title: Detection of biofilm production and antibiotic resistance pattern in clinical isolates from indwelling medical devices.
abstract: Microbial biofilms pose great threat for patients requiring indwelling medical devices (IMDs) as it is difficult to remove them. It is, therefore, crucial to follow an appropriate method for the detection of biofilms. The present study focuses on detection of biofilm formation among the isolates from IMDs. We also aimed to explore the antibiogram of biofilm producers. This prospective analysis included 65 prosthetic samples. After isolation and identification of bacteria following standard methodology, antibiogram of the isolates were produced following Kirby-Bauer disc diffusion method. Detection of biofilms was done by tube adherence (TA), Congo red agar and tissue culture plate (TCP) methods. Out of 67 clinical isolates from IMDs, TCP detected 31 (46.3 %) biofilm producers and 36 (53.7 %) biofilm non-producers. Klebsiella pneumoniae, Pseudomonas aeruginosa and Burkholderia cepacia complex were found to be the most frequent biofilm producers. The TA method correlated well with the TCP method for biofilm detection. Higher antibiotic resistance was observed in biofilm producers than in biofilm non-producers. The most effective antibiotics for biofilm producing Gram-positive isolates were Vancomycin and Tigecycline, and that for biofilm producing Gram-negative isolates were Polymyxin-B, Colistin Sulphate and Tigecycline. Nearly 46 % of the isolates were found to be biofilm producers. The antibiotic susceptibility pattern in the present study showed Amoxicillin to be an ineffective drug for isolates from the IMDs. For the detection of biofilm production, TA method can be an economical and effective alternative to TCP method.
authors.affiliation: Department of Microbiology, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal, shyammishra@iom.edu.np.
authors.forename: Shyam Kumar
authors.initials: SK
authors.lastname: Mishra
authors.forename: Prashant
authors.initials: P
authors.lastname: Basukala
authors.forename: Om
authors.initials: O
authors.lastname: Basukala
authors.forename: Keshab
authors.initials: K
authors.lastname: Parajuli
authors.forename: Bharat Mani
authors.initials: BM
authors.lastname: Pokhrel
authors.forename: Basista Prasad
authors.initials: BP
authors.lastname: Rijal
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D018407:Bacterial Physiological Phenomena; D018441:Biofilms; D024881:Drug Resistance, Bacterial; D004866:Equipment Contamination / Q000706:statistics & numerical data; D006801:Humans; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents