Background:Staphylococci, notably Staphylococcus aureus and coagulase-negative staphylococci (CoNS), are prominent pathogens implicated in chronic infections and those linked to indwelling medical devices. The propensity of these bacteria to establish biofilms is a critical factor in their persistent nature, antibiotic resistance, and treatment failures, thereby imposing a significant socio-economic challenge, particularly in developing nations.Methods:This investigation entailed the isolation and characterization of 200 Staphylococci strains collected from a variety of clinical specimens, such as pus, blood, urine, pleural fluid, and ascitic fluid, derived from patients suffering from chronic infections or possessing indwelling medical devices. An additional cohort of 50 strains from a control group was also examined. These isolates were meticulously identified to the species level utilizing conventional biochemical tests. Antibiotic susceptibility was determined through the Kirby-Bauer disk diffusion method in accordance with CLSI guidelines, and methicillin resistance was assessed using the cefoxitin disk test. Biofilm formation was evaluated using three established phenotypic methods: the Tissue Culture Plate (TCP) assay, the Tube Method (TM), and the Congo Red Agar (CRA) method. The collected data were analyzed to ascertain the prevalence of biofilm-producing strains and their correlation with antibiotic resistance patterns. Results: Of the 200 clinical isolates, 68% were identified as Staphylococcus aureus, and 32% were coagulase-negative Staphylococci (CoNS), primarily Staphylococcus epidermidis. Biofilm production was observed in 75% of the S. aureus isolates and 85% of the CoNS isolates. Methicillin resistance was detected in 60% of S. aureus and 50% of CoNS strains. There was a significant association between biofilm production and multidrug resistance, with 70% of biofilm-producing strains showing resistance to three or more classes of antibiotics. The Tissue Culture Plate (TCP) method proved to be the most sensitive in detecting biofilm producers, followed by the Tube Method (TM) and the Congo Red Agar (CRA) methods.Conclusion: The high prevalence of biofilm-producing, multidrug-resistant Staphylococci among patients with chronic infections and indwelling medical devices underscores the need for routine biofilm screening in clinical microbiology laboratories. Targeted strategies to disrupt biofilms could enhance treatment efficacy and reduce the burden of chronic Staphylococcal infections.
