Biofilm production and its correlation with antibiotic resistance pattern among clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital in north-east India

Abstract

INTRODUCTIONPseudomonas aeruginosa is an aerobic, motile, nutritionally versatile, gram negative bacteria. It is ubiquitous, human opportunistic pathogen and has implications on morbidity, mortality and healthcare costs both in hospitals and in the community.1 Infections caused by P. aeruginosa are frequently life-threatening and difficult to treat causing increased stay in hospital and even increased morbidity and mortality as it exhibits intrinsically high resistance to many antimicrobials and the development of multi-drug resistance in health care settings.2,3 Biofilms are defined as microbially derived sessile communities characterized by the cells that are irreversibly attached to a substratum or to each other. They are embedded in a matrix of extracellular polymeric substances (EPS) they have produced, and exhibit an altered phenotype with respect to growth rate and gene transcription.4 Within a biofilm, bacteria communicate with each other by production of chemotactic particles or ABSTRACT Background: Pseudomonas aeruginosa is an ubiquitous pathogen capable of surviving in a variety of environmental conditions. It is increasingly gaining importance as a multidrug resistant nosocomial pathogen. Biofilm acts as a barrier, reducing the penetration of these drugs and consequently, preventing them from exercising their actions. The aim of this study is to isolate and identify Pseudomonas aeruginosa from various clinical specimen and to find out their production of biofilms and their correlation with antibiotic susceptibility pattern. Methods: All Pseudomonas aeruginosa over a period of 1 year were isolated and identified from clinical specimens and antibiotic susceptibility test was done following standard operative procedures. Biofilm detection was done by Congo Red Agar method (CRA). Results: 134 isolates of Pseudomonas aeruginosa was isolated. Maximum isolates were isolated from sputum samples 55 (41%) and most were from wards 68 (51%) giving a probability of increased healthcare associated infections. Biofilm production by the isolates was seen in 39 (29%). All the biofilm producing isolates shows more resistant pattern in comparison to non-biofilm producers. 69% of Imipenem and 82% of Meropenem resistant isolates produce biofilm. All the P. aeruginosa including MDR and biofilm forming strains were sensitive to Colistin. Conclusions: Resistance to antimicrobial agents is the most important feature of biofilm infections. Ability of P. aeruginosa to form biofilms renders antibiotic treatments inefficient and therefore promotes chronic infectious diseases. As a result, infections caused by bacterial biofilms are persistent and very difficult to eradicate.

Association of biofilm production in ESBL and MBL producing clinical isolates of Pseudomonas aeruginosa

“…The present study show, maximum biofilm-producing isolates recovered from specimens received from ICU (63.64%) compared to the ward (36.36%) and similar findings was shown in another study (83.3%) [2]. This could be possibly due to the ICU setup uses multiple medical devices for treatment and intervention of patient care although indwelling devices used widely in hospitals [24] and biofilm is known for colonizing these medical devices.…”

“…This may be due to the widespread use of these easily available antibiotics without knowing the infection status. All isolates were susceptible to polymyxin-B and colistin like other studies [1,2,21].…”

“…The antibiotic susceptibility of biofilm-producing bacteria is reduced because of a restricted antibiotic penetration, adaptive response and the occurrence of persisting cells [2].…”

“…Pseudomonas aeruginosa is remarkably considered one of the most adaptive nosocomial pathogens [1]. Infections resulting from P. aeruginosa are frequently life-threatening and hard to treat causing elevated stay in a medical institution or even accelerated morbidity and mortality as it exhibits intrinsically excessive resistance to many antimicrobials and the development of multi-drug resistance in health care settings [2]. Pseudomonas aeruginosa is a gram-negative, non-fermenting, obligately aerobic, the saprophytic bacterium which is widely distributed [3].…”

Insights into Antagonistic Interactions of Multidrug Resistant Bacteria in Mangrove Sediments from the South Indian State of Kerala

“…Such variation within species would make it unreliable to establish a concentrate relationship on the biofilm formation and genus. Moreover, significant correlation was found between antibiotic resistance and biofilm formation in Pseudomonas aeruginosa [45,46] while other studies have found otherwise [47]. A study between P. aeruginosa from environmental and human sources observed significantly weaker biofilm formation and susceptibility to most antibiotics from environmental isolates as compared to human sources [48].…”