Biofilm Formation and its Association with Gram Negative Sepsis Pathogenicity

Abstract

Background and objectives: Biofilm formation is an important virulence factor that protects an organism from antimicrobial agents as well as host immune effectors, thus allowing organisms to invade, survive, and cause persistent-reoccurring infection in host cells. The aim of this study was to investigate the ability of sepsis-causing gram-negative bacteria to form biofilms, evaluate the association between antibiotic resistance pattern and biofilm formation, determine the role and influence of biofilm formation on pathogenicity and clinical outcome of sepsis. Methods: A prospective study conducted from October 2020 to August 2021, non-replicated gram-negative bacteria isolates were recovered from blood samples of patients with suspected bacteremia, sepsis, and sepsis shock and identified using biochemical procedures. Antimicrobial susceptibility patterns of GNB isolates were determined using the Kirby-Bauer disc diffusion method and interpreted using CLSI guidelines. The ability of GNB isolates to form biofilm was assessed using Congo red agar and the tissue culture plate method. Results: Of the 160 Gram-negative bacteria tested, biofilm formation was seen in 73 (45.63%) isolates. Isolates are Klebsiella pneumoniae (39.73%), Acinetobacter spp. (34.25%), Escherichia coli (23.29%), Pseudomonas aeruginosa (1.37%), and other non-fermenters (1.37%). Isolates were highly resistant to cephalosporins, fluoroquinolones, and the penicillin group of antibiotics. No statistical relationship was found between resistance pattern, clinical outcome, and biofilm formation. Conclusion: In the current study, we found that 45.63% of gram-negative bacteria causing sepsis were biofilm producers. Klebsiella pneumonia isolates exhibited the highest levels of biofilm formation and antimicrobial resistance. Based on the strength of biofilm formation, most isolates were weak biofilm producers, and there was no statistical correlation between the formation of biofilms and antimicrobial resistance, indicating that the formation of biofilms was not a determining factor for resistance.

Molecular evaluation of aminoglycosides resistance and biofilm formation inKlebsiella pneumoniaeclinical isolates: A cross‐sectional study

“…However, the presence of association between antibiotic resistance and biofilm formation capacity is still debated by some researchers. 40,41 This study showed that ecpA, fimA, mrkD, and mrkA genes were harbored by all biofilm producing K. pneumoniae strains, whereas fimH was determined in 93% (82/88) of isolates. The prevalence of mrkA, ecpA, and fimH (100%) in our study were almost similar to that reported by Alcántar-Curiel et al 21 In addition, consistent with our results, Alcántar-Curiel et al, 21 showed that 80% of K. pneumoniae isolates were able to produce biofilm and all isolates carried the mrkA gene.…”

“…In line with our results, Vuotto et al 39 showed a positive relationship between antibiotic resistance profile and biofilm‐forming ability in XDR K. pneumoniae strains. However, the presence of association between antibiotic resistance and biofilm formation capacity is still debated by some researchers 40,41 …”

“…However, the presence of association between antibiotic resistance and biofilm formation capacity is still debated by some researchers. 40 , 41 …”

Biofilm formation and antimicrobial resistance in Enterobacterales isolated from cases of septicemia-Protocol

“…Bio lms are microbial-derived surface-associated cells that are enclosed in an extracellular polymeric substance matrix and attached to substratum or to each other in an irreversible way. Bio lms are important virulence factors which are produced through a serial process beginning with a single species of bacteria with mbria, pili or agella attaching to the conditioning lm then progressing to form microcolonies and colonies after longer exposure eventually forms a mass that detaches after maturation 3 . Bacteria form bio lm as a part of their survival mechanisms [4].…”

“…Bacteria form bio lm as a part of their survival mechanisms [4]. Bio lm formation is a serious clinical issue because bio lms promotes antimicrobial resistance by slowing down antimicrobial diffusion and also by facilitating plasmid exchange [3].Bio lm formation is also associated with the severity, persistence and relapse of infection [3] For Enterobacterales resistance to the beta lactam class of antibiotics is particularly concerning because they are the cornerstone of treatment for these infections. Resistance to beta lactam antibiotics can occur via e ux pumps, altered penicillin binding sites and beta lactamases which cleave the beta lactam ring and inactivate the target antibiotic [2] The present study will be conducted to nd out the bacteria belonging to Enterobacterales family causing septicaemia in our community and their ability to form bio lms and also to correlate the antimicrobial resistance pattern of the organisms with bio lm forming capacity.…”