The relationship between biofilm production capacity with clinical outcomes and antibiotic resistance of Gram-Negative bacteria of pneumonia patients on mechanical ventilation

Pneumonia is a public health issue with a broad impact on quality of life, productivity, and social and economic aspects, ranking among the leading causes of hospitalization in Indonesia.Gram-negative bacteria that because pneumonia are capable of producing biofilms.Biofilms play a crucial role in pathogenesis and antimicrobial resistance because they protect bacteria from antibiotic therapy and contribute to treatment failure, thereby potentially affecting patients' clinical outcomes.The correlation between biofilm-producing capacity, clinical outcomes, and antibiotic resistance of Gram-negative bacteria has not yet been extensively investigated, indicating the need for further research.Objective.To analyze the relationship between biofilm production capacity, clinical outcomes, and antibiotic resistance of Gram-negative bacteria of pneumonia patients on mechanical ventilation.Methods.This was an observational analytic study with a cross-sectional design involving 20 mechanically ventilated pneumonia patients in the intensive care unit of Dr. Soetomo General Hospital, Surabaya, who met the study criteria.Samples were collected between February and August 2025.The biofilm production capacity of Gram-negative bacteria was assessed in relation to clinical outcomes and antibiotic resistance using bronchoalveolar lavage (BAL) fluid samples.Results.No significant relationship was found between the biofilm production capacity of bacteria and clinical outcomes or antibiotic resistance of Gram-negative bacteria, as determined by Chi-square or Fisher's exact statistical test with a p-value >0.05.Conclusions.The assessment of biofilm production capacity does not show a correlation with clinical outcomes or antibiotic resistance in Gram-negative bacteria.