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Montoya-Hinojosa EI, Villarreal-Treviño L, Bocanegra-Ibarias P, Camacho-Ortiz A, Flores-Treviño S. Drug Resistance in Biofilm and Planktonic Cells of Achromobacter spp., Burkholderia spp., and Stenotrophomonas maltophilia Clinical Isolates. Microb Drug Resist 2024; 30:354-362. [PMID: 39029506 DOI: 10.1089/mdr.2023.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
Background: Biofilm production in nonfermenting Gram-negative bacteria influences drug resistance. The aim of this work was to evaluate the effect of different antibiotics on biofilm eradication of clinical isolates of Achromobacter, Burkholderia, and Stenotrophomonas maltophilia. Methods: Clinical isolates were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry in a third-level hospital in Monterrey, Mexico. Crystal violet staining was used to determine biofilm production. Drug susceptibility testing was determined by broth microdilution in planktonic cells and biofilm cells. Results: Resistance in planktonic cells was moderate to trimethoprim-sulfamethoxazole, and low to chloramphenicol, minocycline, levofloxacin (S. maltophilia and Burkholderia), ceftazidime, and meropenem (Burkholderia and Achromobacter). Biofilm eradication required higher drug concentrations of ceftazidime, chloramphenicol, levofloxacin, and trimethoprim-sulfamethoxazole than planktonic cells (p < 0.05). Levofloxacin showed biofilm eradication activity in S. maltophilia, minocycline and meropenem in Burkholderia, and meropenem in Achromobacter. Conclusions: Drug resistance increased due to biofilm production for some antibiotics, particularly ceftazidime and trimethoprim-sulfamethoxazole for all three pathogens, chloramphenicol for S. maltophilia and Burkholderia, and levofloxacin for Burkholderia. Some antibiotics could be used for the treatment of biofilm-associated infections in our population, such as levofloxacin for S. maltophilia, minocycline and meropenem for Burkholderia, and meropenem for Achromobacter.
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Affiliation(s)
- Edeer Iván Montoya-Hinojosa
- Departament of Microbiology, School of Biological Sciences, Autonomous University of Nuevo Leon, Avenida Pedro de Alba, San Nicolás de los Garza, Mexico
| | - Licet Villarreal-Treviño
- Departament of Microbiology, School of Biological Sciences, Autonomous University of Nuevo Leon, Avenida Pedro de Alba, San Nicolás de los Garza, Mexico
| | - Paola Bocanegra-Ibarias
- Department of Infectious Diseases, University Hospital "Dr. José E. González" and School of Medicine, Autonomous University of Nuevo Leon, Avenida Madero S/N esq Avenida Gonzalitos, Mitras Centro, Monterrey, Mexico
| | - Adrián Camacho-Ortiz
- Department of Infectious Diseases, University Hospital "Dr. José E. González" and School of Medicine, Autonomous University of Nuevo Leon, Avenida Madero S/N esq Avenida Gonzalitos, Mitras Centro, Monterrey, Mexico
| | - Samantha Flores-Treviño
- Department of Infectious Diseases, University Hospital "Dr. José E. González" and School of Medicine, Autonomous University of Nuevo Leon, Avenida Madero S/N esq Avenida Gonzalitos, Mitras Centro, Monterrey, Mexico
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Río-Chacón JMD, Rojas-Larios F, Bocanegra-Ibarias P, Salas-Treviño D, Espinoza-Gómez F, Camacho-Ortiz A, Flores-Treviño S. Biofilm Eradication of Stenotrophomonas maltophilia by Levofloxacin and Trimethoprim-Sulfamethoxazole. Jpn J Infect Dis 2024; 77:213-219. [PMID: 38296539 DOI: 10.7883/yoken.jjid.2023.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Stenotrophomonas maltophilia is a nonfermenting Gram-negative drug-resistant pathogen that causes healthcare-associated infections. Clinical isolates from Mexico were assessed for biofilm formation using crystal violet staining. Antimicrobial susceptibility was evaluated in planktonic and biofilm cells using the broth microdilution method. The effects of antibiotics on biofilms were visualized using fluorescence microscopy. Fifty isolates were included in this study, of which 14 (28%) were biofilm producers (9 [64%] from blood and 5 [36%] from respiratory samples). In planktonic cells 4/50 (8%) of isolates were resistant to levofloxacin (8.0%) and 22/50 (44%) were resistant to trimethoprim-sulfamethoxazole. All isolates were resistant to levofloxacin and trimethoprim-sulfamethoxazole in biofilm cells. Bacterial biofilms treated with different concentrations of both antibiotics were completely disrupted. In conclusion, S. maltophilia isolated from blood had higher biofilm production than those isolated from respiratory samples. Biofilm production was associated with increased antibiotic resistance. Antibiotic monotherapy might not be the best course of action for the treatment of S. maltophilia infections in Mexico, because it might cause biofilm production and antimicrobial resistance.
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Affiliation(s)
| | | | - Paola Bocanegra-Ibarias
- Department of Infectious Diseases, University Hospital Dr. José Eleuterio González and School of Medicine, Autonomous University of Nuevo León, Mexico
| | - Daniel Salas-Treviño
- Department of Infectious Diseases, University Hospital Dr. José Eleuterio González and School of Medicine, Autonomous University of Nuevo León, Mexico
| | | | - Adrián Camacho-Ortiz
- Department of Infectious Diseases, University Hospital Dr. José Eleuterio González and School of Medicine, Autonomous University of Nuevo León, Mexico
| | - Samantha Flores-Treviño
- Department of Infectious Diseases, University Hospital Dr. José Eleuterio González and School of Medicine, Autonomous University of Nuevo León, Mexico
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Yashar M, Basarir KE, Tanriverdi ES, Celep S, Sirekbasan L, Rakici E, Ejder N, Musellim E, Cicek AC, Yilmaz M. Stenotrophomonas maltophilia outbreak originating from a pull-out faucet in a pediatric intensive care unit in Turkey: Insights from clinical records and molecular typing. Am J Infect Control 2024; 52:605-610. [PMID: 38043636 DOI: 10.1016/j.ajic.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Nosocomial Stenotrophomonas maltophilia-related cases are rising and pose a threat to immunocompromised patients. Twelve patients from our pediatric intensive care unit (PICU) presented with S maltophilia-associated bloodstream infection. METHODS This outbreak investigation includes 12 patients from PICU between the ages of 2 months and 4 years (mean 16 months, 7 male). To identify the origin, samples from all possible sources throughout the hospital were collected and ran through DNA isolation and Pulse Field Gel Electrophoresis. RESULTS 120 samples were collected during the outbreak. 31 samples (26%) were positive for S maltophilia. 30 S maltophilia isolates were analyzed, 10 different genotypes were identified. Clustering isolates were grouped into 3 different clusters (tolerance and optimization 1.0, cutoff 90%). The largest cluster was genotype 1, which included 19 isolates, those belong to patients' samples and a sample from a pull-out faucet inside the PICU. The Pull-out faucet was the origin of the bloodstream infection. DISCUSSION Pull-out faucets allow biofilm production, due its structure. Pulse Field Gel Electrophoresis identifies the transmission dynamics of the outbreak, with its high discriminatory power. CONCLUSIONS Water sources should be monitored on a regular basis. Pull-out faucets enable bacterial overgrowth; therefore, we recommend water surveillance during outbreak investigations.
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Affiliation(s)
- Meltem Yashar
- Department of School of Medicine, Istanbul Medipol University, School of Medicine, Istanbul, Turkey.
| | - Kerem E Basarir
- Department of International School of Medicine, Istanbul Medipol University, International School of Medicine, Istanbul, Turkey
| | - Elif S Tanriverdi
- Department of Clinical Microbiology, Malatya Training and Research Hospital, Clinical Microbiology Laboratory, Malatya, Turkey
| | - Selcuk Celep
- Istanbul Medipol Mega Hospital, Department of Clinical Microbiology, Istanbul, Turkey
| | - Leyla Sirekbasan
- Istanbul Medipol Mega Hospital, Department of Clinical Microbiology, Istanbul, Turkey
| | - Erva Rakici
- Department of Clinical Microbiology, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkey
| | - Nebahat Ejder
- Department of Clinical Microbiology, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkey
| | - Eda Musellim
- Department of Infection control Unit, Istanbul Medipol Mega Hospital, Infection Control Unit, Istanbul, Turkey
| | - Aysegul C Cicek
- Istanbul Medipol University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Mesut Yilmaz
- Istanbul Medipol University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Guillén-Navarro D, González-Vázquez R, León-Ávila G, Giono-Cerezo S. Quorum Quenching with a Diffusible Signal Factor Analog in Stenotrophomonas maltophilia. Pathogens 2023; 12:1448. [PMID: 38133331 PMCID: PMC10746098 DOI: 10.3390/pathogens12121448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Stenotrophomonas maltophilia is a multidrug-resistant Gram-negative bacillus associated with nosocomial infections in intensive care units, and nowadays, its acquired resistance to trimethoprim-sulfamethoxazole (SXT) by sul genes within class 1 integrons is a worldwide health problem. Biofilm and motility are two of the major virulence factors in this bacterium and are auto-induced by the diffusible signal factor (DSF). In recent studies, retinoids have been used to inhibit (Quorum Quenching) these virulence factors and for their antimicrobial effect. The aim was to reduce biofilm formation and motility with retinoic acid (RA) in S. maltophilia SXT-resistant strains. Eleven SXT-resistant strains and two SXT-susceptible strains were tested for biofilm formation/reduction and planktonic/sessile cell viability with RA and SXT-MIC50/RA; motility (twitching, swimming, swarming) was measured with/without RA; and MLST typing was determined. The biofilm formation of the strains was classified as follows: 15.38% (2/13) as low, 61.54% (8/13) as moderate, and 23.08% (3/13) as high. It was significantly reduced with RA and SXT-MIC50/RA (p < 0.05); cell viability was not significantly reduced with RA (p > 0.05), but it was with SXT-MIC50/RA (p < 0.05); and swimming (p < 0.05) and swarming (p < 0.05) decreased significantly. MLST typing showed the first and novel strains of Mexican S. maltophilia registered in PubMLST (ST479-485, ST497, ST23, ST122, ST175, ST212, and ST300). In conclusion, RA reduced biofilm formation and motility without affecting cell viability; furthermore, antimicrobial synergism with SXT-MIC50/RA in different and novel STs of S. maltophilia was observed.
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Affiliation(s)
- Dafne Guillén-Navarro
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Departamento de Microbiología, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
- Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
| | - Rosa González-Vázquez
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Departamento de Microbiología, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
- Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional La Raza. Seris y Zaachila S/N, Col. La Raza, Alcaldía Azcapotzalco, Mexico City 04960, Mexico
| | - Gloria León-Ávila
- Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Departamento de Zoología, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
| | - Silvia Giono-Cerezo
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Departamento de Microbiología, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
- Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Prolongación de Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo, Mexico City 11340, Mexico
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Sameni F, Hajikhani B, Hashemi A, Owlia P, Niakan M, Dadashi M. The Relationship between the Biofilm Genes and Antibiotic Resistance in Stenotrophomonas maltophilia. Int J Microbiol 2023; 2023:8873948. [PMID: 37692920 PMCID: PMC10484654 DOI: 10.1155/2023/8873948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/01/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives Today, Stenotrophomonas maltophilia (S. maltophilia) is a major opportunistic pathogen among hospitalized or immunocompromised patients. Antibiotic-resistant clinical isolates are increasing in several parts of the world. Various antibiotic-resistance and biofilm-forming genes are identified in this bacterium. Its capacity to form biofilms is an important virulence factor that may impact antibiotic-resistance patterns. In the current study, we evaluated the biofilm-formation capacity, antibiotic-resistance profile, and prevalence of biofilm-forming genes as well as antibiotic resistance genes among S. maltophilia isolates. Materials and Methods In this cross-sectional study, 94 clinical S. maltophilia isolates were recovered from four tertiary-care hospitals in Iran between 2021 and 2022. The presence of the selected antibiotic-resistance genes and biofilm-forming genes was examined by polymerase chain reaction (PCR). The ability of biofilm formation was examined by microtiter plate assay. The Kirby-Bauer disc diffusion method was used to evaluate the trimethoprim-sulfamethoxazole (TMP-SMX), levofloxacin, and minocycline resistance. Results S. maltophilia is mainly isolated from bloodstream infections. Notably, 98.93% of isolates were biofilm producers, of which 19.35%, 60.22%, and 20.43% produced strong, moderate, and weak biofilm, respectively. The frequency of biofilm genes was 100%, 97.88%, 96.80%, and 75.53% for spgM, rmlA, smf-1, and rpfF, respectively. Isolates with the genotype of smf-1+/rmlA+/spgM+/rpfF+ were mostly strong biofilm producers. Among the antibiotic-resistance genes, the Smqnr, L1, and sul1 had the highest prevalence (76.59%, 72.34%, and 64.89), respectively. Antimicrobial susceptibility evaluation showed 1.06%, 3.19%, and 6.3% resistance to minocycline, TMP-SMX, and levofloxacin. Conclusion The results of the current study demonstrated that S. maltophilia isolates differ in biofilm-forming ability. Moreover, smf-1, rmlA, and spgM genes were presented in all strong biofilm producers. Although the overall resistance rate to the evaluated antibiotics was high, there was no statistically significant relation between antibiotic resistance and the type of biofilm.
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Affiliation(s)
- Fatemeh Sameni
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Bahareh Hajikhani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Hashemi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parviz Owlia
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Mohammad Niakan
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Caldara M, Belgiovine C, Secchi E, Rusconi R. Environmental, Microbiological, and Immunological Features of Bacterial Biofilms Associated with Implanted Medical Devices. Clin Microbiol Rev 2022; 35:e0022120. [PMID: 35044203 PMCID: PMC8768833 DOI: 10.1128/cmr.00221-20] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The spread of biofilms on medical implants represents one of the principal triggers of persistent and chronic infections in clinical settings, and it has been the subject of many studies in the past few years, with most of them focused on prosthetic joint infections. We review here recent works on biofilm formation and microbial colonization on a large variety of indwelling devices, ranging from heart valves and pacemakers to urological and breast implants and from biliary stents and endoscopic tubes to contact lenses and neurosurgical implants. We focus on bacterial abundance and distribution across different devices and body sites and on the role of environmental features, such as the presence of fluid flow and properties of the implant surface, as well as on the interplay between bacterial colonization and the response of the human immune system.
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Affiliation(s)
- Marina Caldara
- Interdepartmental Center on Safety, Technologies, and Agri-food Innovation (SITEIA.PARMA), University of Parma, Parma, Italy
| | - Cristina Belgiovine
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Scuola di Specializzazione in Microbiologia e Virologia, Università degli Studi di Pavia, Pavia, Italy
| | - Eleonora Secchi
- Institute of Environmental Engineering, ETH Zürich, Zürich, Switzerland
| | - Roberto Rusconi
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele–Milan, Italy
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