Biofilm formation is not associated with worse outcome in Acinetobacter baumannii bacteraemic pneumonia

Sci Rep. 2018 May 8;8(1):7289. doi: 10.1038/s41598-018-25661-9.

Abstract

The effect of biofilm formation on bacteraemic pneumonia caused by A. baumannii is unknown. We conducted a 4-year multi-center retrospective study to analyze 71 and 202 patients with A. baumannii bacteraemic pneumonia caused by biofilm-forming and non-biofilm-forming isolates, respectively. The clinical features and outcomes of patients were investigated. Biofilm formation was determined by a microtitre plate assay. The antimicrobial susceptibilities of biofilm-associated cells were assessed using the minimum biofilm eradication concentration (MBEC) assay. Whole-genome sequencing was conducted to identify biofilm-associated genes and their promoters. Quantitative reverse transcription polymerase chain reaction was performed to confirm the expression difference of biofilm-associated genes. There was no significant difference in the clinical characteristics or the outcomes between patients infected with biofilm-forming and non-biofilm-forming strains. Compared with non-biofilm-forming isolates, biofilm-forming isolates exhibited lower resistance to most antimicrobials tested, including imipenem, meropenem, ceftazidime, ciprofloxacin and gentamicin; however, the MBEC assay confirmed the increased antibiotic resistance of the biofilm-embedded bacteria. Biofilm-associated genes and their promoters were detected in most isolates, including the non-biofilm-forming strains. Biofilm-forming isolates showed higher levels of expression of the biofilm-associated genes than non-biofilm-forming isolates. The biofilm-forming ability of A. baumannii isolates might not be associated with worse outcomes in patients with bacteraemic pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter Infections / genetics
  • Acinetobacter Infections / microbiology
  • Acinetobacter Infections / pathology
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / genetics
  • Acinetobacter baumannii / pathogenicity
  • Anti-Bacterial Agents / administration & dosage
  • Bacterial Proteins / genetics*
  • Biofilms / drug effects*
  • Biofilms / growth & development
  • Ciprofloxacin / administration & dosage
  • Drug Resistance, Multiple, Bacterial
  • Gene Expression Regulation / drug effects
  • Humans
  • Meropenem / administration & dosage
  • Microbial Sensitivity Tests
  • Pneumonia / drug therapy*
  • Pneumonia / genetics
  • Pneumonia / microbiology
  • Pneumonia / pathology
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Ciprofloxacin
  • Meropenem