EVALUATION OF BIOFILM PRODUCTION IN PSEUDOMONAS AERUGINOSA FROM CYSTIC FIBROSIS PATIENTS

Gordana Mirchevska; Nadica Krsteva; Sara Nedelkoska Kokaroska; Radomir Jovchevski; Elizabeta Janchevska; Aleksandra Kacarska; Valentina Cvejoska Cholakovska; Stojka Fushtikj Naceva; Emilija Antova; Vladanka Okova Jovanovska

Gordana Mirchevska Institute of Microbiology and Parasitology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Nadica Krsteva Institute of Microbiology and Parasitology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Sara Nedelkoska Kokaroska Institute of Microbiology and Parasitology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Radomir Jovchevski Institute of Microbiology and Parasitology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Elizabeta Janchevska Institute of Public Health, Skopje, Faculty of Medicine,“Ss Cyril and Methodius” University in Skopje, North Macedonia,
Aleksandra Kacarska Institute of Public Health, Skopje, Faculty of Medicine,“Ss Cyril and Methodius” University in Skopje, North Macedonia,
Valentina Cvejoska Cholakovska University Clinic for Children’s Diseases, Skopje, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Stojka Fushtikj Naceva University Clinic for Children’s Diseases, Skopje, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Emilija Antova University Clinic for Cardiology, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Vladanka Okova Jovanovska Institute of Microbiology and Parasitology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia

Abstract

Introduction: Cystic fibrosis is a multisystemic autosomal recessive disease causing viscous secretions that predispose patients to chronic infections. Pseudomonas aeruginosa, a common pathogen in CF patients, possesses the ability to form biofilms, a key factor contributing to antimicrobial resistance and persistence. Aim of the study: This study aimed to phenotypically analyze and compare biofilm formation in 48 P. aeruginosa isolates from CF and non-CF patients. Material and Methods: Material and Methods: Isolates were identified using conventional methods and the Vitek-2 system. Biofilm production was assessed using a quantitative colorimetric assay. Results: Biofilm production was confirmed in 46% (22/48) of isolates. Among biofilm producers, 86% (19/22) originated from CF patients versus 13.6% (3/22) from controls, though this difference was not statistically significant (p=0.466), likely due to limited sample size. Mucoid strains comprised 28% of CF isolates; 73% (8/11) of these produced biofilm compared to 39% (11/28) of non-mucoid strains (p=0.145). Biofilm strength was distributed as strong (13%), moderate (36%), and weak/non-producer (51%), with no significant difference between groups (p=0.804). Conclusion: Despite the lack of statistical significance, the high proportion of biofilm producers among CF isolates, particularly mucoid phenotypes, aligns with established literature on P. aeruginosa pathogenesis. These findings underscore the clinical relevance of biofilm production in CF infections and support the need for larger studies to confirm these associations.

Keywords: Biofilm, Pseudomonas aeruginosa, mucoid, non-mucoid, CF.