Shenade Annie Kerketta, Amity University Kolkata
Medical devices (MD) such as Venous catheter (CVC), abdominal drain tube, and Foley’s catheter tip are used in patients to transfer fluids. These devices tend to harbour certain microbial strains that produce biofilm. Biofilm is a polymeric matrix that conceals several bacterial strains into a single unit and provides antibiotic resistance. The antibiotic resistance exhibited by such strains makes it difficult to cure the infections incurred. The hospitalized patients suffer more due to DRIs. The MDs used for these patients mainly lead to DRIs. This is why the reason (MDR strains) behind DRIs must be studied to help with patient care. This article will discuss the recent experiment conducted to study MULTI-DRUG RESISTANCE (MDR) strains growing on MD.
How was the study conducted?
DEVICE-RELATED INFECTIONS (DRIs) are contributing largely to the mortality rate. Prolonged exposure(>48hrs) to MDs lead to fungal and bacterial infections. This experiment aimed to study MDR strains and how they become antibiotic-resistant. This study was done to come up with a remedial solution for DRIs. The following procedures were followed to measure the different parameters.
- 65 CVCs, 8 Foley catheters, 2 nephrostomy tubes, and 1 abdominal drain tube were collected for the experiment.
- MALDI-TOF MS was used to conduct bacterial identifications. A score >=2.0 indicated the presence of a species.
- The confirmation of results obtained from MALDI-TOF MS was completed by PHOENIX BD. Phoenix BD was also used to test for antibiotic resistance (according to EUCAST guidelines). Resistance >=3 determined antibiotic-resistant strains.
- TCP (tissue culture plate) method was applied to assess biofilm formation. Biofilm formation was categorized as negative, weak, moderate, and strong. It was calculated according to the formula:
OD (optical density) cutoff = ODavg of negative control +(3*standard deviation of ODs of negative control).
- IMB SPSS software was used to carry out statistical analysis of the data collected.
- The antibiotics used in this experiment to check for antibiotic resistance were: Ampicillin, amoxicillin, amikacin, cefotaxime, cefuroxime, fosfomycin, gentamicin, imipenem, and levofloxacin
Results:
Some medical devices had single microbial contamination (77.6%) while others had polymicrobial contamination. The CVCs showed the maximum amount of polymicrobial contamination. Biofilm production was more prevalent in the MDR strains indicating a clear relationship between antibiotic resistance and biofilm production. It is safe to say that antibiotic resistance is caused due to biofilm formation. Biofilm production and antibiotic resistance were strongly seen in (A.baumannii, S.marcescenes, P.mirabilis, K.pneumoniae, CoNS, and E.coli).
Conclusion:
Through this experiment, we discovered the different strains that cause DRIs and how to deal with them. Glycopeptides and sulphonamides antibiotic class work against CoNS strains, and fluoroquinolones, aminoglycoside are effective against (P.aeruginosa, E.coli, and K.pneumoniae). We can also sterilize MDs to prevent microbial growth. We also learned about the relationship between antibiotic resistance and biofilm production. The reason for antibiotic treatment failure is known now, which will encourage solutions leading to better patient care and treatment plan.
Also read: ADE: Antibody Assisted Entry of Viruses
Reference:
- Folliero, V., Franci, G., Dell’Annunziata, F., Giugliano, R., Foglia, F., Sperlongano, R., De Filippis, A., Finamore, E., & Galdiero, M. (2021). Evaluation of antibiotic resistance and biofilm production among clinical strain isolated from medical devices. International Journal of Microbiology, 2021, 1–11. https://doi.org/10.1155/2021/9033278
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