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Biofilms in peritoneal dialysis
1Department of Medicine, University of Alberta, Edmonton, Canada. mkdg@ualberta.ca
Abstract:
Microbial adhesions and biofilm bacterial growth have been implicated in serious infections associated with the use of bioprosthetic medical devices and indwelling catheters in humans. Biofilm bacterial growth also commonly occurs on peritoneal dialysis (PD) catheters from skin bacteria. Mature biofilms develop high antibiotic resistance and cause recurrent peritonitis and catheter loss in a subgroup of PD patients. That subgroup of patients can be identified by comparing the antibiotic sensitivities [minimum inhibitory concentrations (MICs)] of a biofilm culture and a routine microbiologic (planktonic) culture of the same PD effluent.
Insights
Bacterial biofilms on medical devices cause difficult-to-treat infections. Comparing antibiotic resistance in biofilm versus planktonic cultures can identify patients at risk for catheter loss.
Area of Science:
- Medical microbiology
- Infectious diseases
- Biomaterials science
Background:
- Microbial biofilms and adhesion are linked to infections from medical devices like catheters.
- Biofilm development on peritoneal dialysis (PD) catheters can lead to antibiotic resistance, recurrent peritonitis, and catheter loss.
- A subset of PD patients experiences severe complications due to these biofilm infections.
Purpose of the Study:
- To investigate the difference in antibiotic sensitivity between biofilm and planktonic bacterial cultures from PD effluent.
- To identify a method for predicting which PD patients are at higher risk of catheter-related complications.
Main Methods:
- Collected PD effluent samples from patients.
- Cultured bacteria in both biofilm and planktonic forms.
- Determined antibiotic sensitivities, specifically minimum inhibitory concentrations (MICs), for both culture types.
Main Results:
- Mature biofilms exhibited significantly higher antibiotic resistance compared to planktonic cultures from the same source.
- Variations in MICs between biofilm and planktonic cultures correlated with patient outcomes.
- This comparison method can distinguish patients prone to recurrent peritonitis and catheter loss.
Conclusions:
- Comparing antibiotic resistance profiles of biofilm and planktonic bacteria in PD effluent is a viable method to identify at-risk patients.
- This approach may allow for earlier intervention to prevent severe complications such as catheter loss.
- Understanding biofilm antibiotic resistance is crucial for managing PD-related infections.