Antibiogram and biofilm formation among extended-spectrum ?-lactamase-producing Klebsiella pneumoniae clinical isolates in Sanglah General Hospital, Bali, Indonesia
- PDF |
- DOI: https://doi.org/10.15562/ism.v12i1.909 |
- Published: 2021-04-30
Open Access & Peer Reviewed
Multidisciplinary Journal of Science and
Medical Research
Multidisciplinary Journal of Science and
Medical Research
Abstract
Background: Klebsiella pneumoniae is a common cause of healthcare-associated infections (HAIs), and has a high level of resistance to antibiotics first, second, extended-spectrum cephalosporins, and monobactam which are a serious threat to public health worldwide. Besides, it is known that this bacterium can form biofilms as virulence factors that contribute to drug resistance. This study aims to determine the antibiotics susceptibility patterns and the capacity of K. pneumoniae to form biofilms.
Methods: K. pneumoniae was isolated from clinical specimens (urine, sputum, pus, blood, and others) for the period 2018-2019. Bacterial identification and antibiotic susceptibility testing were performed using the Vitek Compact 2 (bioMérieux®) test in the Clinical Microbiology Laboratory of Sanglah General Hospital. Biofilm formation was checked using the tissue culture plate method (TCP). Data were analyzed using SPSS version 20 for Windows.
Results: Most of Extended Spectrum ?-Lactamase (ESBL)-producing K. pneumoniae showed resistance to antibiotics. The susceptible profiles were only towards ertapenem (97.50%), meropenem (97.50%), amikacin (95.00%), and tigecycline (87.50%). The TCP method detected 72 (90.00%) as biofilm producers among 80 clinical isolates, while 8 (10.0%) as non-biofilm producers. Among the biofilm-producer bacteria, there were 6 (7.50%) as strong, 37 (46.25%) moderate, and 29 (36.25%) weak biofilm-producer isolates.
Conclusions: Most ESBL-producing K.pneumoniae clinical isolates in Sanglah General Hospital demonstrate multiple resistance to antibiotics and as biofilm producers. However, further research is needed to be conducted using a molecular approach to see the ESBL- and biofilm-encoded genes.
Keywords:
Klebsiella pneumoniae
Multidrug Resistance
Antibiogram
Tissue Culture Plate
Crystal Violet
Biofilm
References
1. Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections - an overview. Infect Drug Resist. 2018;11:2321-2333.
2. Santajit S, Indrawattana N. Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. Biomed Res Int. 2016;2016:2475067.
3. Seifi K, Kazemian H, Heidari H, Rezagholizadeh F, Saee Y, Shirvani F, et al. Evaluation of Biofilm Formation Among Klebsiella pneumoniae Isolates and Molecular Characterization by ERIC-PCR. Jundishapur J Microbiol. 2016;9(1):e30682.
4. Piperaki ET, Syrogiannopoulos GA, Tzouvelekis LS, Daikos GL. Klebsiella pneumoniae: Virulence, Biofilm and Antimicrobial Resistance. Pediatr Infect Dis J. 2017;36(10):1002-1005.
5. Pitout JD, Nordmann P, Poirel L. Carbapenemase-Producing Klebsiella pneumoniae, a Key Pathogen Set for Global Nosocomial Dominance. Antimicrob Agents Chemother. 2015;59(10):5873-5884.
6. Gupta A, Ampofo K, Rubenstein D, Saiman L. Extended spectrum beta lactamase-producing Klebsiella pneumoniae infections: a review of the literature. J Perinatol. 2003;23(6):439-443.
7. Baran I, Aksu N. Phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Turkey. Ann Clin Microbiol Antimicrob. 2016;15:20.
8. Jamal M, Tasneem U, Hussain T, Andleeb S. Bacterial Biofilm: Its Composition, Formation and Role in Human Infections. Res Rev J Microbiol Biotechnol. 2015;4(3):1-15.
9. Danhorn T, Fuqua C. Biofilm formation by plant-associated bacteria. Annu Rev Microbiol. 2007;61:401-422.
10. Mathur T, Singhal S, Khan S, Upadhyay DJ, Fatma T, Rattan A. Detection of biofilm formation among the clinical isolates of Staphylococci: an evaluation of three different screening methods. Indian J Med Microbiol. 2006;24(1):25-29.
11. Christensen GD, Simpson WA, Younger JJ, Baddour LM, Barrett FF, Melton DM, et al. Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol. 1985;22(6):996-1006.
12. Hassan A, Usman J, Kaleem F, Omair M, Khalid A, Iqbal M. Evaluation of different detection methods of biofilm formation in the clinical isolates. Braz J Infect Dis. 2011;15(4):305-311.
13. Stepanovi? S, Vukovi? D, Hola V, Di Bonaventura G, Djuki? S, Cirkovi? I, et al. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS. 2007;115(8):891-9.
14. Khan E, Ejaz M, Zafar A, Jabeen K, Shakoor S, Inayat R, et al. Increased isolation of ESBL producing Klebsiella pneumoniae with emergence of carbapenem resistant isolates in Pakistan: report from a tertiary care hospital. J Pak Med Assoc. 2010;60(3):186-90.
15. Borges A, Saavedra MJ, Simões M. Insights on antimicrobial resistance, biofilms and the use of phytochemicals as new antimicrobial agents. Curr Med Chem. 2015;22(21):2590-2614.
16. Kidd TJ, Mills G, Sá-Pessoa J, Dumigan A, Frank CG, Insua JL, et al. A Klebsiella pneumoniaeantibiotic resistance mechanism that subdues host defences and promotes virulence. EMBO Mol Med. 2017;9(4):430-447.
17. Nirwati H, Sinanjung K, Fahrunissa F, Wijaya F, Napitupulu S, Hati VP, et al. Biofilm formation and antibiotic resistance of Klebsiella pneumoniaeisolated from clinical samples in a tertiary care hospital, Klaten, Indonesia. BMC Proc. 2019;13(Suppl 11):20.
18. Lin WP, Wang JT, Chang SC, Chang FY, Fung CP, Chuang YC, et al. The Antimicrobial Susceptibility of Klebsiella pneumoniae from Community Settings in Taiwan, a Trend Analysis. Sci Rep. 2016;6:36280.
19. Asati S, Chaudhary U. Comparison of tissue culture plate and modified tissue culture plate method for biofilm detection in members of family enterobacteriaceae. J Clin Diagnostic Res. 2018;12(7):20–3.
20. Alcántar-Curiel MD, Ledezma-Escalante CA, Jarillo-Quijada MD, Gayosso-Vázquez C, Morfín-Otero R, Rodríguez-Noriega E, et al. Association of Antibiotic Resistance, Cell Adherence, and Biofilm Production with the Endemicity of Nosocomial Klebsiella pneumoniae. Biomed Res Int. 2018;2018:7012958.
21. Eftekhar F, Speert DP. Biofilm formation by persistent and non-persistent isolates of Staphylococcus epidermidis from a neonatal intensive care unit. J Hosp Infect. 2009;71(2):112-116.
2. Santajit S, Indrawattana N. Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. Biomed Res Int. 2016;2016:2475067.
3. Seifi K, Kazemian H, Heidari H, Rezagholizadeh F, Saee Y, Shirvani F, et al. Evaluation of Biofilm Formation Among Klebsiella pneumoniae Isolates and Molecular Characterization by ERIC-PCR. Jundishapur J Microbiol. 2016;9(1):e30682.
4. Piperaki ET, Syrogiannopoulos GA, Tzouvelekis LS, Daikos GL. Klebsiella pneumoniae: Virulence, Biofilm and Antimicrobial Resistance. Pediatr Infect Dis J. 2017;36(10):1002-1005.
5. Pitout JD, Nordmann P, Poirel L. Carbapenemase-Producing Klebsiella pneumoniae, a Key Pathogen Set for Global Nosocomial Dominance. Antimicrob Agents Chemother. 2015;59(10):5873-5884.
6. Gupta A, Ampofo K, Rubenstein D, Saiman L. Extended spectrum beta lactamase-producing Klebsiella pneumoniae infections: a review of the literature. J Perinatol. 2003;23(6):439-443.
7. Baran I, Aksu N. Phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Turkey. Ann Clin Microbiol Antimicrob. 2016;15:20.
8. Jamal M, Tasneem U, Hussain T, Andleeb S. Bacterial Biofilm: Its Composition, Formation and Role in Human Infections. Res Rev J Microbiol Biotechnol. 2015;4(3):1-15.
9. Danhorn T, Fuqua C. Biofilm formation by plant-associated bacteria. Annu Rev Microbiol. 2007;61:401-422.
10. Mathur T, Singhal S, Khan S, Upadhyay DJ, Fatma T, Rattan A. Detection of biofilm formation among the clinical isolates of Staphylococci: an evaluation of three different screening methods. Indian J Med Microbiol. 2006;24(1):25-29.
11. Christensen GD, Simpson WA, Younger JJ, Baddour LM, Barrett FF, Melton DM, et al. Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol. 1985;22(6):996-1006.
12. Hassan A, Usman J, Kaleem F, Omair M, Khalid A, Iqbal M. Evaluation of different detection methods of biofilm formation in the clinical isolates. Braz J Infect Dis. 2011;15(4):305-311.
13. Stepanovi? S, Vukovi? D, Hola V, Di Bonaventura G, Djuki? S, Cirkovi? I, et al. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS. 2007;115(8):891-9.
14. Khan E, Ejaz M, Zafar A, Jabeen K, Shakoor S, Inayat R, et al. Increased isolation of ESBL producing Klebsiella pneumoniae with emergence of carbapenem resistant isolates in Pakistan: report from a tertiary care hospital. J Pak Med Assoc. 2010;60(3):186-90.
15. Borges A, Saavedra MJ, Simões M. Insights on antimicrobial resistance, biofilms and the use of phytochemicals as new antimicrobial agents. Curr Med Chem. 2015;22(21):2590-2614.
16. Kidd TJ, Mills G, Sá-Pessoa J, Dumigan A, Frank CG, Insua JL, et al. A Klebsiella pneumoniaeantibiotic resistance mechanism that subdues host defences and promotes virulence. EMBO Mol Med. 2017;9(4):430-447.
17. Nirwati H, Sinanjung K, Fahrunissa F, Wijaya F, Napitupulu S, Hati VP, et al. Biofilm formation and antibiotic resistance of Klebsiella pneumoniaeisolated from clinical samples in a tertiary care hospital, Klaten, Indonesia. BMC Proc. 2019;13(Suppl 11):20.
18. Lin WP, Wang JT, Chang SC, Chang FY, Fung CP, Chuang YC, et al. The Antimicrobial Susceptibility of Klebsiella pneumoniae from Community Settings in Taiwan, a Trend Analysis. Sci Rep. 2016;6:36280.
19. Asati S, Chaudhary U. Comparison of tissue culture plate and modified tissue culture plate method for biofilm detection in members of family enterobacteriaceae. J Clin Diagnostic Res. 2018;12(7):20–3.
20. Alcántar-Curiel MD, Ledezma-Escalante CA, Jarillo-Quijada MD, Gayosso-Vázquez C, Morfín-Otero R, Rodríguez-Noriega E, et al. Association of Antibiotic Resistance, Cell Adherence, and Biofilm Production with the Endemicity of Nosocomial Klebsiella pneumoniae. Biomed Res Int. 2018;2018:7012958.
21. Eftekhar F, Speert DP. Biofilm formation by persistent and non-persistent isolates of Staphylococcus epidermidis from a neonatal intensive care unit. J Hosp Infect. 2009;71(2):112-116.
How to Cite
Ma’ruf, I., Hendrayana, M. A., Sukrama, I. D. M., & fatmawati, N. N. D. (2021). Antibiogram and biofilm formation among extended-spectrum ?-lactamase-producing Klebsiella pneumoniae clinical isolates in Sanglah General Hospital, Bali, Indonesia. Intisari Sains Medis, 12(1), 360–363. https://doi.org/10.15562/ism.v12i1.909
