ArticleCureus2026
Biofilm Detection in Bacterial Isolates From Musculoskeletal Infections: A Comparative Study of Tissue Culture Plate and Congo Red Agar Methods With Antimicrobial Susceptibility Correlation.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background Musculoskeletal infections are a significant cause of morbidity and are frequently associated with prolonged hospital stay, increased healthcare costs, and poor functional outcomes. A major contributing factor to the persistence and recurrence of these infections is the ability of microorganisms to form biofilms. Biofilm-associated bacteria exhibit enhanced resistance to host immune responses and antimicrobial agents, making their detection clinically important. This study aimed to evaluate the prevalence of biofilm formation in bacterial isolates from musculoskeletal infections, compare phenotypic detection methods, and assess their antimicrobial susceptibility patterns. Methods This prospective study was conducted over a period of 12 months in the Bacteriology division of a tertiary care hospital. A total of 105 non-duplicate bacterial isolates obtained from 90 cases of musculoskeletal infections were included. Biofilm detection was performed using two phenotypic methods: Congo red agar (CRA) and the tissue culture plate (TCP) method, a standardized microtiter plate assay. The TCP method was considered the reference standard. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disc diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Results The most common clinical condition was infected/open fractures (18; 20.0%), followed by trauma (7; 7.8%), osteomyelitis, implant infections, and joint infections (6; 6.7% each), while miscellaneous cases accounted for 37 (41.1%).
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