Abstract

DIABETIC FOOT ULCERS AND BIOFILM FORMATION

B.V.S Lakshmi*, Hima Bindhu, M. Sudhakar, G. Apoorva, J. Uhasri, M. Pradeep, D. Sahaja

ABSTRACT

Objectives: Diabetic foot infections are predominantly polymicrobial, most are multidrug resistant. Delayed wound healing appears to be largely related to the presence of micro-organism growing in a biofilm. This study aimed to identify the spectrum of multidrug-resistant bacteria associated with these infections, their antibiotic sensitivity pattern, and to detect the biofilm formation. Methods: A prospective study at a tertiary care hospital. 100 patients over the age of 18, having chronic diabetic foot ulcer, and attending the surgery outpatient department were included. Samples of pus were collected from deep wounds and processed using standard techniques for culture and sensitivity. Biofilm detection was done. Results were compiled and statistically analyzed. Results: 28(35%) Gram positive organisms and 52(65%) gram negative organisms were isolated. No polymicrobial infections were noted. Psuedomonas aueroginosa1-8(22.5%) Staphylococcus aureus-14(17.5%) was the most commonly isolated organism. Biofilm formation was seen in 34(42.5%). Gram negative- 23(67.64%) Gram positive-11(32.35%) microbes have predominant Biofilm production like E.coli (26.4%), Klebsiella pneumonia (23.1%), Staphylococcus aureus (17.64%) Pseudomonas aueroginosa (14.7%), MSSA (8.82%), Betahemolytic streptococci (5.88%), Citrobacter(1%). Conclusion: Difficulty in eradicating a chronic diabetic foot infection associated with biofilm formation has been reported, and biofilm-producing bacteria have been shown to resist higher antibiotic and disinfectant concentrations than non-biofilm producing bacteria. Therefore, additional screening of multidrug-resistant organisms as well as non-resistant organisms like E.coli and Klebsiella pneumonia often associated with biofilms should be considered. Detection of biofilm formation is an easy and cost-effective test that can be performed routinely in the laboratoryand will help surgeons to effectively manage these infections by providing more aggressive source control and appropriate antibiotics resulting in decrease mortality and the morbidity in patients.

Keywords: Biofilm; Diabetic Foot; Resistance; Amputation.