Abstract：
Bacteria commonly adhere to surfaces and produce polymeric material to encase the attached cells to form communities called biofilms. Within these biofilms, bacteria can appear to be many times more resistant to antibiotics or disinfectants. This systematic review explores the prevalence and microbial profile associated with biofilm production of bacteria isolated from endotracheal tubes and its associations with antimicrobial resistance. A comprehensive search was performed on databases PubMed, Embase, and Google Scholar for relevant articles published between 1st January 2000 and 31st December 2022. The relevant articles were exported to Mendeley Desktop 1.19.8 and screened by title and abstract, followed by full text screening based on the eligibility criteria of the study. Quality assessment of the studies was performed using the Newcastle-Ottawa Scale (NOS) customized for cross-sectional studies. Furthermore, the prevalence of antimicrobial resistance in biofilm-producers isolated from endotracheal tube specimens was investigated. Twenty studies encompassing 981 endotracheal tubes met the eligibility criteria. Pseudomonas spp. and Acinetobacter spp. were predominant isolates among the biofilm producers. These biofilms provided strong resistance against commonly used antibiotics. The highest resistance rate observed in Pseudomonas spp. was against fluoroquinolones whereas the least resistance was seen against piperacillin-tazobactam. A similar trend of susceptibility was observed in Acinetobacter spp. with a very high resistance rate against fluoroquinolones, third-generation cephalosporins and carbapenems. In conclusion, endotracheal tubes were associated with colonization by biofilm forming bacteria with varying levels of antimicrobial resistance. Biofilms may promote the occurrence of recalcitrant infections in endotracheal tubes which need to be managed with appropriate protocols and antimicrobial stewardship. Research focus should shift towards meticulous exploration of biofilm-associated infections to improve detection and management.
摘要：
细菌通常粘附到表面并产生聚合物材料以包裹附着的细胞以形成称为生物膜的群落。在这些生物膜中，细菌对抗生素或消毒剂的抗性可能高出许多倍。本系统综述探讨了与从气管内导管分离的细菌的生物膜产生相关的流行和微生物概况及其与抗菌药物耐药性的关系。对PubMed数据库进行了全面搜索，Embase,和谷歌学者在2000年1月1日至2022年12月31日期间发表的相关文章。相关文章导出到MendeleyDesktop1.19.8，并按标题和摘要进行筛选，然后根据研究的合格标准进行全文筛选.使用为横断面研究定制的纽卡斯尔-渥太华量表（NOS）进行研究质量评估。此外，本研究调查了从气管内导管标本中分离出的生物膜生产者对抗菌药物的耐药性.包含981个气管内导管的20项研究符合资格标准。假单胞菌属。和不动杆菌属。是生物膜生产者中的主要分离株。这些生物膜提供了对常用抗生素的强抗性。在假单胞菌属中观察到的最高耐药率。对氟喹诺酮类药物的耐药性最低，而对哌拉西林-他唑巴坦的耐药性最低。在不动杆菌属中观察到相似的敏感性趋势。对氟喹诺酮类药物有很高的耐药率，第三代头孢菌素和碳青霉烯类。总之,气管内导管与生物膜形成细菌的定植有关，这些细菌具有不同水平的抗菌药物耐药性。生物膜可能会促进气管内导管中顽固性感染的发生，这需要通过适当的方案和抗菌药物管理来管理。研究重点应转向对生物膜相关感染的细致探索，以改善检测和管理。
