Biofilm Formation by Pathogens Causing Ventilator-Associated Pneumonia at Intensive Care Units in a Tertiary Care Hospital: An Armor for Refuge.

Background. Emerging threat of drug resistance among pathogens causing ventilator-associated pneumonia (VAP) has resulted in higher hospital costs, longer hospital stays, and increased hospital mortality. Biofilms in the endotracheal tube of ventilated patients act as protective shield from host imm...

Descripción completa

Detalles Bibliográficos
Publicado en:BioMed Research International pp. 1 - 11
Autores principales: Baidya, Sujata, Sharma, Sangita, Mishra, Shyam Kumar, Kattel, Hari Prasad, Parajuli, Keshab, Sherchand, Jeevan Bahadur
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell 5/29/2021
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150574716&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 150574716
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        23146133
        FT2T
      jtl: BioMed Research International
      issn: 23146133
      maglogo: N
    pubinfo:
      dt: 5/29/2021
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        150574716
        150574716
        150574716
        10.1155/2021/8817700
        150574716
      ppf: 1
      ppct: 10
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Biofilm Formation by Pathogens Causing Ventilator-Associated Pneumonia at Intensive Care Units in a Tertiary Care Hospital: An Armor for Refuge.
      aug:
        au:
          Baidya, Sujata
          Sharma, Sangita
          Mishra, Shyam Kumar
          Kattel, Hari Prasad
          Parajuli, Keshab
          Sherchand, Jeevan Bahadur
        affil: Department of Clinical Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
      sug:
        subj:
          Biofilms
          Equipment Contamination Adverse Effects
          Pneumonia, Ventilator-Associated Etiology
          Drug Resistance
          Intensive Care Units
          Tertiary Health Care
          Human
          Respiration, Artificial Adverse Effects
          Bronchoalveolar Lavage
          Aspiration Microbiology
          Nepal
          Pseudomonas
          Acinetobacter Infections
          Gram-Negative Aerobic Bacteria
          Klebsiella
          Citrobacter
          Staphylococcus Aureus
          Escherichia
          Enterococcus
          Burkholderia
          Candida Albicans
          Female
          Male
          Infant, Newborn
          Infant
          Child, Preschool
          Child
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Descriptive Statistics
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Background. Emerging threat of drug resistance among pathogens causing ventilator-associated pneumonia (VAP) has resulted in higher hospital costs, longer hospital stays, and increased hospital mortality. Biofilms in the endotracheal tube of ventilated patients act as protective shield from host immunity. They induce chronic and recurrent infections that defy common antibiotics. This study intended to determine the biofilm produced by pathogens causing VAP and their relation with drug resistance. Methods. Bronchoalveolar lavage and deep tracheal aspirates (n = 70) were obtained from the patients mechanically ventilated for more than 48 hours in the intensive care units of Tribhuvan University Teaching Hospital, Kathmandu, and processed according to the protocol of the American Society for Microbiology (ASM). Antibiotic susceptibility testing was done following Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines. Biofilm formation was determined using the microtiter plate method described by Christensen and modified by Stepanovoic et al. Results. Significant microbial growth was seen in 78.6% of the total samples with 52.7% monomicrobial, 45.5% polymicrobial, and 1.8% fungal infection. Among the 71 isolates obtained, bulk was gram-negative (n = 64 , 90.1%). Pseudomonas aeruginosa (31.0%) was the predominant isolate followed by Acinetobacter calcoaceticus baumannii complex (16.9%), Klebsiella pneumoniae (16.9%), Citrobacter freundii (15.5%), Staphylococcus aureus (7.0%), Escherichia coli (5.6%), Citrobacter koseri (2.8%), Enterococcus faecalis (1.4%), Burkholderia cepacia complex (1.4%), and Candida albicans (1.4%). Of the total isolates, 56.3% were biofilm producers. Multidrug-resistant (MDR) organisms, extended-spectrum β-lactamase (ESBL), and metallo-β-lactamase (MBL) producers were preeminent among the biofilm producers. The highest producer of biofilm was P. aeruginosa (19.7%). Among gram-negative biofilm producers, 42.2% were MDR, 21.9% were ESBL producers, and 7.8% were MBL producers. Conclusion. Gram-negative nonfermenter bacteria account for the bulk of nosocomial pneumonia. MDR, ESBL, and MBL production was preponderant among the biofilm producers. The rampant spread of drug resistance among biofilm producers is summoning novel interventions to combat multidrug resistance.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N