Antimicrobial resistance in biofilms on invasive devices
DOI:
https://doi.org/10.36517/2175-6783.20262796142Keywords:
Biofilms; Equipment and Supplies; Cross Infection; Drug Resistance, Microbial.Abstract
Objective: to evaluate the microbiological profile and resistance patterns of biofilms on invasive devices recovered from Intensive Care Unit patients. Methods: a prospective cohort study of 157 adult patients in the immediate postoperative period. We analyzed 275 invasive devices collected under aseptic conditions and subjected to microbiological culture and susceptibility testing. Data were analyzed using Chi-square and Mann-Whitney tests. Results: biofilm formation occurred on the majority of devices, yielding 200 isolates, primarily Klebsiella pneumoniae (30%), Acinetobacter baumannii (25%), and Pseudomonas aeruginosa (20%). Multidrug-resistant (MDR) isolates accounted for 48% of the sample, while 19% were extensively drug-resistant (XDR) and 3% were pandrug-resistant (PDR). Central venous catheters showed a significantly higher rate of colonization by multidrug-resistant microorganisms (p<0.010). This contrasted with findings for indwelling urinary catheters (p=0.072) and endotracheal tubes (p=0.064). Conclusion: the microbiological profile of biofilms on invasive devices consisted mainly of Gram-negative bacteria with broad-spectrum resistance to multiple antibiotics, negatively impacting patient safety and quality of care. Contributions to practice: these findings support the strengthening of preventive strategies and control of healthcare-associated infections, thereby promoting patient safety and quality of care in the Intensive Care Unit.
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1. Liu X, Long Y, Greenhalgh C, Steeg S, Wilkinson J, Li H, et al. A systematic review and meta-analysis of risk factors associated with healthcare-associated infections among hospitalized patients in Chinese general hospitals from 2001 to 2022. J Hosp Infect. 2023;135:37-49. doi: https://doi.org/10.1016/j.jhin.2023.02.013
2. Adal O, Tsehay YT, Ayenew B, Abate TW, Mekonnen GB, Mulatu S, et al. The burden and predictors of hospital-acquired infection in intensive care units across Sub-Sahara Africa: systematic review and metanalysis. BMC Infect Dis. 2025;25(1):634. doi: https://doi.org/10.1186/s12879-025-11038-7
3. Rather MA, Gupta K, Mandal M. Microbial biofilm: formation, architecture, antibiotic resistance, and control strategies. Braz J Microbiol. 2021;52(4):1701-18. doi: https://dx.doi.org/10.1007/s42770-021-00624-x
4. Karnwal A, Jassim AY, Mohammed AA, Al-Tawaha ARMS, Selvaraj M and Malik T. Addressing the global challenge of bacterial drug resistance: insights, strategies, and future directions. Front Microbiol. 2025;16:1517772. doi: http://doi.org/10.3389/fmicb.2025.1517772
5. El-Raheem GOHA, Dihesh MEA, Elmardi MEB, Elamin HES, Zeinelabdin LEA, Ahmed DOS, et al. Antimicrobial susceptibility at intensive care units in Sudan, antibiogram development. BMC Microbiol. 2025;25:(1):290. doi: https://dx.doi.org/10.1186/s12866-025-04021-4
6. Li P, Yin R, Cheng J, Lin J. Bacterial biofilm formation on biomaterials and approaches to its treatment and prevention. Int J Mol Sci. 2023;24(14):11680. doi: https://doi.org/10.3390/ijms241411680
7. Wang T, Zhang R, Chen Z, Cao P, Zhou Q, Wu Q. A global bibliometric and visualized analysis of bacterial biofilm eradication from 2012 to 2022. Front Microbiol. 2023;14:1287964. doi: https://doi.org/10.3389/fmicb.2023.1287964
8. Gondil VS, Subhadra B. Biofilms and their role on diseases. BMC Microbiol. 2023;23(1):203. doi: https://doi.org/10.1186/s12866-023-02954-2
9. Wijaya M, Halleyantoro R, Kalumpiu JF. Biofilm: the invisible culprit in catheter-induced candidemia. AIMS Microbiol. 2023;9(3):467-85. doi: https://doi.org/10.3934/microbiol.2023025
10. Kavvalou A, Stehling F, Tschiedel E, Kehrmann J, Walkenfort B, Hasenberg M, et al. Biofilm infection of a central venous port-catheter caused by Mycobacterium avium complex in an immunocompetent child with cystic fibrosis. BMC Infect Dis. 2022;22(1):921. doi: https://dx.doi.org/10.1186/s12879-022-07899-x
11. Moreno LZ, Morcillo AM. Comparação de dois grupos independentes: teste de Mann-Whitney. Campinas: Unicamp; 2019.
12. Cangui-Panchi S, Ñacato-Toapanta AL, Enríquez-Martínez LJ, Reyes J, Garzon-Chavez D, Machado A. Biofilm-forming microorganisms causing hospital-acquired infections from intravenous catheter: a systematic review. Curr Res Microb Sci. 2022;3:100175. doi: https://doi.org/10.1016/j.crmicr.2022.100175
13. Campos DMP, Toledo LV, Matos SS, Alcoforado CLGC, Ercole FF. Incidence and risk factors for incidents in intensive care patients. Rev Rene. 2022;23:e72426. doi: https://doi.org/10.15253/2175-6783.20222372426
14. Ji J, Chen W, Jiang P, Zheng J, Shen H, Liu C, et al. Risk and prognostic factors for bloodstream infections due to clonally transmitted Acinetobacter baumannii ST2 with armA, blaOXA-23, and blaOXA-66: a retrospective study. Infect Drug Resist. 2025;18:1867-79. doi: https://doi.org/10.2147/IDR.S498212
15. David C, Silva VM, Ventura SL, Munhoz OL. Clinical and care profile of patients with sepsis/septic shock admitted to intensive care: retrospective study. Rev Pesq Cuid Fundam Online. 2025;7:e13739. doi: https://doi.org/10.9789/2175-5361.rpcfo.v17.13739
16. Silva MEP, Gomes MA, Rodrigues RS, Lima NC S, Carvalho AG, Taborda RL, et al. Multidrug-resistant Acinetobacter spp. from hospital intensive care units in Brazilian Amazon. Braz J Infect Dis. 2023;27(6):103687. doi: https://doi.org/10.1016/j.bjid.2023.103687
17. Salam T, Bari KF, Rahman M, Gafur DMM, Faruk O, Akter K, et al. Emergence of antibiotic-resistant infections in ICU patients. J Angiother. 2024 8(5):1-9. doi: https://doi.org/10.25163/angiotherapy.859560
18. Jesus SC, Bertoncello KCG, Gonçalves FAF, Colaço AD, Lentz GNS, Schneider DG. Construction of a nursing care instrument for patients with central venous catheters. Rev Rene. 2022;23:e70967. doi: http://doi.org/10.15253/2175-6783.20222370967
19. Cui Y, Yi C, Zhang C, Yang C, Wang X, Chen W, et al. Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital in Shanghai, China. Sci Rep. 2024;14(1):12765. doi: https://doi.org/10.1038/s41598-024-63594-8
20. Hoffman T, Margalit I, Tabah A, Ruckly S, Barbier F, Singer P, et al. Risk factors for mortality among older adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study. Infect Dis Ther. 2025;14(2):483-92. doi: https://doi.org/10.1007/s40121-024-01104-z
21. Fan J, Chen S, Sun L, Si Y, Pishgar E, Alaei K, et al. Predicting short-term mortality in elderly ICU patients with diabetes and heart failure: a distributional inference framework. arXiv. 2025. Preprint(v.1) [cited Sep 28, 2025]. doi: https://arxiv.org/pdf/2506.15058
22. Costa RPAF, Gomes RG, Silva VC, Resck ZMR, Martinez MR, Sanches RS. Reporting adverse events in a hospital environment from the perspective of nursing professionals. Rev Rene. 2024;25:e93625. doi:https://dx.doi.org/10.15253/2175-6783.20242593625
23. Gheorghe DC, Illie A, Niculescu AG, Grumezescu AM. Preventing biofilm formation and development on ear, nose and throat medical devices. Biomedicines. 2021;9(8):1025. doi: https://doi.org/10.3390/biomedicines9081025
24. Codru IR, Vintilă BI, Bereanu AS, Sava M, Popa LM, Birlutiu V. Antimicrobial resistance patterns and biofilm analysis via sonication in intensive care unit patients at a county emergency hospital in Romania. Pharmaceuticals. 2025;18(2):161. doi: https://doi.org/10.3390/ph18020161
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Copyright (c) 2026 Tomás Manuel Djú, Thaís Honório Lins Bernardo, Christefany Régia Braz Costa, Mirelle dos Santos, Yhasmin Santos Silva, Anny Gabrielly Santos Silva, Teresa Biussum Iurna
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