year 19, Issue 5 (September - October 2025)                   Iran J Med Microbiol 2025, 19(5): 330-340 | Back to browse issues page

XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Majdani R, Zaeri Z, Derakhshandeh A, Sattarinezhad E, Motevasel M. Relationship between Biofilm Formation and Antibiotic Resistance in Clinical Acinetobacter baumannii Isolates from Hospitalized Patients in Iran. Iran J Med Microbiol 2025; 19 (5) :330-340
URL: http://ijmm.ir/article-1-2633-en.html
1- Department of Biology, Faculty of Basic Sciences, University of Maragheh, Maragheh, Iran
2- Department of Pathobiology, Faculty of Veterinary Medicine, Shiraz University, Shiraz, Iran
3- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
4- Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran , motevaselm10@gmail.com
Abstract:   (333 Views)

Background and Aim: Acinetobacter (A.) baumannii is an opportunistic pathogen in humans, affecting immunocompromised patients and is becoming increasingly important as a hospital-acquired infection. These strains exhibit resistance to essential current antibiotics, posing a real health threat worldwide. The aim of this study was to investigate the relationship between biofilm formation and antibiotic resistance in clinical Acinetobacter baumannii isolates.
Materials and Methods: A total of 40 clinical isolates were collected from Iranian hospitalized patients. Disk diffusion method was performed to assess the antimicrobial resistance. Crystal violet staining was used to assess the biofilm-forming ability and polymerase chain reaction (PCR) was employed to determine the frequency of biofilm-related genes (bfmR, bfmS, pgaA, bap, ompA, csuE, and abaI). The relationship between biofilm-forming ability and resistance to antibiotics was statistically analyzed using Fisher's exact test and P≤0.05 was considered significant. 
Results: All A. baumannii isolates were multidrug-resistant (MDR). The frequency of extensively drug-resistant (XDR) was 80%, and the rest were pan-drug-resistant (PDR). Most of the MDR isolates (85%) were strong biofilm formers, and the rest of them were moderate biofilm formers. All PDRs and 81.25% of XDRs formed strong biofilms. The bfmR, bfmS, pgaA, bap, and ompA genes were existed in all MDRs. The csuE and abaI genes were detected in 97.5% and 82.5% of MDRs, respectively. All XDRs carried csuE gene, and 90.62% possessed abaI gene. Among PDR isolates, 87.5% presented csuE gene, and 50% exhibited abaI gene.
Conclusion: The presence of biofilm-forming genes may be related to antibiotic resistance in clinical A. baumannii isolates, although a clone of PDR is evolving with strong biofilm-forming ability and lacking abaI gene.

     
Type of Study: Original Research Article | Subject: Antibiotic Resistance
Received: 2025/06/10 | Accepted: 2025/09/20 | ePublished: 2025/11/11

References
1. Martínez-Trejo A, Ruiz-Ruiz JM, Gonzalez-Avila LU, Saldaña-Padilla A, Hernández-Cortez C, Loyola-Cruz MA, et al. Evasion of antimicrobial activity in Acinetobacter baumannii by target site modifications: an effective resistance mechanism. Int J Mol Sci. 2022;23(12):6582. [DOI:10.3390/ijms23126582]
2. Dolma KG, Khati R, Paul AK, Rahmatullah M, de Lourdes Pereira M, Wilairatana P, et al. Virulence characteristics and emerging therapies for biofilm-forming Acinetobacter baumannii: a review. Biology. 2022;11(9):1343. [DOI:10.3390/biology11091343]
3. Abd El-Baky RM, Farhan SM, Ibrahim RA, Mahran KM, Hetta HF. Antimicrobial resistance pattern and molecular epidemiology of ESBL and MBL producing Acinetobacter baumannii isolated from hospitals in Minia, Egypt. Alex J Med. 2020;56(1):4-13. [DOI:10.1080/20905068.2019.1707350]
4. Strateva TV, Sirakov I, Stoeva TJ, Stratev A, Peykov S. Phenotypic and molecular characteristics of carbapenem-resistant Acinetobacter baumannii isolates from Bulgarian Intensive Care Unit patients. Microorganisms. 2023;11(4):875. [DOI:10.3390/microorganisms11040875]
5. Mousavi SM, Babakhani S, Moradi L, Karami S, Shahbandeh M, Mirshekar M, et al. Bacteriophage as a novel therapeutic weapon for killing colistin-resistant multi-drug-resistant and extensively drug-resistant gram-negative bacteria. Curr Microbiol. 2021;78(12):4023-36. [DOI:10.1007/s00284-021-02662-y]
6. Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii antibiotic resistance mechanisms. Pathogens. 2021;10(3):373. [DOI:10.3390/pathogens10030373]
7. Vahhabi A, Hasani A, Rezaee MA, Baradaran B, Hasani A, Kafil HS, et al. Carbapenem resistance in Acinetobacter baumannii clinical isolates from northwest Iran: high prevalence of OXA genes in sync. Iran J Microbiol. 2021;13(3):282. [DOI:10.18502/ijm.v13i3.6388] [PMID] [PMCID]
8. Abbaszadeh F, Hasani A, Rezaee MA, Sadeghi J, Hasani A, Oskouee MA, et al. Genetic characterization of extensive drug resistant Acinetobacter baumannii: an appalling impediment. Folia Med. 2021;63(5):726-37. [DOI:10.3897/folmed.63.e56566]
9. Hajiagha MN, Kafil HS. Efflux pumps and microbial biofilm formation. Infect Genet Evol . 2023;112:105459. [DOI:10.1016/j.meegid.2023.105459]
10. Roy S, Chowdhury G, Mukhopadhyay AK, Dutta S, Basu S. Convergence of biofilm formation and antibiotic resistance in Acinetobacter baumannii infection. Front Med. 2022;9:793615. [DOI:10.3389/fmed.2022.793615]
11. Law SK, Tan HS. The role of quorum sensing, biofilm formation, and iron acquisition as key virulence mechanisms in Acinetobacter baumannii and the corresponding anti-virulence strategies. Microbiol Res. 2022;260:127032. [DOI:10.1016/j.micres.2022.127032]
12. Khoshnood S, Sadeghifard N, Mahdian N, Heidary M, Mahdian S, Mohammadi M, et al. Antimicrobial resistance and biofilm formation capacity among Acinetobacter baumannii strains isolated from patients with burns and ventilator‐associated pneumonia. J Clin Lab Anal. 2023;37(1):e24814. [DOI:10.1002/jcla.24814]
13. Fallah A, Rezaee MA, Hasani A, Barhaghi MH, Kafil HS. Frequency of bap and cpaA virulence genes in drug resistant clinical isolates of Acinetobacter baumannii and their role in biofilm formation. Iran J Basic Med Sci. 2017;20(8):849.
14. Chukamnerd A, Saipetch N, Singkhamanan K, Ingviya N, Assanangkornchai N, Surachat K, et al. Association of biofilm formation, antimicrobial resistance, clinical characteristics, and clinical outcomes among Acinetobacter baumannii isolates from patients with ventilator‐associated pneumonia. Clin Respir J 2024;18(1):e13732. [DOI:10.1111/crj.13732]
15. Guddeti PK, Shah H, Karicheri R, Singh L. Carbapenem resistance and biofilm production in clinical isolates of Acinetobacter baumannii in a tertiary care hospital, central India. Morb Mortal. 2023;26(60):3-5. [DOI:10.22207/JPAM.17.3.03]
16. Farzana R, Swedberg G, Giske CG, Hasan B. Molecular and genetic characterization of emerging carbapenemase-producing Acinetobacter baumannii strains from patients and hospital environments in Bangladesh. Infect Prev Pract. 2022;4(2):100215. [DOI:10.1016/j.infpip.2022.100215]
17. Mortazavi SM, Farshadzadeh Z, Janabadi S, Musavi M, Shahi F, Moradi M, et al. Evaluating the frequency of carbapenem and aminoglycoside resistance genes among clinical isolates of Acinetobacter baumannii from Ahvaz, south-west Iran. New Microbes New Infect. 2020;38:100779. [DOI:10.1016/j.nmni.2020.100779]
18. Al-Shamiri MM, Zhang S, Mi P, Liu Y, Xun M, Yang E, et al. Phenotypic and genotypic characteristics of Acinetobacter baumannii enrolled in the relationship among antibiotic resistance, biofilm formation, and motility. Microb Pathog. 2021;155:104922. [DOI:10.1016/j.micpath.2021.104922]
19. Clinical laboratory and standards Instiute (CLSI). Performance standards for antimicrobial susceptibility testing. 30th ed. Wayne, PA: Clinical Laboratory and Standards Institute (CLSI). 2020. [https://clsi.org/media/3481/m100ed30_sample.pdf]
20. Elbehiry A, Marzouk E, Moussa IM, Dawoud TM, Mubarak AS, Al-Sarar D, et al. Acinetobacter baumannii as a community foodborne pathogen: Peptide mass fingerprinting analysis, genotypic of biofilm formation and phenotypic pattern of antimicrobial resistance. Saudi J Biol Sci. 2021;28(1):1158-66. [DOI:10.1016/j.sjbs.2020.11.052]
21. Eze EC, El Zowalaty ME, Pillay M. Antibiotic resistance and biofilm formation of Acinetobacter baumannii isolated from high-risk effluent water in tertiary hospitals in South Africa. J Glob Antimicrob Resist. 2021;27:82-90. [DOI:10.1016/j.jgar.2021.08.004]
22. Shakib NH, Hashemizadeh Z, Zomorodi AR, Khashei R, Sadeghi Y, Bazargani A. Evaluation of the relatedness between the biofilm-associated genes and antimicrobial resistance among Acinetobacter baumannii isolates in the southwest Iran. Iran J Microbiol. 2025;17(1):80. [DOI:10.18502/ijm.v17i1.17804]
23. Yousefi Nojookambari N, Eslami G, Sadredinamin M, Vaezjalali M, Nikmanesh B, Dehbanipour R, et al. Sub-minimum inhibitory concentrations (sub-MICs) of colistin on Acinetobacter baumannii biofilm formation potency, adherence, and invasion to epithelial host cells: an experimental study in an Iranian children's referral hospital. Microbiol Spectr. 2024;12(2):e02523-23. [DOI:10.1128/spectrum.02523-23]
24. Saadulla SOK, Muhammed SM. Detection of biofilm-related genes and antibiotic resistance in Acinetobacter baumannii isolated from clinical specimens. Biodiversitas J Biol Diversity. 2023;24(3):1809. [DOI:10.13057/biodiv/d240356]
25. Monfared AM, Rezaei A, Poursina F, Faghri J. Detection of genes involved in biofilm formation in MDR and XDR Acinetobacter baumannii isolated from human clinical specimens in Isfahan, Iran. Arch Clin Infect Dis. 2019;14(2):6. [DOI:10.5812/archcid.85766]
26. Mazraeh FN, Hasani A, Sadeghi J, Kafil HS, Barhaghi MHS, Sefidan FY, et al. High frequency of blaPER-1 gene in clinical strains of Acinetobacter baumannii and its association with quorum sensing and virulence factors. Gene Rep. 2021;24:101232. [DOI:10.1016/j.genrep.2021.101232]
27. Acharya K, Bhattacharya U, Biswas S, Pradhan N, Bhattacharya S, Ghosh M, et al. Identification of Evolutionary Trade‐Offs Associated With High‐Level Colistin Resistance in Acinetobacter baumannii. APMIS. 2025;133(12):e70121. [DOI:10.1101/2025.01.17.633615]
28. Wiradiputra MR, Khuntayaporn P, Thirapanmethee K, Wanapaisan P, Chomnawang MT. Genomic insights into biofilm-associated virulence in extensively drug-resistant Acinetobacter baumannii. Curr Res Microb Sci. 2025:100434. [DOI:10.1016/j.crmicr.2025.100434]
29. Roy S, Chowdhury G, Mukhopadhyay AK, Dutta S, Basu S. Convergence of biofilm formation and antibiotic resistance in Acinetobacter baumannii infection. Front Med. 2022;9:793615. [DOI:10.3389/fmed.2022.793615]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2026 CC BY-NC 4.0 | Iranian Journal of Medical Microbiology

Designed & Developed by : Yektaweb | Publisher: Farname Inc