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. 2014 Aug 29;45(2):539-44.
doi: 10.1590/s1517-83822014005000042. eCollection 2014.

Multi drug resistance in strong biofilm forming clinical isolates of Staphylococcus epidermidis

Gulcan Sahal  1 , Isil Seyis Bilkay  1
Affiliations

Multi drug resistance in strong biofilm forming clinical isolates of Staphylococcus epidermidis

Gulcan Sahal et al. Braz J Microbiol. .

Abstract

Staphylococcus epidermidis which exists in healthy human skin as a commensal inhabitant is also an important pathogen forming biofilms on many surfaces and recently, increased resistance traits were suggested to be acquired in biofilm environments. In this study; clinical Prevalences, antibiotic resistances and biofilm formations of S. epidermidis strains were determined and comparison of all these findings with each other was carried out in order to take precautions against them and figure out if high biofilm forming S. epidermidis strains display multi drug resistance. According to our results; samples of wound and blood were the most S. epidermidis isolated clinical materials (40%; 35%) and cardiothoracic surgery was the most S. epidermidis observed service unit. All of these strains were sensitive to vancomycin, however 65% of them showed resistance to all β-lactam antibiotics (Penicillin, Oxacillin, Amoxicilin/Clavulonic acid), used in this study and 60% of all S. epidermidis strains were found as multi drug resistant. When the results of strong biofilm forming S. epidermidis strains are examined; they were isolated from sample of blood and service unit of cardiovascular surgery in highest frequency and 80% of them were β-lactam resistant whereas 100% of them were multi drug resistant. One of these multi drug resistant strains which was resistant to maximum amount of different antimicrobial classes, was also observed as maximum biofilm forming strain among all the other S. epidermidis isolates. Multi drug resistance in strong biofilm forming strains shows that; biofilms play a role in antimicrobial resistance traits of S. epidermidis.

Keywords: Staphylococcus epidermidis; biofilm formation; indwelling medical device related infections; multi drug resistance; β-lactam resistance.

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Figures

Figure 1
Figure 1
Percentage of S. epidermidis strains in different clinical materials according to their biofilm formation levels. (N: Non Biofilm Formers, W: Weak Biofilm Formers, I: Intermediate Biofilm Formers, S: Strong Biofilm Formers).
Figure 2
Figure 2
Percentage of S. epidermidis strains in different service units according to their biofilm formation levels. (P.R.: Physical Rehabilitation, C.S.: Cardiothoracic Surgery, D.: Dermatology, I.C.U.: Intensive Care Unit, N: Neurology, G.S.: General Surgery, E.M.: Emergency, T.M.: Thoracic Medicine, PED: Pediatrics, N: Non Biofilm Formers, W: Weak Biofilm Formers, I: Intermediate Biofilm Formers, S: Strong Biofilm Formers).
Figure 3
Figure 3
Percentage of S. epidermidis strains displaying resistance to 11 different antibiotics according to their biofilm formation levels. (F: Nitrofurantoin, SXT: Trimethoprim/Sulfamethoxazole, AMC: Amoxicilin/Clavulonic acid, CN: Gentamicin, P: Penicillin, OX: Oxacillin, CC: Clindamycin; VA: Vancomycin, E: Eritromycin, TE: Tetracyclin, CIP: Ciprofloxacin, N: Non Biofilm Formers, W: Weak Biofilm Formers, I: Intermediate Biofilm Formers, S: Strong Biofilm Formers).
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