الفهرس 
INTRODUCTIIONOnly 14 pages are availabe for public view
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Abstract
Summary
Bacteria exist, in most environments, as complex
organised communities of sessile cells embedded within a
matrix of self-produced, hydrated extracellular polymeric
substances known as biofilms. Bacterial biofilms contribute to
more than 80% of hospital acquired and community acquired
infections. S. aureus is an important example of the pathogens
able to form biofilms.
The capability to form biofilm by bacteria can be
considered as a virulence factor. Infections caused by biofilm
forming pathogens typically exhibit tolerance to antimicrobial
and immunological challenges. This renders them difficult,
sometimes impossible, to treat using conventional chemotherapeutic
agents. Effective alternative approaches for
prevention and eradication of biofilm associated infections are
therefore urgently required.
This study aimed to examine the effect of esomeprazole
and its combined action with vancomycin on S. aureus biofilm
formation.
This study was conducted during the period from January
2015 till March 2016 on 69 S. aureus isolates obtained from
laboratories of Ain Shams University hospitals including
Outpatient departments 21(30.43%), medical Departments
Summary
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14(20.29%), surgical Departments 18(27.54%) and ICUs
16(21.74%). Samples from which isolates were obtained were
27(39.13%) body fluids, 28(40.58%) swabs and 14(20.29%)
access devices.
All isolates were identified according to Collee et al.,
(1996). The differentiation between S. areus and other species
of Staphylococci was done by slide coagulase test, tube
coagulase test, culturing on mannitol salt agar and dry spot
STAPHYTECT PLUS test.
Staphylococcus areus isolates were tested for their ability
to form biofilm using MTP based system. Then the effect of
esomeprazole and its combined action with vancomycin was
tested on the isolates detected to be biofilm forming.
It was found that:
· Biofilm was formed in 30 (43.48%) out of 69 isolates.
· Among 30 biofilm forming isolates 11(36.7%) were strong,
13(43.3%) were moderate and 6(20%) were weak biofilm
producers.
· Among different types of samples, swabs have the highest
rate of biofilm formation 18 (60%).
· In weak biofilm forming isolates, there was statistically
significant difference between the OD readings with and
without the presence of esomeprazole at 72 hrs of incubation
Summary
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(P value : 0.02) and after challenging isolates with
vancomycin (P value : 0.001).
· In moderate biofilm forming isolates, there was statistically
significant difference between the OD readings with and
without the presence of esomeprazole at 24hrs (P value :
0.013), 48hrs (P value : 0.001) and 72 hrs of incubation (P
value : < 0.001) and after challenging isolates with
vancomycin (P value : < 0.001).
· In strong biofilm forming isolates, there was statistically
significant difference between the OD readings with and
without the presence of esomeprazole at 48hrs (P value:
0.001) and 72 hrs of incubation (P value : 0.001) and after
challenging isolates with vancomycin (P value : < 0.001).
Conclusion
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CONCLUSIION
- The intrinsic resistance of biofilm related infections to
conventional therapy necessitates exploration of new
methods dealing with these infections.
- Swabs have the highest rate among biofilm forming isolates.
- Esomeprazole showed inhibitory effect on biofilm formation
by S. aureus and synergistic effect with vancomycin on
biofilm formation.
Recommendations
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RECOMMENDATIIONS
1. Future large scale studies on a large number of clinical
isolates are recommended to study the effect of
esomeprazole on S. aureus biofilm formation.
2. Use of esomeprazole as an adjuvant therapeutic agent for the
treatment or prevention of biofilm related infections.
3. Future dose-response studies will be required to assess if
decrease in biofilm formation is possible with different
dosing regimens as this study used fixed, physiologically
relevant concentrations of vancomycin and esomeprazole.
4. Studies will also be required to be repeated in other relevant
in vitro/in vivo models to confirm these results