The Role of Biofilm Formation of Secondary Bacterial Infections in Severity of COVID-19 Patients

Abstract

The present study included One hundred and fifty-five specimens were collected from COVID-19 patients (male and female) admitted and hospitalized in ICU after confirming the infection by using Reverse transcription-polymerase chain reaction (RT-PCR) as well as X ray and CT scan at Baqubaa Teaching Hospital from the period of the first of October 2021 to the first to March 2022.The sources of the specimens include (100) pharyngeal swabs and (55) sputum. Selective and differential media, microscopic examination, biochemical tests and the Vitek-2 compact system were used in diagnose all the isolates. Forty-five (29%) isolates from a total of 155 sever COVID-19 patients showed positive growth at a percentage (30%) while 70% showed negative growth. The positive growth isolates were distributed as 155/10 (6.45%) isolates of gram-positive Staphylococcus aureus were isolated only from Pharyngeal swab at a percentage of 10 (10%) and two types of gram-negative isolates which was 155/22(14.19%) of Pseudomonas aeruginosa and 13(8.38%) Acinetobacter baumannii, both of them isolated from Pharyngeal swab 5 (5%) and 9 (9%), and from Sputum was 17 (30.9%), and 4(7.27%) respectively.  Antibiotics sensitivity test revealed strong resistance against 12 antibiotics from different classes were used for each isolates, the results showed that there was numerous bacterium isolates with multiple drug resistance (MDR) and extensively drug resistance (XDR) the results indicated that from the total 10 isolates of Staphylococcus aureus showed resistance to Chloramphenicol (87%), Clarithromycin (85% ), Trimethoprim- sulfamethoxazole (82%), Imipenem (81 %), Levofloxacin (79 % ), Nitrofurantoin (78%), Penicillin and Doxycycline (75%), Gentamicin (74 %), Azithromycin (73%), Tetracycline (66%), Ciprofloxacin (62 %) and Clindamycin (60%). The resistance of P. aeruginosa was variable as follows: 83%, 81%, 80% 79%, 78% and 76% of the isolates resistant to Ciprofloxacin, imipenem, piperacillin, Gentamicin, Tetracycline, Amikacin and Meropenem respectively. Whereas the resistance against Tobramycin and Levofloxacin was 73% and 65% respectively. Concerning to A. baumannii; the resistance rate was 88%, 85%nad 81% against Gentamicin, piperacillin and cefatzidime and cefepime respectively, while the resistance against meropenem and imipenem was 78% and 75% respectively. About tobramycin, Amikacin, tetracycline and Levofloxacin the rate of resistance was 79%, 76%, 71% and 66% respectively. Biofilms formation of the bacteria isolated from severity cases of COVID-19 patients showed that 75% of S. aureus were strongly former, 20% moderately and 5% were non-former, whereas A. baumannii isolates (90%) were strongly former, 10% moderately and no isolate was former. About P. aeruginosa (85%) were strongly former, 15% moderately and no one was former.