Microbiology Biofilm Associated Infections

Question: An 83-year-old woman was admitted to the hospital following a fever and hypotensive episode while at a nursing home. The patient had a clinical history of rheumatoid arthritis, hypertension, atrioventricular block, gastroesophageal reflux disease, deep vein thrombosis with pulmonary embolism, and depression. The patient also had a history of recurrent prosthetic left knee joint infections subsequent to the total knee arthroplasty 2 years earlier. Vancomycin-resistant enterococcus (VRE), Enterococcus faecium, was the predominate organism isolated from synovial fluid taken from her knee. The patient was placed on multiple antimicrobial regimens with numerous revisions. The course of her illness was complicated by pancytopenia, most likely caused by injury to the bone marrow, possibly from a drug reaction. At this admission, blood and synovial fluid cultures were collected. The patient was given antimicrobial therapy and supportive care, but her condition worsened and comfort measures o nly were instituted. When the patient died, an autopsy was requested by the family. The final pathologic diagnoses were: (a) nonhealing chronic wound infection (due to VRE) associated with prosthetic left knee joint and clinical history of sepsis; (b) pulmonary edema and pleural and peritoneal effusions; (c) pulmonary vascular calcifications and cardiomegaly. Consider the following issues. 1. The role and significance of biofilms in infectious diseases . 2. Consequences of untreated biofilm diseases. 3. Whether standard laboratory practices should be altered in meeting the challenge presented by biofilm-associated infections. Answer: 1: Biofilms are associated with almost 80% of microorganism-induced infectious diseases (Conlon et al., 2015). Biofilms cause several common and uncommon problems including gingivitis, bacterial vaginosis, urinary tract infections, endocarditis, etc. Bacterial Biofilms can also impair wound healing and diminish antibacterial efficiency. This worsens the wound and causes several other difficulties. Severe cases may lead to death. 2: When biofilm diseases are left untreated for long periods, the major risk factors contribute towards development and progression of the disease. The disease may further themselves into other organs and infect them. A once treatable disease can become fatal in no time at all if it is left untreated. 3: There are several procedures to detect the production of biofilms. There are other contributing factors, which remain undetected in spite of the common laboratory tests. This may lead to an undetected case of bacterial biofilm formation, which can further cause an untreatable fatal disease. References Conlon, B. P., Rowe, S. E., Lewis, K. (2015). Persister cells in biofilm associated infections. InBiofilm-based Healthcare-associated Infections(pp. 1-9). Springer International Publishing.