DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20203916

Biofilm production and its effects on virulence of MRSA: a study in tertiary care hospital, Delhi

Amir Khan, Rachna Tewari, Neetusree ., Mridu Dudeja

Abstract


Background: The aim of this study was to study the prevalence of biofilm formation in MRSA and its effect on virulence and the antimicrobial resistance pattern on MRSA strains from different clinical samples.

Methods: A total of 221 isolates of S. aureus isolates were selected from various clinical specimens. Prevalence was estimated according to age, sex, and location.  The antibiotic susceptibility test was conducted according to the guidelines of CLSI by the VITEK 2 automated system. 113 strains were identified as MRSA by cefoxitin disc methods which were then subjected to Microtiter plate assay method to confirm phenotypic biofilm formation.

Results: 51.13% isolates were resistant to methicillin, and 48.86% isolates were methicillin sensitive. The most common source of MRSA isolation was blood. MRSA isolates were mostly isolated from male. 33.63% MRSA and 19.44% MSSA isolates were strong biofilm producers while 12.38% MRSA and 14.81% were low biofilm producers. The resistance for commonly used antibiotics like benzyle penicillin, ciprofloxacin, cotrimoxazole, and erythromycin was more in MRSA strains and MIC was higher in biofilm producers.

Conclusion: Statistical difference was observed between MSSA and MRSA regarding biofilm formation and antimicrobial resistance. A Biofilm producer shows resistance to many antibiotics and also make host immunity in effective. In hospitals Biofilm production should be checked regularly before giving treatment. And research should be done to find out other effective drugs to eradicate biofilms.

 


Keywords


Biofilm, Methicillin-resistant Staphylococcus aureus, Biofilm producers

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References


Von Eiff C, Becker K, Machka K, Stammer H, Peters G. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med. 2001;344(1):11-6.

Plata, K., A.E. Rosato, and G. Wegrzyn. Staphylococcus aureus as an infectious agent: overview of biochemistry and molecular genetics of its pathogenicity. Acta Biochim Pol.009;56(4): 597-612.

Liu, G.Y., et al., Staphylococcus aureus golden pigment impairs neutrophil killing and promotes virulence through its antioxidant activity. J Exp Med, 2005;202(2):209-15.

Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospi-tals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39: 309-17.

Deurenberg RH, Stobberingh EE. The evolution of Staphylococcus aureus. Infection, genetics and evolution. J Mol Epidemiol Evolut Genet Infect Dis. 2008;8:747-63.

Kirby, W.M., Extraction of a Highly Potent Penicillin Inactivator from Penicillin Resistant Staphylococci. Science, 1944. 99(2579): p. 452-3.

Barber, M. and M. Rozwadowska-Dowzenko, Infection by penicillin-resistan staphylococci. Lancet, 1948;2(6530):641-4.

Periasamy S, Joo HS, Duong AC, Bach THL, Tan VY, Chatterjee SS, Cheung GY, Otto M. How Staphylo-coccus aureus biofilms develop their characteristic structure. Proceedings of the national academy of sciences USA. 2012;109(4):1281-6.

Mirzaee M, Najar-Peerayeh S, Behmanesh M, Forouzandeh Moghadam M. Relationship between adhesin genes and biofilm formation in vancomycin-intermediate Staphylococcus aureus clinical isolates. Current microbiology. 2015;70:665-670.

O'Gara JP. ica and beyond: biofilm mechanisms and regulation in Staphylococcus epidermidis and Staphylococcus aureus. FEMS microbiology letters 2007;270(2):179-188.

Foster TJ. Immune evasion by staphylococci. Nature reviews microbiology. 2005;3(12):948-958.

Atshan SS, Nor Shamsudin M, Sekawi Z, Lung LTT, Hamat RA, Karunanidhi A, et al. Prevalence of adhesion and regulation of biofilm-related genes in different clones of Staphylococcus aureus. J biomed Biotechnol 2012.

Archer NK, Mazaitis MJ, Costerton JW, Leid JG, Powers ME, Shirtliff ME. Staphylococcus aureus biofilms: properties, regulation, and roles in human disease. Virulence. 2011;2(5):445-459.

Collee JG, Mackie TJ, McCartney JE. Mackie and McCartney Practical Medical Microbiology. New York: Churchill Livingstone.1996

Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; 20th Informational Supplement. Wayne PA: Clinical and Laboratory Standards Institute. 2010.

Eichi Ando, Koichi Mordem et al., Biofilm formation among MRSA isolates from patients with urinary tract infection-Japan.

Gopalakrishnan R, Sureshkumar D. Changing trends in antimicrobial susceptibility and hospital acquired infections over an 8 year period in a tertiary care hospital in relation to introduction of an infection control programme. J Assoc Physicians India. 2010;58:25-31.

Ranbeer pal and Sumit Kar et al., Prevelance of MRSA in clinical isolate. 2011.

Sangeeta Joshi, Pallab Ray, et al., Methicillin resistant Staphylococcus aureus (MRSA) in India: Prevalence & susceptibility pattern Indian Network for Surveillance of Antimicrobial Resistance (INSAR) group, India.

P. G. Bowler, Antibiotic resistance and biofilm tolerance: a combined threat in the treatment of chronic infections, J. Wound Care. 2018;27(5):273-7.

L. Hall-Stoodley, J. W. Costerton and P. Stoodley, Bacterial biofilms: from the natural environment to infectious diseases, Nat. Rev. Microbiol. 2004;2(2):95-108.

S. Miyaue, E. Suzuki, Y. Komiyama, Y. Kondo, M. Morikawa and S. Maeda, Bacterial Memory of Persisters: Bacterial Persister Cells Can Retain Their Phenotype for Days or Weeks After Withdrawal From Colony-Biofilm Culture, Front. Microbial. 2018;9:1396.

T. K. Wood, Strategies for combating persister cell and biofilm infections, Microb. Biotechnol., 2017;10(5):1054-6.

B. P. Conlon, S. E. Rowe and K. Lewis, Persister cells in biofilm associated infections, Adv. Exp. Med. Biol., 2015;831:1-9.

Antibiotic resistance and biofilm production among the strains of Staphylococcus aureus isolated in a tertiary care hospital in Nepal.Belbase A, Pant ND, Nepal K, Neupane B, Baidhya R, Baidya R, Lekhak B.Ann Clin Microbiol Antimicrob. 2017 Apr 13;16(1):30.

D. L. Ackerman, K. M. Craft, R. S. Doster, J. H. Weitkamp, D. M. Aronoff and J. A. Gaddy, et al., Antimicrobial and Antibiofilm Activity of Human Milk Oligosaccharides against Streptococcus agalactiae, Staphylococcus aureus, and Acinetobacte.