Biofilm formation and antimicrobial resistance in Klebsiella pneumoniae isolated from patients visiting a tertiary care center of Nepal

Abstract

Objective: To evaluate the biofilm forming ability of Klebsiella pneumoniae (K. pneumoniae) isolates recovered from patients visiting a tertiary care center of Nepal and to determine their antimicrobial resistance with special reference to extended spectrum -lactamase (ESBL) production. Methods: A total 60 phenotypically identified clinical isolates were included in this study. The production of biofilm was detected by tissue culture plate method and their antimicrobial susceptibility was determined by standard microbiological methods. Results: Among the total isolates, 44 (73.3%) isolates were found to be biofilm producers. The biofilm positive strains exhibited higher rate of antimicrobial resistance compared to the biofilm negative strains. Multi-drug resistance was seen in 39/60 (65%) isolates of which 36 (92.3%) were biofilm producers and 3 (7.7%) were biofilm non-producers. Similarly, ESBL production was detected in 26/60 (43.3%) isolates. Among ESBL producers, 24 (92.3%) were biofilm producers and the rest 2 (7.7%) were non-producers. Conclusions: Biofilm formation in clinical isolates of K. pneumoniae is very high with varying degrees of resistance to all commonly used antimicrobial agents. The biofilm positive strains are more resistant to antimicrobial agents than the biofilm negative strains. Therefore, it is recommended to identify biofilm producing K. pneumoniae for the effective use of antimicrobial agent.