Comparative analysis of in vitro biofilm formation in gram-positive and gram-negative pathogens from orthopaedic implant infections: a retrospective cross-sectional study in a tertiary care centre

Ipsita Paul; Anil Kumar Bilolikar; Srinivas Kasha; Krishnaveni Malisetti

doi:10.18203/issn.2455-4510.IntJResOrthop20251795

Authors

Ipsita Paul Department of Microbiology, KIMS, Secunderabad, Telangana, India
Anil Kumar Bilolikar Department of Microbiology, KIMS, Secunderabad, Telangana, India
Srinivas Kasha Department Orthopaedics, KIMS, Secunderabad, Telangana, India
Krishnaveni Malisetti Department of Microbiology, KIMS, Secunderabad, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251795

Keywords:

Orthopaedic implant infections, Biofilm production, Gram positive

Abstract

Background: Orthopaedic implant infections (ODRI) remain a significant clinical challenge due to their association with persistent biofilm formation, which complicates treatment. 1.2 Objective: This study aimed to investigate the biofilm-forming potential of Gram-positive and Gram-negative pathogens isolated from orthopaedic implant infections in a tertiary care setting.

Methods: A retrospective cross-sectional study was conducted at the Krishna Institute of Medical Sciences, Secunderabad, India, from February 2023 to January 2024. Clinical samples from orthopaedic implant infections, were processed for bacterial culture and biofilm formation using the Tissue Culture Plate (TCP) method in triplicates. Bacterial identification was performed using the Vitek 2 Compact system.

Results: Of 87 patients diagnosed with orthopaedic implant infections, 62 (71.26%) were culture-positive, with 35 (56.45%) Gram-negative bacilli and 27 (43.54%) Gram-positive cocci. Biofilm formation was observed in 59.25% of Gram-positive isolates, with 18.51% strong biofilm producers, 40.74% moderate producers, and 40.74% weak/non-producers. Among Gram-negative isolates, 31.42% were biofilm producers, with 5.71% strong, 25.71% moderate, and 68.57% weak/non-producers. A higher prevalence of biofilm production was noted in Gram-positive organisms compared to Gram-negative bacteria.

Conclusion: The study highlights the higher propensity of Gram-positive bacteria to form biofilms, which may contribute to the persistence and chronicity of orthopaedic implant infections.

Metrics

Metrics Loading ...

References

Rao TS. Bacterial biofilms and implant infections: A perspective. Arch Orthop. 2020;1(4):98-105. DOI: https://doi.org/10.33696/Orthopaedics.1.016

Rohde H, Burandt EC, Siemssen N, Frommelt L, Burdelski C, Wurster S, et al. Polysaccharide intercellular adhesin or protein factors in biofilm accumulation of Staphylococcus epidermidis and Staphylococcus aureus isolated from prosthetic hip and knee joint infections. Biomaterials. 2007;28(9):1711-20. DOI: https://doi.org/10.1016/j.biomaterials.2006.11.046

Funari R, Shen AQ. Detection and characterization of bacterial biofilms and biofilm-based sensors. ACS Sens. 2022;7(2):347–57. DOI: https://doi.org/10.1021/acssensors.1c02722

Lewis K. Riddle of biofilm resistance. Antimicrob Agents Chemother. 2001;45(4):999-1007. DOI: https://doi.org/10.1128/AAC.45.4.999-1007.2001

Vickery K, Hu H, Jacombs AS, Bradshaw DA, Deva AK. A review of bacterial biofilms and their role in device-associated infection. Healthcare infection. 2013;18(2):61-6. DOI: https://doi.org/10.1071/HI12059

Christensen GD, Simpson WA, Younger JJ, Baddour LM, Barrett FF, Melton DM, et al. Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol. 1985;22(6):996-1006. DOI: https://doi.org/10.1128/jcm.22.6.996-1006.1985

Sarangi, Samir k, Padhi S. Bacteriological profile of post-operative orthopedic implant infections and their antibiotic sensitivity pattern in a tertiary care hospital of southern Odisha. J Dr NTR Univ Health Sci. 2019;8(2):114-7. DOI: https://doi.org/10.4103/JDRNTRUHS.JDRNTRUHS_48_19

Alelign D, Tena T, Tadesse D, Tessema M, Seid M. Bacteriological profiles, antimicrobial susceptibility patterns, and associated factors in patients undergoing orthopedic surgery with suspicion of surgical site infection at Arba Minch General Hospital in Southern Ethiopia. Infect Drug Resist. 2022;15:2427-43. DOI: https://doi.org/10.2147/IDR.S367510

Perumal PG, Patil AB, Jnaneshwara K. Microbiological profile of orthopaedic implant associated infections: a prospective study. Natl J Lab Med. 2021;10:4-7. DOI: https://doi.org/10.7860/NJLM/2021/49000.2544

Fernandes A, Dias M. The microbiological profiles of infected prosthetic implants with an emphasis on the organisms which form biofilms. J Clin Diagn Res. 2013;7(2):219-23. DOI: https://doi.org/10.7860/JCDR/2013/4533.2732

Shah MQ, Zardad MS, Khan A, Ahmed S, Awan AS, Mohammad T. Surgical site infection in orthopaedic implants and its common bacteria with their sensitivities to antibiotics, in open reduction internal fixation. J Ayub Med Coll Abbottabad. 2017;29(1):50-3.

Medegar S, Mansabdar P, Patil AB. An evaluation of three different biofilm detection methods in orthopedic implant associated infections and its implication in healthcare system. IP Int J Med Microbiol Tropical Dis. 2022;8(1):63-8. DOI: https://doi.org/10.18231/j.ijmmtd.2022.014

Ruhal R, Kataria R. Biofilm patterns in gram-positive and gram-negative bacteria. Microbiol Res. 2021;251:126829. DOI: https://doi.org/10.1016/j.micres.2021.126829