Microbiological analysis of tracheostomy tube biofilms and antibiotic resistance profiles of potentially pathogenic microorganisms

Abstract

Introduction. In hospitalized patients, tracheostomy tubes (TTs) are susceptible to colonization by biofilm producing potentially pathogenic microorganisms (PPMs). Contact with TTs, which are situated in a critical region of the body with enormous microbial exposure, may lead to the emer-gence of resistant respiratory infections. Objective. Our study aimed to isolate and identify Gram-positive and Gram-negative PPMs, mark their antibiotic resistance and determine the bacteriological pattern of the biofilm colonizing the TTs. Methods. The study was conducted on 45 tracheostomy tubes obtained from 45 hospitalized adult patients with trachestomy with intubation periods ranging from 1 to 28 days. Tracheal aspirates (TA) obtained from polyvinyl chloride (PVC) TTs were used for the analysis. Bacteria in biofilms were identified by standard microbiological techniques, tested for antibiotic resistance and phenotypic resistance according to the EUCAST guidelines and visualized by SEM. Results. Out of 45 TTs, 100% were found to be positive in bacterial cultures with 58 PPM isolates (10 species) correlating well with the SEM findings. Overall, 72% of isolates were Gram-negative bacilli, followed by Gram-positive cocci (28%). Staphylococcus aureus was the predominant bacte-rium (identified in 35.5% of patients), followed by Klebsiella pneumoniae (identified in 23.8%). Among the Gram-negative PPMs, 50% of isolates were identified as multidrug-resistant (MDR), 8.6% as extremely drug-resistant (XDR) and 5.2% were pandrug-resistant (PDR). Conclusions. Our study showed a rapid colonization of the TT surface by biofilm producing PPMs. Patients with tracheostomies, also those with non-infectious conditions, were mainly colonized with highly resistant bacteria.