Biofilm Formation and Antibiotic resistance of Enterobacteriaceae isolates from Surgical Site infections in Hôpital de Référence Saint Joseph, Kinshasa, Democratic Republic of Congo

Abstract

<title>Abstract</title> <bold>Background</bold>: <italic>Enterobacteriaceae</italic> are one of the most predominant pathogen in surgical site infections. In recent years we oberved increase in resistance among bacteria from surgical site infections. The aim of this study was to evaluate antimicrobial suceptibility pattern of <italic>Enterobacteriaceae</italic> isolates from surgical site infections, the biofilm formation and the production of OXA-48 carbapenemase.<bold>Methods</bold>: A total of 41 <italic>Enterobacteriaceae</italic> (19 <italic>Escherchia</italic> <italic>coli</italic>, 8 <italic>Enterobacter</italic> sp., 9 <italic>Citrobacter</italic> sp., and 5 <italic>Serratia</italic> <italic> </italic>sp. ) clinical isolates were collected from patients with SSI in Hôpital Saint Joseph (Kinshasa) for diagnostic purposes. The pus samples were cultured and the antibiotic susceptibility profile of the isolates were determined by disk-diffusion method following Clinical and Laboratory Standards Institute 2012 recommendations. OXA-48-producing <italic>Enterobacteriaceae</italic> were detected using Chromatic^TM OXA-48 chromogenic medium. Crystal Violet Staining Method was used to assess the ability of bacteria strains to form a biofilm. <bold>Results</bold>: All <italic>Enterobacteriacea</italic> isolates studied were biofilm producers and highly resistant to the majority of antibiotics tested. <italic>E. coli, Enterobacter</italic> sp.<italic>, Citrobacter </italic>sp., and <italic>Serratia </italic>sp. were 100 % resistant cefotaxime, imipenem, and amoxicillin-clavulanic acid, and ampicillin. <italic>Serratia</italic> sp. isolates were 100% and 80% sensitive to norfloxacine and amikacine respectively. There was relationship between antibiotic resistance and biofilm production. <italic>E. coli</italic>, <italic>Enterobacter</italic> sp., and <italic>Citrobacter</italic> sp. strains were all OXA-48 producers.<bold>Conclusion</bold>: The results of the present study demonstrate the emergence of multidrug resistant organisms, the correlation between antibiotic resistance- biofilm formation and OXA-48 production. These results suggest the implementation of antimicrobial resistance survey programm in order to prevent and combat the spread of multidrug resistant organisms in hospital and community in Democratic Republic of Congo.