The value of biofilm testing to guide antimicrobial stewardship in chronic respiratory diseases

Front Cell Infect Microbiol. 2023 May 2:13:1142274. doi: 10.3389/fcimb.2023.1142274. eCollection 2023.

Abstract

Introduction: Biofilm production is an important yet currently overlooked aspect of diagnostic microbiology that has implications for antimicrobial stewardship. In this study, we aimed to validate and identify additional applications of the BioFilm Ring Test® (BRT) for Pseudomonas aeruginosa (PA) isolates from patients with bronchiectasis (BE).

Materials and methods: Sputa were collected from BE patients who had at least one PA positive culture in the previous year. We processed the sputa to isolate both mucoid and non-mucoid PA, and determined their susceptibility pattern, mucA gene status, and presence of ciprofloxacin mutations in QRDR genes. The Biofilm production index (BPI) was obtained at 5 and 24 hours. Biofilms were imaged using Gram staining.

Results: We collected 69 PA isolates, including 33 mucoid and 36 non-mucoid. A BPI value below 14.75 at 5 hours predicted the mucoid PA phenotype with 64% sensitivity and 72% specificity.

Conclusion: Overall, our findings suggest that the fitness-cost associated with the mucoid phenotype or ciprofloxacin resistance is shown through a time-dependent BPI profile. The BRT has the potential to reveal biofilm features with clinical implications.

Keywords: Pseudomonas aeruginosa; antimicrobial agents; antimicrobial resistances; biofilm; biofilm diagnose.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Antimicrobial Stewardship*
  • Biofilms
  • Ciprofloxacin / pharmacology
  • Ciprofloxacin / therapeutic use
  • Humans
  • Phenotype
  • Pseudomonas Infections* / diagnosis
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas Infections* / microbiology
  • Pseudomonas aeruginosa / genetics
  • Respiratory Tract Diseases*

Substances

  • Ciprofloxacin
  • Anti-Bacterial Agents

Grants and funding

CB 06/06/0028/CIBER de enfermedades respiratorias- Ciberes, Intramural ciberes 2018 (ES18PI01X1-2021), ISCIII-FEDER (FIS18-PI18/00145 awarded to AT and LF-B; FI19/00090 awarded to RL-A), ICREA Academy/Institució Catalana de Recerca i Estudis Avançats, 2.603/IDIBAPS, SGR/Generalitat de Catalunya, SEPAR 2017, 2018 grants to LF-B. Funders did not play any role in paper design, data collection, data analysis, interpretation, writing of the paper.