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Open AccessCommunication

Biofilm-Forming by Carbapenem Resistant Enterobacteriaceae May Contribute to the Blood Stream Infection

1
Chidoribashi General Hospital, Fukuoka 812-0044, Japan
2
Department of Infection Control and Prevention, Kurume University School of Medicine, Kurume 830-0011, Japan
3
Department of Microbiology and Infectious Diseases, Nara Medical University, Nara 634-0813, Japan
4
Department of Pharmacy, Kurume University Hospital, Kurume 830-0011, Japan
5
Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume 830-0011, Japan
*
Author to whom correspondence should be addressed.
These authors contributed equally to work described in this paper.
Int. J. Mol. Sci. 2019, 20(23), 5954; https://doi.org/10.3390/ijms20235954
Received: 8 October 2019 / Revised: 17 November 2019 / Accepted: 22 November 2019 / Published: 26 November 2019
(This article belongs to the Special Issue Biofilms and Bacterial Virulence)
Bloodstream infection (BSI) due to carbapenem-resistant Enterobacteriaceae (CRE) has a high mortality rate and is a serious threat worldwide. Ten CRE strains (eight Enterobacter cloacae, one Klebsiella pneumoniae and one Citrobacter freundii) were isolated from the blood of nine patients, a percentage of whom had been treated with indwelling devices. The steps taken to establish cause included minimum inhibitory concentration (MIC) tests, a pulsed-field gel electrophoresis (PFGE), biofilm study, a multiplex PCR for resistant genes of carbapenemases and extended-spectrum beta-lactamases (ESBLs), and plasmid incompatibility typing. All strains showed a tendency toward resistance to multiple antibiotics, including carbapenems. Frequently isolated genes of ESBLs and carbapenemases include blaTEM-1 (four strains), blaSHV-12 (four strains) and blaIMP-1 (six strains). A molecular analysis by PFGE was used to divide the XbaI-digested genomic DNAs of 10 CRE strains into eight patterns, and the analysis showed that three E. cloacae strains detected from two patients were either identical or closely related. The biofilm production of all CRE strains was examined using a microtiter biofilm assay, and biofilm growth in continuous flow chambers was observed via the use of a confocal laser scanning microscope. Our study indicates that biofilm formation on indwelling devices may pose a risk of BSI due to CRE. View Full-Text
Keywords: carbapenem-resistant Enterobacteriaceae; CRE; bloodstream infection; biofilm carbapenem-resistant Enterobacteriaceae; CRE; bloodstream infection; biofilm
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Yaita, K.; Gotoh, K.; Nakano, R.; Iwahashi, J.; Sakai, Y.; Horita, R.; Yano, H.; Watanabe, H. Biofilm-Forming by Carbapenem Resistant Enterobacteriaceae May Contribute to the Blood Stream Infection. Int. J. Mol. Sci. 2019, 20, 5954.

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