Detection and Control of Biofilm Formation by from Febrile Neutropenic Patient.

INTRODUCTION

Febrile neutropenia (FN) is the evolution of fever in a patient with neutropenia over 38.0°C. Neutropenia is diagnosed when absolute neutrophil count (ANC) <1500 cells/µL. FN represents a common complication of cancer treatment. Hence, it is featured to be a major cause of morbidity and mortality in cancer patients. is one of the most important microorganisms isolated from the blood of febrile neutropenic patients. Infections caused by range from mild to life-threatening diseases. Biofilm production by is one of the most significant virulence factors of the bacterium as it prevents the penetration of antibiotics. Recently, it has been shown that carries the operon responsible for biofilm production. The aim of the work is to determine a genotypic characterization that includes not only the detection of and genes in but also the determination of their relation to clinical and microbiological features. Empiric antibacterial treatment was recommended for cancer patients receiving chemotherapy.

MATERIALS AND METHODS

The relation between the presence of and and biofilm production was determined in a collection of 66 samples from febrile neutropenic patients. Biofilm-forming ability was tested on Congo Red agar plates. Also, the effect of the most sensitive antibiotics on the bacterial cells was determined by an electron microscope.

RESULTS

Of the bacterial samples, 48 were biofilm-productive and 18 were non-biofilm productive. For the biofilm productive bacteria, 37.5% were positive for , 22.9% were positive for and 10.4% were positive for both. Linezolid was the most effective antibiotic and it is highly recommended for the treatment of febrile neutropenia caused by biofilm-productive . Severe changes were found on the bacterial cell after being treated with Linezolid. The and genes were present in only 50% of biofilm-productive bacteria.

CONCLUSION

The operon is present in only 50% of biofilm-productive and Linezolid is the best antibiotic against these bacteria.