EVALUATION OF BIOFILM PRODUCTION IN STAPHYLOCOCCUS AUREUS FROM CYSTIC FIBROSIS PATIENTS
DOI:
https://doi.org/10.53582/07p86p95Keywords:
Biofilm, Staphylococcus aureus, MSSA, MRSA, CFAbstract
Cystic fibrosis (CF) is a multisystemic, life-limiting autosomal recessive disease. It is characterized by impaired chloride transport, which results in mucus retention that predisposes patients to chronic respiratory infections. Among the most common pathogens isolated from CF patients is Staphylococcus aureus, which possesses the ability to form biofilms. This ability is a key factor contributing to antimicrobial resistance and persistence. This study aimed to evaluate biofilm production in 41 clinical isolates of S. aureus from CF patients and 11 non-CF controls, using the quantitative colorimetric microtiter plate assay. Results showed that 51% (21/41) of CF isolates were methicillin-sensitive S. aureus (MSSA), while 49% (20/41) were methicillin-resistant S. aureus (MRSA). Among non-CF isolates, 27.3% (3/11) were MRSA and 72.7% (8/11) were MSSA. Biofilm production was observed in 32% (13/41) of CF S. aureus isolates. Among these, 46% (6/13) were MSSA and 54% (7/13) were MRSA. The biofilm phenotypes of CF isolates were distributed as follows: 6.8% strong, 24.4% moderate, and 68.3% weak or non-producers. In non-CF isolates, 18.2% (2/11) were biofilm producers, with one strong and one moderate producer; the remaining 82% (9/11) were weak or non-producers. These findings highlight the clinical relevance of biofilm production in CF-associated S. aureus infections and underscore the need for tailored antimicrobial strategies.
References
1. Bobadilla JL, Macek M Jr, Fine JP, Farrell PM. Cystic fibrosis: a worldwide analysis of CFTR mutations-correlation with incidence data and application to screening. Hum Mutat 2002; 19(6): 575-606. doi: 10.1002/humu.10041.
2. Orenti A, Zolin A, Jung A, van Rens J, Fox A, Kransyk M, et al. European Cystic Fibrosis Society Patient Registry (ECFSPR) Annual Report 2020. 2022:48-67.
3. Kunzelmann K. CFTR: interacting with everything? News Physiol Sci 2001; 16(4): 167-170. doi: 10.1152/physiologyonline.2001.16.4.167.
4. Sabharwal S. Gastrointestinal Manifestations of Cystic Fibrosis. Gastroenterol Hepatol (N Y) 2016; 12(1): 43-7. PMID: 27330503.
5. Filkins LM, O'Toole GA. Cystic Fibrosis Lung Infections: Polymicrobial, Complex, and Hard to Treat. PLoS Pathog 2015; 11(12): e1005258. doi: 10.1371/journal. ppat.1005258.
6. Li C, Wu Y, Riehle A, Ma J, Kamler M, Gulbins E, et al. Staphylococcus aureus Survives in Cystic Fibrosis Macrophages, Forming a Reservoir for Chronic Pneumonia. Infect Immun 2017;85(5): e00883-16. doi: 10.1128/IAI.00883-16.
7. Rumpf C, Lange J, Schwartbeck B, Kahl BC. Staphylococcus aureus and Cystic Fibrosis-A Close Relationship. What Can We Learn from Sequencing Studies? Pathogens 2021; 10(9): 1177. doi: 10.3390/pathogens10091177.
8. Sahoo K, Meshram S. Biofilm Formation in Chronic Infections: A Comprehensive Review of Pathogenesis, Clinical Implications, and Novel Therapeutic Approaches. Cureus 2024; 16(10): e70629. doi: 10.7759/cureus.70629.
9. Jean-Pierre V, Boudet A, Sorlin P, Menetrey Q, Chiron R, Lavigne JP, et al. Biofilm Formation by Staphylococcus aureus in the Specific Context of Cystic Fibrosis. Int J Mol Sci 2022; 24(1): 597. doi: 10.3390/ijms24010597.
10. Stepanović S, Vuković D, Hola V, Di Bonaventura G, Djukić S, Ćirković I, et al. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS 2007; 115(8): 891-899. doi: 10.1111/j.1600-0463.2007.apm_630.x.
11. Boudet A, Sorlin P, Pouget C, Chiron R, Lavigne JP, Dunyach-Remy C, et al. Biofilm Formation in Methicillin-Resistant Staphylococcus aureus Isolated in Cystic Fibrosis Patients Is Strain-Dependent and Differentially Influenced by Antibiotics. Front Microbiol 2021; 12: 750489. doi: 10.3389/fmicb.2021.750489.
12. Lu KY, Wagner NJ, Velez AZ, Ceppe A, Conlon BP, Muhlebach MS. Antibiotic Tolerance and Treatment Outcomes in Cystic Fibrosis Methicillin-Resistant Staphylococcus aureus Infections. Microbiol Spectr 2023; 11(1): e0406122. doi: 10.1128/spectrum.04061-22.
13. Dasenbrook EC, Merlo CA, Diener-West M, Lechtzin N, Boyle MP. Persistent methicillin-resistant Staphylococcus aureus and rate of FEV1 decline in cystic fibrosis. Am J Respir Crit Care Med 2008; 178(8): 814-821. doi: 10.1164/rccm.200802-327OC.
14. Leshem T, Schnall BS, Azrad M, Baum M, Rokney A, Peretz A. Incidence of biofilm formation among MRSA and MSSA clinical isolates from hospitalized patients in Israel. J Appl Microbiol 2022; 133(2): 922-999. doi: 10.1111/jam.15612.
15. Buruiană G, Sima CM, Anton-Păduraru DT, Bădescu AC, Luncă C, Duhaniuc A, et al. Airway Microbiome in Children with Cystic Fibrosis: A Review of Microbial Shifts and Therapeutic Impacts. Medicina (Kaunas) 2025; 61(9): 1605. doi: 10.3390/ medicina61091605.
16. Aktas NC, Erturan Z, Karatuna O, Yagci AK. Panton-valentine leukocidin and biofilm production of Staphylococcus aureus isolated from respiratory tract. J Infect Dev Ctries 2013; 7(11): 888-891. doi: 10.3855/jidc.4135.
17. Kadkhoda H, Ghalavand Z, Nikmanesh B, Kodori M, Houri H, Maleki DT, et al. Characterization of biofilm formation and virulence factors of Staphylococcus aureus isolates from paediatric patients in Tehran, Iran. Iran J Basic Med Sci 2020; 23(5): 691-698. doi: 10.22038/ijbms.2020.36299.8644.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Gordana Mirchevska, Nadica Krsteva, Sara Nedelkoska Kokaroska, Radomir Jovchevski, Elizabeta Janchevska, Aleksandra Kacarska, Valentina Cvejoska Cholakovska, Stojka Fushtikj Naceva, Vesna Kotevska

This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under CC BY 4.0 