Biofilm production and multidrug resistant bacterial isolates in ventilator associated pneumonia
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Date
2018-01
Journal Title
Journal ISSN
Volume Title
Publisher
Scientific Scholar
Abstract
Context: Ventilator-associated pneumonia is the second most common complication among all types of nosocomial infections.
Mechanical ventilation predisposes to formation of a biofilm which worsens the prognosis because of increased multidrug
resistant isolates implicated in formation of biofilm.
Aim of the Study: The study was conducted to find out the relationship between duration of mechanical ventilation, biofilm
formation, and antibiotic resistance among VAPpathogens.
Study Design and Methods: A descriptive analytical study of 150 clinically suspected VAPpatients was done. Patients were
divided into Group I and II based on intubation duration for 1–5 days and more than 6 days, respectively. Endotracheal aspirate
was collected from clinically diagnosed cases and processed as per standard microbiological techniques. Bacterial counts ? 106
CFU/ mLfor quantitative cultures were considered significant. Biofilm production was detected by tissue culture plate method.
Multivariate analysis was done to find out the association of the various factors.
Results: Klebsiella pneumoniae was the predominant bacteria isolated followed by Acinetobacterbaumannii. Among Gram
negative bacteria 66.8% were ?-lactamase producers. In biofilm production by tissue culture method, Group I patients, 72.4%
of the isolates showed either strong / moderate biofilm formation and in Group II patients, 92.3% of the isolates showed either
strong / moderate biofilm formation. Multivariate analysis revealed that bacteria isolated from VAPoccurring after 5 days of
mechanical ventilation among prior antibiotic-treated patients were resistant to all the antibiotics tested.
Conclusion: Bacterial aetiology, prolonged intubation, biofilm formation, and drug resistance have ramification on outcome of
VAP. Hence removal of ET tube in regular intervals should be considered with a proper choice of antimicrobial treatment or
using ETtube coated with drugs/ biomaterials that discourage biofilm formation may be explored.
Description
Keywords
Ventilator-associated pneumonia, Biofilm, Multidrug-resistant bacteria
Citation
C.S Vinod Kumar, Patil Satish, Prasad B.S., A Arun Kumar, Kalappanavar N.K., K.G Raghu Kumar, V.L Jayasimha, K.G Basavarajappa. Biofilm production and multidrug resistant bacterial isolates in ventilator associated pneumonia. Indian Journal of Medical Sciences. 2018 JAN; 70(1): 23-27