1887

Abstract

Hospital-acquired infections caused by enterococci have increased dramatically since the 1970s. Many nosocomial enterococcal bloodstream infections are associated with medical devices such as central venous catheters. The ability to form biofilm on medical devices is a potential virulence trait that may allow enterococci to cause infections in the expanding population of patients managed with such devices. In this study, the hypothesis that increased ability to form biofilm is associated with medical-device-related infection was tested. A microplate assay was employed to assess biofilm-forming characteristics of enterococci in 0.9 % (w/v) sodium chloride, an oligotrophic environment, and BHI, a nutrient-rich environment. Results were compared in isolates from different sources of infection. One hundred and nine enterococcal bloodstream isolates were assayed. Biofilm formation on microplates was demonstrated by all isolates and 16/38 (42 %) isolates. isolates produced significantly more biofilm than isolates in both media ( < 0.0001, Mann–Whitney U test). isolates from intravascular-catheter-related bloodstream infections (CRBSIs) produced significantly more biofilm than non-CRBSI isolates ( < 0.0001), or isolates of uncertain clinical significance ( < 0.0001). Biofilm formed by isolates was not significantly affected by culture medium and did not differ between isolates from the different clinical categories. In conclusion, there was significantly more biofilm formed by isolates causing CRBSI compared with isolates from other types of infection or from isolates of uncertain clinical significance. The ability of isolates to form biofilm appears to be a marker of a virulence trait that enhances the ability of isolates to cause CRBSI.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.05201-0
2003-07-01
2019-12-07
Loading full text...

Full text loading...

/deliver/fulltext/jmm/52/7/JM520703.html?itemId=/content/journal/jmm/10.1099/jmm.0.05201-0&mimeType=html&fmt=ahah

References

  1. Darouiche, R. O. ( 2001;). Device-associated infections: a macroproblem that starts with microadherence. Clin Infect Dis 33, 1567–1572.[CrossRef]
    [Google Scholar]
  2. Durack, D. T., Lukes, A. S. & Bright, D. K. ( 1994;). New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings.Duke Endocarditis Service. Am J Med 96, 200–209.[CrossRef]
    [Google Scholar]
  3. Facklam, R. R., Sahm, D. F. & Teixeira, L. M. ( 1999;). Enterococcus. In Manual of Clinical Microbiology, pp. 297–305. Edited by P. R. Murray, E. J. Baron, M. A. Pfaller, F. C. Tenover & R. H. Yolken. Washington, DC: American Society for Microbiology.
  4. Fluit, A. C., Schmitz, F. J. & Verhoef, J. ( 2001;). Frequency of isolation of pathogens from bloodstream, nosocomial pneumonia, skin and soft tissue, and urinary tract infections occurring in European patients. Eur J Clin Microbiol Infect Dis 20, 188–191.
    [Google Scholar]
  5. Fridkin, S. K. & Gaynes, R. P. ( 1999;). Antimicrobial resistance in intensive care units. Clin Chest Med 20, 303–316.[CrossRef]
    [Google Scholar]
  6. Garrison, R. N., Fry, D. E., Berberich, S. & Polk, H. C., Jr ( 1982;). Enterococcal bacteremia: clinical implications and determinants of death. Ann Surg 196, 43–47.[CrossRef]
    [Google Scholar]
  7. Gilmore, M. S., Coburn, P. S., Nallapareddy, S. R. & Murray, B. E. ( 2002;). Enterococcal virulence. In The Enterococci, pp. 301–354. Edited by M. S. Gilmore. Washington, DC: American Society for Microbiology.
  8. Gray, J., Marsh, P. J., Stewart, D. & Pedler, S. J. ( 1994;). Enterococcal bacteraemia: a prospective study of 125 episodes. J Hosp Infect 27, 179–186.[CrossRef]
    [Google Scholar]
  9. Hartke, A., Giard, J. C., Laplace, J. M. & Auffray, Y. ( 1998;). Survival of Enterococcus faecalis in an oligotrophic microcosm: changes in morphology, development of general stress resistance, and analysis of protein synthesis. Appl Environ Microbiol 64, 4238–4245.
    [Google Scholar]
  10. Jett, B. D., Huycke, M. M. & Gilmore, M. S. ( 1994;). Virulence of enterococci. Clin Microbiol Rev 7, 462–478.
    [Google Scholar]
  11. Joyanes, P., Pascual, A., Martinez-Martinez, L., Hevia, A. & Perea, E. J. ( 1999;). In vitro adherence of Enterococcus faecalis and Enterococcus faecium to plastic biomaterials. Clin Microbiol Infect 5, 382–386.[CrossRef]
    [Google Scholar]
  12. Klimek, J. J., Ajemian, E., Gracewski, J., Klemas, B., Rios, I., Maderazo, E. & Quintiliani, R. ( 1980;). Enterococcal infections in a large community hospital, with emphasis on bacteremia. Am J Infect Control 8, 58–61.[CrossRef]
    [Google Scholar]
  13. Maki, D. G. & Agger, W. A. ( 1988;). Enterococcal bacteremia: clinical features, the risk of endocarditis, and management. Medicine (Baltimore) 67, 248–269.[CrossRef]
    [Google Scholar]
  14. Malone, D. A., Wagner, R. A., Myers, J. P. & Watanakunakorn, C. ( 1986;). Enterococcal bacteremia in two large community teaching hospitals. Am J Med 81, 601–606.[CrossRef]
    [Google Scholar]
  15. Murray, B. E. ( 1990;). The life and times of the Enterococcus. Clin Microbiol Rev 3, 46–65.
    [Google Scholar]
  16. Patterson, J. E., Sweeney, A. H., Simms, M., Carley, N., Mangi, R., Sabetta, J. & Lyons, R. W. ( 1995;). An analysis of 110 serious enterococcal infections: epidemiology, antibiotic susceptibility, and outcome. Medicine (Baltimore) 74, 191–200.[CrossRef]
    [Google Scholar]
  17. Reacher, M. H., Shah, A., Livermore, D. M. & 8 other authors ( 2000;). Bacteraemia and antibiotic resistance of its pathogens reported in England and Wales between 1990 and 1998: trend analysis. Br Med J 320, 213–216.[CrossRef]
    [Google Scholar]
  18. Sandoe, J. A. T., Witherden, I. R., Au-Yeung, H.-K. C., Kite, P., Kerr, K. G. & Wilcox, M. H. ( 2002;). Enterococcal intravascular catheter-related bloodstream infection: management and outcome of 61 consecutive cases. J Antimicrob Chemother 50, 577–582.[CrossRef]
    [Google Scholar]
  19. Shlaes, D. M., Levy, J. & Wolinsky, E. ( 1981;). Enterococcal bacteremia without endocarditis. Arch Intern Med 141, 578–581.[CrossRef]
    [Google Scholar]
  20. Toledo-Arana, A., Valle, J., Solano, C. & 7 other authors ( 2001;). The Enterococcal Surface Protein, Esp, is involved in Enterococcus faecalis biofilm formation. Appl Environ Microbiol 67, 4538–4545.[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.05201-0
Loading
/content/journal/jmm/10.1099/jmm.0.05201-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error