Beyond the Surface: The Role of Biofilm Production and Antibiotic Resistance Pattern among Microbial Isolates from Neonatal Peripheral IV Catheter Samples in a Tertiary Care Hospital

Abstract

Background: Catheter-related infections (CRIs), particularly in vulnerable populations such as neonates, represent a significant clinical challenge due to the pervasive issue of biofilm formation and associated antimicrobial resistance. This study investigated biofilm-forming ability of microorganisms causing CRIs by analysing samples from intravascular catheters and blood. Our findings reveal a high rate of positive tip cultures, with 46.98% of peripheral intravascular catheters (IVC) showing colonization. Candida species were the most common organisms colonizing IVCs (70.7%), predominantly non-C. albicans (86.2%), followed by Coagulase-negative staphylococci (CoNS) (20.7%). A critical finding was the exceptionally high rate of biofilm production (95.1%) among clinical isolates, with 87.18% classified as strong biofilm producers. Antibiotic susceptibility testing demonstrated significant resistance patterns: all CoNS isolates were 100% resistant to Ampicillin and 88.2% resistant to Methicillin, yet were highly sensitive to Vancomycin (94.1%) and Linezolid (100%). Every gram-negative isolate was 100% dependent on imipenem but 100% resistant to ampicillin or amoxycillin-clavulanic acid. These results underscore the need to detect biofilm production in CRIs, given their persistent nature and significant antimicrobial resistance, highlighting crucial clinical implications for targeted management and prevention strategies, particularly in neonatal intensive care units (NICUs).