Quantitative biofilm for bacterial pathogens of ventilator-associated pneumonia

Abstract

Background & Objective: Ventilator–associated pneumonia (VAP) is one of the most common nosocomial infections in clinical care settings. Several bacteria with biofilm–producing ability offer serious challenge in their eradication. Prompt and accurate diagnosis is needed to provide the best care for the patients. This study aimed to analyze whether biofilm examination using quantitative method can be used as a diagnostic tool for bacterial pathogens associated with VAP.
 Methodology: This observational analytical study was conducted in Intensive Care Units of three teaching hospitals in Surakarta, Central Java, Indonesia, from November 2019 to April 2020. The subjects were between 19 and 65 y old, with a newly introduced endotracheal tube (ETT) connected to mechanical ventilators, and without pneumonia. Biofilm quantitative measurement used a microtiter plate method from bacterial culture found on ETT at the 48th hour after being mechanically ventilated. The Clinical Pulmonary Infection Score (CPIS) assessment was done at the 48th hour and CPIS of less than 6 was defined as VAP. The analysis used Spearman’s rank and Kendall tau–b correlation. The samples were taken using a consecutive sampling technique. 
 Results: A significant correlation between biofilm and VAP was found (ρ = 0.039, p < 0.05). Biofilm was also sufficiently correlated with an increase in CPIS (τb = 0.341, p < 0.05)
 Conclusions: Quantitative biofilm can be used as a diagnostic tool for establishing the diagnosis of VAP so that appropriate therapy can be administered immediately.
 Key words: Bacterial pathogen; Biofilm; Ventilator–associated pneumonia
 Abbreviations: CPIS: Clinical Pulmonary Infection Score; VAP: Ventilator–associated pneumonia; ETT: Endotracheal tube; PCR: Polymerase chain reaction; OD: Optical density
 Citation: Dewi FH, Suradi, Purwanto B, Wasita B. Quantitative biofilm for bacterial pathogens of ventilator-associated pneumonia. Anaesth. pain intensive care 2021;25(2):132-137. DOI: 10.35975/apic.v25i2.1468
 Received: 24 September 2020, Reviewed: 27, 30 October 2020, Accepted: 3 March 2021