240. https://doi.org/10.1310/sci2503-228

Garza-González, E., Bocanegra-Ibarias, P., Bobadilla-Del-Valle, M., Ponce-de-León-Garduño, L. A., Esteban-Kenel, V., Silva-Sánchez, J., Garza-Ramos, U., Barrios-Camacho, H., López-Jácome, L. E., & Colin-Castro, C. A. (2021). Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the INVIFAR network. PLOS ONE, 16, e0248614. https://doi.org/10.1371/journal.pone.0248614

Garza-Ramos, U., Silva-Sánchez, J., López-Jácome, L. E., Hernández-Durán, M., Colín-Castro, C. A., Sánchez-Pérez, A., Rodríguez-Santiago, J., Morfín-Otero, R., Rodriguez-Noriega, E., & Velázquez-Acosta, M. D. (2023). Carbapenemase-encoding genes and colistin resistance in Gram-negative bacteria during the COVID-19 pandemic in Mexico: Results from the Invifar Network. Microbial Drug Resistance, 29, 239–248. https://doi.org/10.1089/mdr.2022.0226

Gashaw, M., Gudina, E. K., Ali, S., Gabriele, L., Seeholzer, T., Alemu, B., Froeschl, G., Kroidl, A., & Wieser, A. (2024). Molecular characterization of carbapenem-resistance in Gram-negative isolates obtained from clinical samples at Jimma Medical Center, Ethiopia. Frontiers in Microbiology, 15, 1336387. https://doi.org/10.3389/fmicb.2024.1336387

Gould, C. V., Umscheid, C. A., Rajender, Agarwal, K., Kuntz, G., & Pegues, D. A. (2019). Guideline for prevention of catheter-associated urinary tract infections. Centers for Disease Control and Prevention. https://www.cdc.gov/infectioncontrol/guidelines/cauti/

Health Protection Surveillance Centre (2011). Guidelines for the Prevention of Catheter-Associated Urinary Tract Infection. Published on behalf of SARI by HSE Health Protection Surveillance Centre, 2011. ISBN 978-0-9551236-9-6

Ilang, D. C., Peter, I. U., & Iroha, I. R. (2023a). Antibiotic resistance profile of clinical importance biofilm forming extended spectrum beta-lactamase and carbapenemase phenotype in Gram-negative bacteria isolates. International Journal of Pharmacognosy and Life Science, 4(2), 120–127. https://doi.org/10.33545/27072827.2023.v4.i2b.97

Ilang, D. C., Peter, I. U., & Iroha, I. R. (2023b). Characterization of VIM, VEB and CTX-M beta-lactamase gene in Escherichia coli and Pseudomonas aeruginosa isolated from urine samples of patients visiting a tertiary hospital in Abakaliki. International Journal of Medical Sciences and Pharma Research, 9(4), 7–11. https://doi.org/10.22270/ijmspr.v9i4.77

Jean, S. S., Harnod, D., & Hsueh, P. R. (2022). Global threat of carbapenem-resistant Gram-negative bacteria. Frontiers in Cellular and Infection Microbiology, 12, 823684. https://doi.org/10.3389/fcimb.2022.823684

John-Onwe, B. N., Aniokete, U. C., Ibiam, F. A., Peter, I. U., Iroha, C. S., & Iroha, I. R. (2023). Dissemination of multidrug-resistant, extensively drug resistant and pandrug-resistant Pseudomonas aeruginosa isolates among in-patients and out-patients in a multi-profile health care settings. Journal of Advances in Microbiology, 23(10), 109–115. https://doi.org/10.9734/jamb/2023/v23i10761

Joseph, I. S., Okolo, I. O., Udenweze, E. C., Nwankwo, C. E., Peter, I. U., Ogbonna, I. P., & Iroha, I. R. (2023). Comparison of antibiotic-resistant pattern of extended spectrum beta-lactamase and carbapenem resistant Escherichia coli isolates from clinical and non-clinical sources. Journal of Drug Delivery and Therapeutics, 13(7), 107–118. https://doi.org/10.22270/jddt.v13i7.5918

Karabay, O., Altindis, M., Koroglu, M., Karatuna, O., & Aydemir, Ö. A. (2016). The carbapenem-resistant Enterobacteriaceae threat is growing: NDM-1 epidemic at a training hospital in Turkey. Annals of Clinical Microbiology and Antimicrobials, 15, 1–6. https://doi.org/10.1186/s12941-016-0118-4

Karampatakis, T., Tsergouli, K., & Behzadi, P. (2023). Carbapenem-resistant Klebsiella pneumoniae: Virulence factors, molecular epidemiology and latest updates in treatment options. Antibiotics, 12, 234. https://doi.org/10.3390/antibiotics12020234

Kołpa, M., Wałaszek, M., Gniadek, A., Wolak, Z., & Dobroś, W. (2018). Incidence, microbiological profile and risk factors of healthcare-associated infections in intensive care units: A 10 year observation in a provincial hospital in Southern Poland. International Journal of Environmental Research and Public Health, 15(1), 112. https://doi.org/10.3390/ijerph15010112

Kulbay, A., Joelsson-Alm, E., Amilon, K., & Tammelin, A. (2024). Asymptomatic bacteriuria and urinary tract infection in geriatric inpatients after indwelling urinary catheter removal: A descriptive two-centre study. Infection Prevention in Practice, 6, 100411. https://doi.org/10.1016/j.infpip.2024.100411

Kumarasamy, K., Toleman, M., Walsh, T., & Al. E. (2010). Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. The Lancet Infectious Diseases, 10, 597–602. https://doi.org/10.1016/S1473-3099(10)70143-2

Liofilchem. (2020). Chromogenic medium for the detection of carbapenem-resistant Enterobacteriaceae.

López-García, A., Rocha-Gracia, R. D. C., Bello-López, E., Juárez-Zelocualtecalt, C., Sáenz, Y., Castañeda-Lucio, M., López-Pliego, L., González-Vázquez, M. C., Torres, C., & Ayala-Nuñez, T. (2018). Characterization of antimicrobial resistance mechanisms in carbapenem-resistant Pseudomonas aeruginosa carrying IMP variants recovered from a Mexican hospital. Infection and Drug Resistance, 11, 1523–1536. https://doi.org/10.2147/IDR.S173455

Luu, T., & Albarillo, F. S. (2022). Asymptomatic bacteriuria: Prevalence, diagnosis, management, and current antimicrobial stewardship implementations. The American Journal of Medicine, 135, 236–244. https://doi.org/10.1016/j.amjmed.2022.03.015

Masi, M., Réfregiers, M., Pos, K. M., & Pagès, J. M. (2017). Mechanisms of envelope permeability and antibiotic influx and efflux in Gram-negative bacteria. Nature Microbiology, 2, 17001. https://doi.org/10.1038/nmicrobiol.2017.1

Mulani, M. S., Kamble, E. E., Kumkar, S. N., Tawre, M. S., & Pardesi, K. R. (2019). Emerging strategies to combat ESKAPE pathogens in the era of antimicrobial resistance: A review. Frontiers in Microbiology, 10, 539. https://doi.org/10.3389/fmicb.2019.00539

Musinguzi, B., Kabajulizi, I., Mpeirwe, M., Turugurwa, J., & Kabanda, T. (2019). Incidence and etiology of catheter-associated urinary tract infection among admitted patients at Kabale Regional Referral Hospital, South Western Uganda. Advances in Infectious Diseases, 9, 183–196. https://doi.org/10.4236/aid.2019.93014

Nakawuki, A. W., Nekaka, R., Ssenyonga, L. V. N., Masifa, G., Nuwasiima, D., & Nteziyaremye, J. (2022). Bacterial colonization, species diversity and antimicrobial susceptibility patterns of indwelling urinary catheters from postpartum mothers attending a tertiary hospital in Eastern Uganda. PLOS ONE, 17(1), e0262414. https://doi.org/10.1371/journal.pone.0262414

Nieto-Saucedo, J. R., López-Jacome, L. E., Franco-Cendejas, R., Colín-Castro, C. A., Hernández-Duran, M., Rivera-Garay, L. R., Zamarripa-Martinez, K. S., & Mosqueda-Gómez, J. L. (2023). Carbapenem-resistant Gram-negative bacilli characterization in a tertiary care center from El Bajio, Mexico. Antibiotics, 12, 1295. https://doi.org/10.3390/antibiotics12081295

Niveditha, S., Pramodhini, S., Umadevi, S., Kumar, S., & Stephen, S. (2012). Isolation and the biofilm formation of uropathogens in the patients with catheter-associated urinary tract infections (UTIs). Journal of Clinical and Diagnostic Research, 6(9), 1478–1482. https://doi.org/10.7860/JCDR/2012/4367.2537

Nomeh, L. O., Federica, O. I., Joseph, O. V., Moneth, E. C., Ogba, R. C., Nkechi, O. A., Peter, I. U., Akpu, P. O., Edemekong, C. I., & Iroha, I. R. (2023). Detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae implicated in urinary tract infection. Asian Journal of Research in Infectious Diseases, 2(1), 15–23. https://doi.org/10.9734/ajrid/2023/v12i1234

Nomeh, O. L., Chukwu, E. B., Ogba, R. C., Akpu, P. O., Peter, I. U., Nwuzo, A. C., & Iroha, I. R. (2022). Prevalence and antibiogram profile of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae among patients with urinary tract infection in Abakaliki, Nigeria. International Journal of Pathogen Research, 11(3), 14–28. https://doi.org/10.9734/ijpr/2022/v11i3212

Ogba, R. C., Nomeh, O. L., Edemekong, C. I., Nwuzo, A. C., Akpu, P. O., Peter, I. U., & Iroha, I. R. (2022). Molecular characterization of carbapenemase encoding genes in Pseudomonas aeruginosa from tertiary healthcare in South Eastern Nigeria. Asian Journal of Biology, Genetic and Molecular Biology, 12(4), 161–168. https://doi.org/10.9734/ajbgmb/2022/v12i4281

Okoche, D., Asiimwe, B. B., Katabazi, F. A., & Kato, L. (2015). Prevalence and characterization of carbapenem-resistant Enterobacteriaceae isolated from Mulago National Referral. PLOS ONE, 10(8), e0135745. https://doi.org/10.1371/journal.pone.0135745

Oumer, Y., Dadi, B. R., Seid, M., Biresaw, G., & Manilal, A. (2021). Catheter-associated urinary tract infection: Incidence, associated factors and drug resistance patterns of bacterial isolates in Southern Ethiopia. Infection and Drug Resistance, 14, 2883–2894. https://doi.org/10.2147/IDR.S311229

Patil, H. V., Patil, V. C., Patange, A. P., & Khan, M. A. (2024). Antibiotic resistance profiles of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL)-producing Klebsiella pneumoniae isolates from diabetic foot ulcers: Implications for treatment strategies. Cureus, 16, e66089. https://doi.org/10.7759/cureus.66089

Perovic, O., Micro, F. S. A., Micro, M., Britz, E., Chb, M. B., & Chetty, V. (2016). In practice molecular detection of carbapenemase-producing genes in referral Enterobacteriaceae in South Africa: A short report. South African Medical Journal, 106(10), 975–977. https://doi.org/10.7196/SAMJ.2016.v106i10.11300

Peter, I. U., Okolo, I. O., Uzoeto, H. O., Edemekong, C. I., Thompson, M. D., Chukwu, E. B., Mohammed, I. D., Ubom, I. J., Joseph, O. V., Nwuzo, A. C., Akpu, P. O, and Iroha, I. R (2022). Identification and Antibiotic Resistance Profile of Biofilm-forming Methicillin-Resistant Staphylococcus aureus (MRSA) Causing Infection among Orthopedic Wound Patients. Asian Journal of Research in Medical and Pharmaceutical Science, 11(4): 45-55. https://doi.org/10.9734/ajrimps/2022/v11i4201

Philippon, A., Arlet, G., & Jacoby, G. A. (2002). Plasmid-determined AmpC-type beta-lactamases. Antimicrobial Agents and Chemotherapy, 46(1), 1–11. https://doi.org/10.1128/AAC.46.1.1-11.2002

Puro, V., Coppola, N., Frasca, A., Gentile, I., Luzzaro, F., & Peghetti, A. (2022). Pillars for prevention and control of healthcare-associated infections. Antimicrobial Resistance and Infection Control, 11(1), 1–13. https://doi.org/10.1186/s13756-022-01125-8

Reid, G., Charbonneau-Smith, R., Lam, D., Kang, Y. S., Lacerte, M., & Hayes, K. C. (1992). The bacterial biofilm formation in the urinary bladder of spinal cord injured patients. Paraplegia, 30(10), 711–717. https://doi.org/10.1038/sc.1992.138

Saleem, M., Moursi, S. A., Altamimi, T. N. A., Alharbi, M. S., Alaskar, A. M., Hammam, S. A. H., Rakha, E., Syed Muhammad, O. I., Almalaq, H. A., & Alshammari, M. N. (2025). Prevalence and molecular characterization of carbapenemase-producing multidrug-resistant bacteria in diabetic foot ulcer infections. Diagnostics, 15(2), 141. https://doi.org/10.3390/diagnostics15020141

Sewunet, T., Asrat, D., Woldeamanuel, Y., Aseffa, A., & Giske, C. G. (2022). Molecular epidemiology and antimicrobial susceptibility of Pseudomonas spp. and Acinetobacter species from clinical samples at Jimma Medical Center, Ethiopia. Frontiers in Microbiology, 13, 951857. https://doi.org/10.3389/fmicb.2022.951857

Shahid, M., Saeed, N. K., Ahmad, N., Shadab, M., Joji, R. M., Al-Mahmeed, A., Bindayna, K. M., Tabbara, K. S., Ismaeel, A. Y., & Dar, F. K. (2023). Molecular screening of carbapenem-resistant K. pneumoniae (CRKP) clinical isolates for concomitant occurrence of beta-lactam genes (CTX-M, TEM, and SHV) in the Kingdom of Bahrain. Journal of Clinical Medicine, 12(24), 7522. https://doi.org/10.3390/jcm12247522

Sharif, F. B., Aminu, A., & Idris, A. M. (2020). Catheter associated urinary tract infection among patients attending some selected hospitals in Kano Metropolis. Bayero Journal of Medical Library Science, 5(2), 174–179.

Sonnevend, Á., Ghazawi, A., Hashmey, R., Jamal, W., Rotimi, V., & Shibl, A. (2015). Characterization of carbapenem-resistant Enterobacteriaceae with high rate of autochthonous transmission in the Arabian Peninsula. PLOS ONE, 10(7), e0131372. https://doi.org/10.1371/journal.pone.0131372

Stærk, K., Andersen, K., Hjelmager, J. S., Jensen, L. K., Jørgensen, B. M., Møller-Jensen, J., Lund, L., & Andersen, T. E. (2024). Effect of bladder catheterization on bacterial interference with asymptomatic Escherichia coli strain 83972 in an experimental porcine model of urinary tract infection. The Journal of Infectious Diseases, 229(4), 1–9. https://doi.org/10.1093/infdis/jiae404

Stickler, D. J. (2014). Clinical complications of urinary catheters caused by crystalline biofilms: Something needs to be done. Journal of Internal Medicine, 276(2), 120–129. https://doi.org/10.1111/joim.12220

Stickler, D. J. (2008). Bacterial biofilms in patients with indwelling urinary catheters. Nature Clinical Practice Urology, 5(11), 598–608. https://doi.org/10.1038/ncpuro1231

Suay-García, B., & Pérez-Gracia, M. T. (2019). Present and future of carbapenem-resistant Enterobacteriaceae (CRE) infections. Antibiotics, 8(3), 122. https://doi.org/10.3390/antibiotics8030122

Tambyah, P. A., & Maki, D. G. (2000). Catheter-associated urinary tract infection is rarely symptomatic. Archives of Internal Medicine, 160(5), 678–682. https://doi.org/10.1001/archinte.160.5.678

Tolera, M., Abate, D., Dheresa, M., & Marami, D. (2018). Bacterial nosocomial infections and antimicrobial susceptibility pattern among patients admitted at Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Advances in Medicine, 2018, 2127814. https://doi.org/10.1155/2018/2127814

Uduku, N. D., Chinwe, I. F., Happiness, O., Immaculate, N. M., Favor, N. O., Peter, I. U., Aniokete, U. C., & Iroha, I. R. (2023). Antibiotics susceptibility profile of biofilm-forming bacteria isolated from soybean milk drinks sold in Abakaliki metropolis, Nigeria. Advances in Research, 24(6), 168–176. https://doi.org/10.9734/air/2023/v24i6997

Wald, H. L. (2008). Indwelling urinary catheter use in the postoperative period. Archives of Surgery, 143(6), 551. https://doi.org/10.1001/archsurg.143.6.551

Warren, J. W. (2001). Catheter-associated urinary tract infections. International Journal of Antimicrobial Agents, 17(4), 299–303. https://doi.org/10.1016/S0924-8579(00)00359-9

Yuan, P. B., Dai, L. T., Zhang, Q. K., Zhong, Y. X., Liu, W. T., Yang, L., Chen, D. Q., & Ponraj, V. P. (2024). Global emergence of double and multi-carbapenemase producing organisms: Epidemiology, clinical significance, and evolutionary benefits on antimicrobial resistance and virulence. Microbiology Spectrum, 12(1), e00008-24. https://doi.org/10.1128/spectrum.00008-24

Yusuf, I., Arzai, A. H., Haruna, M., Sharif, A. A., & Getso, M. I. (2014). Detection of multidrug resistant bacteria in major hospitals in Kano. Brazilian Journal of Microbiology, 45(3), 791–798. https://doi.org/10.1590/S1517-83822014000300005

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2025-06-30

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Peter, I. U., Obike, O. C., Ngwu, J. N., Emeruwa, A. P., Okolo, I. O., & Mohammed, I. D. (2025). Prevalence of Biofilm-forming and Carbapenemase-producing Gram-negative Bacilli Colonizing Indwelling Urinary Catheters of Patients. UMYU Scientifica, 4(2), 270-284. https://doi.org/10.56919/usci.2542.027

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