An evaluation of three different biofilm detection methods in orthopedic implant associated infections and its implication in healthcare system

Abstract

: Biofilms are defined as microbially derived sessile communities characterized by the cells that are irreversibly attached to a substratum. These organisms have been associated with implant associated infectionsThe present study is therefore undertaken 1. To compare the three screening methods used for detection of biofilm formation (Tissue culture plate method, Tube method and Congo red agar method) and 2. To correlate the antibiotic resistance pattern of biofilm producers and non biofilm producers. : A prospective study was carried out in the department of microbiology, on all orthopedic implant associated infections from September 2015 to July 2016 on aspirated pus samples. A total of 120 non repetitive clinical isolates were taken and subjected to biofilm detection. All the bacterial isolates were identified by standard biochemical tests. Antibiotic susceptibility test of bacterial isolates was performed by Kirby Bauer disk diffusion method according to Clinical Laboratory Standard Institute (CLSI) guidelines on Muller Hinton Agar (MHA). A reference strain of Staphylococcus epidermidis ATCC 35984(positive biofilm producer) and Staphylococcus epidermidis ATCC 12228(non biofilm producer) were used as controls. Tissue culture plate method was considered as gold standard as it detected 25% biofilm producers which included 12% weak biofilm producers which was missed by congo red agar (CRA) and tube method (TM). Also, this correlated to methicillin resistant staphylococcus aureus (MRSA), ESBL, amp-c and MDR pattern of antibiogram. : TCP is considered as most reliable screening method for biofilm detection and should be routinely employed to prevent treatment failures as these organisms are intrinsically resistant to many antimicrobials leading to implant associated infections.