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 1 January 2000 and 31 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. spp. and spp. were predominant isolates among the biofilm producers. These biofilms provided strong resistance against commonly used antibiotics. The highest resistance rate observed in spp. was against fluoroquinolones whereas the least resistance was seen against piperacillin-tazobactam. A similar trend of susceptibility was observed in 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.

中文翻译：

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气管插管生物膜的细菌学和抗生素耐药性：系统评价

细菌通常粘附在表面并产生聚合材料来包裹附着的细胞，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抵抗力似乎高出许多倍。本系统综述探讨了与气管插管中分离的细菌生物膜产生相关的流行率和微生物特征及其与抗菌素耐药性的关系。在PubMed、Embase、Google Scholar数据库中全面检索2000年1月1日至2022年12月31日期间发表的相关文章。相关文章导出至Mendeley Desktop 1.19.8，按标题和摘要进行筛选，然后进行全文筛选基于研究的资格标准。使用为横断面研究定制的纽卡斯尔-渥太华量表（NOS）对研究进行质量评估。此外，还调查了从气管内管标本中分离出的生物膜产生者的抗菌药物耐药性流行情况。涉及 981 根气管插管的 20 项研究符合资格标准。种。和 spp。是生物膜生产者中的主要分离株。这些生物膜对常用抗生素具有很强的抵抗力。在 spp 中观察到的最高耐药率。对氟喹诺酮类药物的耐药性最强，而对哌拉西林-他唑巴坦的耐药性最小。在某些物种中也观察到了类似的敏感性趋势。对氟喹诺酮类、三代头孢菌素、碳青霉烯类耐药率极高。总之，气管插管与具有不同程度的抗菌药物耐药性的生物膜形成细菌的定植有关。生物膜可能会促进气管插管中顽固性感染的发生，需要通过适当的方案和抗菌药物管理来进行管理。研究重点应转向对生物膜相关感染的细致探索，以改进检测和管理。