Comprehensive Evaluation of Biofilm-Producing Staphylococci: Correlation with Multidrug Resistance and Comparison of Phenotypic Detection Methods

Abstract

Background: Staphylococcus species are known to form biofilms, which are major virulence factors that cause persistent infections, antimicrobial resistance, and device-associated complications in health care facilities. The clinical correlation of accurate detection and its clinical correlation is a crucial element in effective management.

Aim: To isolate and determine Staphylococcus species of clinical samples and assess their biofilm-forming capacity against antimicrobial resistance.

Methods: A case control study was carried out as a prospective study on 250 clinical samples (200 cases and 50 controls). Standard microbiological methods were used to identify isolates, and the KirbyBauer method was used to detect antimicrobial susceptibility. The formation of biofilms was evaluated by using the Congo Red Agar (CRA), Tube Method (TM), and Tissue Culture Plate (TCP) assay (gold standard). Chi-square test was used to perform statistical analysis.

Results: Biofilm was produced much more in cases (78.5%) than in controls (16.0%) (p<0.001). The most common isolation was Staphylococcus aureus (71.6%). The resistance of methicillin was detected in 67.0 percent of the isolates, and 80.6 percent of the MRSA strains were biofilm producers. TCP method was most sensitive (78.0) to biofilm detection. Maximum sensitivity of linezolid was observed and high resistance to penicillin (61.2%), and erythromycin (45.2%) was observed. Production of biofilms was closely linked with chronic illnesses (94.87%).

Conclusion: Multidrug resistance, chronic comorbidity, and extended stay in the hospital are closely related to biofilm formation. TCP is the most stable detection process. To manage biofilm related staphylococcal infections, early diagnosis and specific antimicrobial interventions are needed.