Abstract
IS THERE CORRELATION OF BIOFILM FORMATION WITH MULTIDRUG RESISTANCE AND ESBL PRODUCTION IN PSEUDOMONAS AERUGINOSA?

Puja Neopane, Hari Prasad Nepal*, Rajendra Gautam, Rama Paudel, Shamshul Ansari, Sony Shrestha, Sangita Thapa

ABSTRACT

Background: Pseudomonas aeruginosa is a Gram-negative ubiquitous bacterium which has emerged as one of the leading cause of nosocomial infections. This bacterium has an ability to form biofilm. Antimicrobial resistance is the innate feature of the biofilm producing P. aeruginosa. Production of extended spectrum β-lactamase (ESBL) enzyme is one of the common antimicrobial resistance mechanisms observed in P. aeruginosa. Therefore, the objective of this study was to determine the correlation of biofilm formation with multidrug resistance and ESBL production in P. aeruginosa. Methods: The study was carried out in the Department of Microbiology of a tertiary care hospital located in central Nepal. A total of 55 strains of P. aeruginosa isolated from clinical samples such as pus/wound, blood, sputum, endotracheal tube and urine were identified by standard microbiological techniques. The isolates were further tested for antimicrobial susceptibility by Kirby-Bauer disk diffusion method on Mueller Hinton agar as per CLSI guidelines. The isolates were considered multidrug resistant (MDR) when they were non-susceptible to ≥ 1 agent in ≥ 3 antimicrobial categories. Biofilm formation was detected by microtitre culture plate method. ESBL production was screened and further confirmed by disk diffusion methods. Results: Biofilm formation was detected in 76.4% of P. aeruginosa. Resistance to cephalosporins; 3rd and 4th generations, and aztreonam were significantly higher in biofilm producers than in biofilm non-producers. All the isolates were sensitive to polymyxin B. Among the biofilm producers, 40.5% were MDR isolates. All the biofilm non-producers were non-MDR isolates. 50% biofilm producers were ESBL producers whereas only 7.7% biofilm non-producers were ESBL producers. Significant association was found to exist between biofilm formation and development of multidrug resistance and ESBL production in P. aeruginosa. Conclusion: P. aeruginosa has high tendency to form biofilm which is strongly associated with multidrug resistance and the ESBL production.

Keywords: Pseudomonas aeruginosa, multidrug resistance, ESBL production.


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