Biofilm Formation of Staphylococcus Aureus in Multiple Sclerosis Patients and its Essential Role in the Pathogenicity of the Disease

Abstract

Background: Multiple sclerosis (MS) is a chronic inflammatory, autoimmune neurological disease of the central nervous system (CNS). One of the most important factors that lead to increased bacterial resistance to an antibacterial agent and also increase the severity of multiple sclerosis, is the capability of producing enterotoxins and biofilm. Aim: To investigate the biofilm-forming Staphylococcus aureus and its correlation with multiple sclerosis severity. Methods: one hundred nasal swab segments from "multiple" "sclerosis" patients and 100 from controls. Staphylococcus aureus was cultured on blood agar, nutrient agar, mannitol salt agar, biochemical tests, and biofilm assay tests were done. Results: A case-control study including (81%) of MS patients were colonized with Staphylococcus aureus in the nasal cavity while only (12%) were colonized in controls, By using the crystal violet microtiter plate method, all Staphylococcus aureus isolates in multiple sclerosis patients can produce biofilm depending on cutoff point (0.171) that measured by ELISA technique, out of 81% isolates from multiple sclerosis patients there were 97.5%, strong biofilm producers, while only 2.5% of isolates were weak biofilm producers. Conclusions: All isolates produce biofilm in high density correlated with increased antibiotic resistance of isolates and increase disease severity.