Diabetic foot ulcers and biofilm formation- The culprits

Abstract

India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the "diabetes capital of the world". DFIs are predominantly polymicrobial caused by a combination of Gram positives like Staphylococcus aureus, Enterococcus, Gram negatives like Pseudomonas aeruginosa, E. coli, Klebseilla pneumoniae, Proteus species etc. and Anaerobes of which, most are multidrug resistant. A Biofilm is defined as a thin robust layer of mucilage adhering to a solid surface and containing a community of bacteria and other microorganisms. These biofilms pave way for the re-emergence of multi-drug resistant strains and result in treatment failure.Therefore proper screening of multi drug resistant organisms that are often associated with biofilms, is essential. Detection of biofilm formation is an easy, cost effective test that must be and can be performed as a routine in the laboratory in all these cases.Hence, liberal debridement in combination with appropriate antibiotics will help surgeons to effectively manage the situation and hereby decrease the incidence of emergence of multi drug resistant organisms thereby reducing mortality and the morbidity in patients.

Inhibition and Reduction of Biofilm Production along with Their Antibiogram Pattern among Gram-Negative Clinical Isolates

“…In our study, bioflmproducing organisms had a higher degree of antimicrobial resistance compared to bioflm nonproducers, which was similar to the study conducted by Mishra et al [17], Panda et al [38], and Zubair et al [39]. Tis higher antibiotic resistance in bioflm producers might be due to the close contact of organisms in bioflm, activity of the exopolysaccharide matrix, growth rate alteration, pH and osmotic variation, and resistant gene or plasmid transfer among isolates within a bioflm [40]. Upon comparative evaluation of the drug-resistance pattern and bioflm production among Gram-negative isolates, it was observed that 66.1% of bioflm producers were MDR, which was similar to the study of Aasti and Chaudhary [41] and Fatima et al [22].…”