Detection of biofilm production and antimicrobial susceptibility in clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa
- hospital pathogens,
- multidrug resistance
How to Cite
Copyright (c) 2022 Radomir Jovchevski, Kakja Popovska, Aneta Todosovska Ristovska, Maja Lameski, Ardian Preshova, Mumin Selmani, Sara Nedelkoska, Hristijan Veljanovski, Marija Gjoshevska
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acinetobacter baumannii and Pseudomonas aeruginosa are commensal which commonly colonize humans. As a result of their ubiquitous nature, reservoirs in hospital environment and resistance to many antimicrobial agents they are responsible for hospital – acquired infections. Additionally treatment of these infections is difficult because of the ability for biofilm formation. Aim of the paper was to determine the association between biofilm formation on medical devices and antibiotic resistance profile, compared to respiratory samples in clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa. Material and methods: The study comprised 50 clinical samples (36 from medical devices and 14 as а control group from respiratory secretions). Acinetobacter baumannii and Pseudomonas aeruginosa were identified by routine microbiological methods. Modification of the microtiter plate assay described by Stepanovic et al. was used to investigate the formation of biofilm. The antimicrobial susceptibility testing was performed according to EUCAST guidelines. Results: Of the 50 analyzed strains, 16 (32%) were non-biofilm producers, and 34 (68%) were producing biofilms. Out of these, 29 (58%) were from medical devices, and 5 (10%) from the control group. Acinetobacter baumannii showed biofilm formation in 19 (67.9%), of which 17 (60.7%) from medical devices, and 2 (7.1%) from control group. Pseudomonas aeruginosa produced biofilm in 15 (68.1%), of which 12 (54.5%) from medical devices, and 3 (13.6%) from the control group. Multidrug resistance was detected in 40 (80%). All strains of Acinetobacter baumannii were multidrug resistant (MDR). For Pseudomonas aeruginosa, 11 (73.3%) biofilm forming isolates were MDR, and 1 (14.2%) non-biofilm forming isolate was MDR. Conclusion: Biofilm production was higher in strains from medical devices. Eighty percent of isolates were MDR. This is a serious challenge for treatment of these hospital-acquired infections.
- Lupo A, Haenni M, Madec JY. Antimicrobial resistance in Acinetobacter spp. and Pseudomonas spp. Microbiol Spectr 2018;6(3). DOI: https://doi.org/10.1128/microbiolspec.ARBA-0007-2017
- Weber BS, Harding CM, Feldman MF. Pathogenic Acinetobacter: from the cell surface to infinity and beyond. J Bacteriol 2015;198(6):880-887. DOI: https://doi.org/10.1128/JB.00906-15
- Moradali MF, Ghods S, Rehm BH. Pseudomonas aeruginosa Lifestyle: A paradigm for adaptation, survival and persistence. Front Cell Infect Microbiol 2017;7:39. DOI: https://doi.org/10.3389/fcimb.2017.00039
- Jurado-Martin I, Sainz-Mejias M, McClean S. Pseudomonas aeruginosa: An audacious pathogen with an adaptable arsenale of virulence factors. Int J MolSci 2021;22(6):3128. DOI: https://doi.org/10.3390/ijms22063128
- Wong D, Nielsen TB, Bonomo RA, Pantapalangkoor P, Luna B, Spellberg B. Clinical and pathophysiological overview of Acinetobacter infections: A century of challenges. Clin Microbiol Rev 2017;30(1):409-447. DOI: https://doi.org/10.1128/CMR.00058-16
- Djordjevic ZM, Folic MM, Jankovic SM. Previous antibiotic exposure and antimicrobial resistance patterns of Acinetobacter spp. and Pseudomonas aeruginosa isolated from patients with nosocomial infections. Balkan Med J 2017;34(6):527-533. DOI: https://doi.org/10.4274/balkanmedj.2016.1844
- Moubareck CA, Halat DH. Insights into Acinetobacterbaumannii: a review of microbiological, virulence and resistance traits in a threatening nosocomial pathogen. Antibiotics (Basel). 2020;9(3):119 DOI: https://doi.org/10.3390/antibiotics9030119
- Thi MTT, Wibowo D, Rehm BH. Pseudomonas aeruginosa biofilms. Int J MolSci 2020;21(22):8671. DOI: https://doi.org/10.3390/ijms21228671
- Eze EC, Chenia HY, El Zowalaty ME. Acinetobacter baumannii biofilms: effects on physisochemical factors, virulence, antibiotic resistance determinants, gene regulation, and future antimicrobial treatments. Infect Drug Resist 2018;11:2277-2299. DOI: https://doi.org/10.2147/IDR.S169894
- Jiang Y, Geng M, Bai L. Targeting biofilms therapy: Current research strategies and development hurdles. Microorganisms 2020;8(8):1222. DOI: https://doi.org/10.3390/microorganisms8081222
- Schulze A, Mitterer F, Pombo JP, Schild S. Biofilms by bacterial human pathogens: Clinical relevance – development, composition and regulation – therapeutical strategies. Microb Cell 2021;8(2):28-56. DOI: https://doi.org/10.15698/mic2021.02.741
- Magana M, Sereti C, Ioannidis A et al. Options and limitantions in clinical investigation of bacterial biofilms. Clin Microbiol Rev 2018;31(3):e00084-16. DOI: https://doi.org/10.1128/CMR.00084-16
- Brisse S, Milatovic D, Fluit AC et al. Molecular surveillance of European quinolone-resistant clinical isolates of Pseudomonas aeruginosa and Acinetobacter spp.using automated ribotyping. J Clin Microbiol 2000;38(10):3636-45. DOI: https://doi.org/10.1128/JCM.38.10.3636-3645.2000
- Stepanović S, Vuković D, Hola V et al. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS. 2007;115(8):891-9. DOI: https://doi.org/10.1111/j.1600-0463.2007.apm_630.x
- EUCAST. Antimicrobial susceptibility testing EUCAST disk diffusion method. Version 9.0. 2021.
- EUCAST. Reading guide for broth microdilution. Version 3.0. 2021.
- Revdiwala S, Rajdev BM, Mulla S. Characterization of bacterial etiologic agents of biofilm formation in medical devices in critical care setup. Crit Care Res Pract 2012:945805. DOI: https://doi.org/10.1155/2012/945805
- Rodríguez-Baño J, Martí S, Soto S et al. Biofilm formation in Acinetobacter baumannii: associated features and clinical implications. Clin Microbiol Infect 2008;14(3):276-8. DOI: https://doi.org/10.1111/j.1469-0691.2007.01916.x
- Lee HW, Koh YM, Lee JC et al. Capacity of multidrug – resistant clinical isolates of Acinetobacter baumannii to form biofilm and adhere to epithelial cell surfaces. Clin Microbiol Infect 2008;14(1):49-54. DOI: https://doi.org/10.1111/j.1469-0691.2007.01842.x
- Danin PE, Girou E, Legrand P et al. Description and microbiology of endotracheal tube biofilm in mechanically ventilated subjects. Respir Care 2015;60(1):21-9. DOI: https://doi.org/10.4187/respcare.02722
- Diez – Aguilar M, Ekkelenkamp M, Morosini MI et al. Anti – biofilm activity of murepavadin against cystic fibrosis Pseudomonas aeruginosa isolates. J Antimicrob Chemother 2021;76(10):2578-2585. DOI: https://doi.org/10.1093/jac/dkab222
- Eze EC, El Zowalaty ME, Pillay M. Antibiotic resistance and biofilm formation of Acinetobacter baumannii isolated from high – risk effluent water in tertiary hospitals in South Africa. J Glob Antimicrob Resist 2021;27:82-90. DOI: https://doi.org/10.1016/j.jgar.2021.08.004
- Konca C, Tekin M, Geyik M. Susceptibility patterns of multidrug – resistant Acinetobacter baumannii. Indian J Pediatr 2021;88(2):120-126. DOI: https://doi.org/10.1007/s12098-020-03346-4
- Folliero V, Franci G, Dell’Annunziata F et al. Evaluation of antibiotic resistance and biofilm production among clinical strain isolated from medical devices. Int J Microbiol 2021; 2021:9033278. DOI: https://doi.org/10.1155/2021/9033278
- Tanriverdi E, Yildirim BZ, Gul S et al. Results of tobramycin inhalation therapy in patients with nocystic fibrosis bronchiectasis with Pseudomonas aeruginosa colonization: real life management. J Aerosol Med Pulm Drug Deliv 2021;34(5):274-279. DOI: https://doi.org/10.1089/jamp.2020.1606
- Abidi SH, Sherwani SK, Siddiqui TR, Bashir A, Kazmi SU. Drug resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolated from contact lenses in Karachi – Pakistan. BMC Ophthalmol 2013;13:57. DOI: https://doi.org/10.1186/1471-2415-13-57