title: Association of biofilm production with colonization among clinical isolates ofAcinetobacter baumannii.
abstract: OBJECTIVE
  The pathogenAcinetobacter baumanniiis increasingly causing healthcare-associated infections worldwide, particularly in intensive care units. Biofilm formation, a factor contributing to the virulence ofA. baumannii, is associated with long-term persistence in hospital environments. The present study investigates the clinical impact of biofilm production on colonization and acquisition after patient admission.
  
  
  METHODS
  Forty-nineA. baumanniiisolates were obtained between August and November 2013 from Keimyung University Dongsan Medical Center, Daegu, Korea. All isolates were obtained from sputum samples of new patients infected or colonized byA. baumannii. The microtiter plate assay was used to determine biofilm formation.
  
  
  RESULTS
  Twenty-fourA. baumanniiisolates (48%) demonstrated enhanced biofilm formation capacity than that of the standardA. baumanniistrain (ATCC 19606). All isolates were resistant to carbapenem, 38 isolates (77%) were collected from patients in an intensive care unit, and 47 isolates (95%) were from patients who had been exposed to antibiotics in the previous month. The median duration of colonization was longer for biofilm-producing isolates than that of the biofilm non-biofilm producing isolates (18 days vs. 12 days,p< 0.05). Simultaneous colonization with other bacteria was more common for biofilm-producing isolates than that for the non-biofilm producing isolates. The most prevalent co-colonizing bacteria wasStaphylococcus aureus.
  
  
  CONCLUSIONS
  Biofilm-producing isolates seem to colonize the respiratory tract for longer durations than the non-biofilm producing isolates. During colonization, biofilm producers promote co-colonization by other bacteria, particularlyS. aureus. Additional research is required to determine possible links between biofilm formation and nosocomial infection.
authors.affiliation: Department of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Seong Yeol
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Department of Microbiology, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Won-Ki
authors.initials: WK
authors.lastname: Baek
authors.affiliation: Department of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Kim
mesh_terms: D000151:Acinetobacter Infections / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000472:pathogenicity* / Q000502:physiology; D000368:Aged; D018441:Biofilms / Q000254:growth & development*; D003428:Cross Infection / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D014774:Virulence
keywords: Acinetobacter baumannii; Biofilms; Cross infection