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. 2023 Jul 26;12(8):975.
doi: 10.3390/pathogens12080975.

Extensive Drug Resistance of Strong Biofilm-Producing Acinetobacter baumannii Strains Isolated from Infections and Colonization Hospitalized Patients in Southern Poland

Tomasz Kasperski  1   2 , Dorota Romaniszyn  2 , Estera Jachowicz-Matczak  2 , Monika Pomorska-Wesołowska  3 , Jadwiga Wójkowska-Mach  2 , Agnieszka Chmielarczyk  2
Affiliations

Extensive Drug Resistance of Strong Biofilm-Producing Acinetobacter baumannii Strains Isolated from Infections and Colonization Hospitalized Patients in Southern Poland

Tomasz Kasperski et al. Pathogens. .

Abstract

Acinetobacter baumannii (AB) is a bacterium that causes infections, particularly in immunocompromised patients. Treatment is challenging due to biofilm formation by AB strains, which hinders antibiotic effectiveness and promotes drug resistance. The aim of our study was to analyze the biofilm-producing capacity of AB isolates from various forms of infections in relation to biofilm-related genes and their drug resistance. We tested one hundred isolates for biofilm formation using the crystal violet microplate method. Drug resistance analyses were performed based on EUCAST and CLSI guidelines, and biofilm genes were detected using PCR. All tested strains were found to form biofilms, with 50% being ICU strains and 72% classified as strong biofilm producers. Among these, 87% were extensively drug-resistant (XDR) and 2% were extra-extensively drug-resistant (E-XDR). The most common gene set was bap, bfmS, csuE, and ompA, found in 57% of all isolates. Our research shows that, regardless of the form of infection, biofilm-forming strains can be expected among AB isolates. The emergence of E-XDR and XDR strains among non-ICU infections highlights the necessity for the rational use of antibiotics to stop or limit the further acquisition of drug resistance by A. baumannii.

Keywords: Acinetobacter baumannii; biofilm; drug resistance.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Ability to form a biofilm among Acinetobacter baumannii isolates. Legend: OD absorbance value: mean (minimum; maximum).
Figure 2
Figure 2
Distribution of strong biofilm-producing Acinetobacter baumannii isolates from various clinical forms of infection and colonization. Legend: BSI—bloodstream infection, PNEU—pneumonia, SSTI—skin and soft tissue infection, colonization; significance is marked with an asterisk * p < 0.001.
Figure 3
Figure 3
Distribution of clinical forms of infection among nMDR, MDR, XDR, and E-XDR strains and weak, moderate, and strong biofilm-producing Acinetobacter baumannii strains. Legend: BSI—bloodstream infection, PNEU—pneumonia, SSTI—skin and soft tissue infection, nMDR—no multidrug resistant, MDR—multidrug resistant, XDR—extensively drug resistant, E-XDR—extra-extensively drug resistant.
Figure 4
Figure 4
Occurrence of set of genes associated with biofilm formation among isolates showing differences in biofilm production, resistance (b), and from different forms of clinical infection and colonization (a). Legend: BSI—bloodstream infection, PNEU—pneumonia, SSTI—skin and soft tissue infection, nMDR—no multidrug resistant, MDR—multidrug resistant, XDR—extensively drug resistant, E-XDR—extra-extensively drug resistant.
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