The diabetic foot infections: Biofilms and antimicrobial resistance

Malik, Abida; Zubair, Mohammad; Ahmad, Jamal

doi:10.1016/j.dsx.2013.02.006

Cited by 65 publications

(56 citation statements)

References 41 publications

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“…A high percentage of biofilm-producing DFU staphylococci was detected at 24 h, as already described by other authors (Malik et al 2013;Swarna et al 2012). In our study, biofilm formation by this bacterial species significantly increased with time, which points out for the importance of time course studies, as evaluation only after a 24 h incubation may originate false-negative results.…”

Section: Discussionsupporting

confidence: 72%

Polymicrobial biofilms by diabetic foot clinical isolates

et al. 2015

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Diabetes mellitus is a major chronic disease that continues to increase significantly. One of the most important and costly complications of diabetes is foot ulceration that may be colonized by pathogenic and antimicrobial resistant bacteria, which may express several virulence factors that could impair treatment success. These bacterial communities can be organized in polymicrobial biofilms, which may be responsible for diabetic foot ulcer (DFU) chronicity. We evaluated the influence of polymicrobial communities in the ability of DFU isolates to produce biofilm, using a microtiter plate assay and a multiplex fluorescent in situ hybridization, at three time points (24, 48, 72 h), after evaluating biofilm formation by 95 DFU isolates belonging to several bacterial genera (Staphylococcus, Corynebacterium, Enterococcus, Pseudomonas and Acinetobacter). All isolates were biofilm-positive at 24 h, and the amount of biofilm produced increased with incubation time. Pseudomonas presented the higher biofilm production, followed by Corynebacterium, Acinetobacter, Staphylococcus and Enterococcus. Significant differences were found in biofilm formation between the three time points. Polymicrobial communities produced higher biofilm values than individual species. Pseudomonas + Enterococcus, Acinetobacter + Staphylococcus and Corynebacterium + Staphylococcus produced higher biofilm than the ones formed by E. faecalis + Staphylococcus and E. faecalis + Corynebacterium. Synergy between bacteria present in dual or multispecies biofilms has been described, and this work represents the first report on time course of biofilm formation by polymicrobial communities from DFUs including several species. The biological behavior of different bacterial species in polymicrobial biofilms has important clinical implications for the successful treatment of these infections.

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Section: Discussionsupporting

confidence: 72%

Polymicrobial biofilms by diabetic foot clinical isolates

et al. 2015

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“…P. aeruginosa accounts for~25 % of SSIs, and its presence in wound correlates with a poor prognosis for healing (Halbert et al, 1992;Madsen et al, 1996;Giacometti et al, 2000;Winstanley et al, 2005;Gjødsbøl et al, 2006;Ramakant et al, 2011;Malik et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

Perioperative high inspired oxygen fraction therapy reduces surgical site infection with Pseudomonas aeruginosa in rats

Goldufsky

Gupta

et al. 2016

Journal of Medical Microbiology

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Surgical site infection (SSI) remains one of the most important causes of healthcare-associated infections, accounting for~17 % of all hospital-acquired infections. Although short-term perioperative treatment with high fraction of inspired oxygen (FiO 2 ) has shown clinical benefits in reducing SSI in colorectal resection surgeries, the true clinical benefits of FiO 2 therapy in reducing SSI remain unclear because randomized controlled trials on this topic have yielded disparate results and inconsistent conclusions. To date, no animal study has been conducted to determine the efficacy of short-term perioperative treatments with high (FiO 2 >60 %) versus low (FiO 2 <40 %) oxygen in reducing SSI. In this report, we designed a rat model for muscle surgery to compare the effectiveness of short-term perioperative treatments with high (FiO 2 =80 %) versus a standard low (FiO 2 =30 %) oxygen in reducing SSI with Pseudomonas aeruginosaone of the most prevalent Gram-negative pathogens, responsible for nosocomial SSIs. Our data demonstrate that 5 h perioperative treatment with 80 % FiO 2 is significantly more effective in reducing SSI with P. aeruginosa compared to 30 % FiO 2 treatment. We further show that whilst 80 % FiO 2 treatment does not affect neutrophil infiltration into P. aeruginosa-infected muscles, neutrophils in the 80 % FiO 2 -treated and infected animal group are significantly more activated than neutrophils in the 30 % FiO 2 -treated and infected animal group, suggesting that high oxygen perioperative treatment reduces SSI with P. aeruginosa by enhancing neutrophil activation in infected wounds.

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“…Structurally, biofilms are distinct microcolonies, often encapsulated by extracellular matrix, and may host one or many different species. A commitment to the biofilm lifestyle results in a complete metabolic shift and profoundly different phenotype from cells growing planktonically . Within the biofilm architecture exists a highly organized and structured system, with water channels for efficient cycling of nutrients and the small signaling molecules used for bacterial communication .…”

Section: Biofilms and Chronic Woundsmentioning

confidence: 99%

The role of the microbiome in nonhealing diabetic wounds

Kalan

Brennan

2018

Annals of the New York Academy of Sciences

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Wound healing is a highly coordinated and complex process, and there can be devastating consequences if it is interrupted. It is believed that, in combination with host factors, microorganisms in a wound bed can not only impair wound healing but can lead to stalled, chronic wounds. It is hypothesized that the wound microbiota persists in chronic wounds as a biofilm, recalcitrant to antibiotic and mechanical intervention. Cultivation-based methods are the gold standard for identification of pathogens residing in wounds. However, these methods are biased against fastidious organisms, and do not capture the full extent of microbial diversity in chronic wounds. Thus, the link between specific microbes and impaired healing remains tenuous. This is partially because local infection and, more specifically, the formation of a biofilm, is difficult to diagnose. This has led to research efforts aimed at understanding if biofilm formation delays healing and leads to persistent and chronic infection. Circumventing challenges associated with culture-based estimations, advances in high-throughput sequencing analysis has revealed that chronic wounds are host to complex, diverse microbiomes comprising multiple species of bacteria and fungi. Here, we discuss how the use of genomic methodologies to study wound microbiomes has advanced the current understanding of infection and biofilm formation in chronic wounds.

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The diabetic foot infections: Biofilms and antimicrobial resistance

Cited by 65 publications

References 41 publications

Polymicrobial biofilms by diabetic foot clinical isolates

Polymicrobial biofilms by diabetic foot clinical isolates

Perioperative high inspired oxygen fraction therapy reduces surgical site infection with Pseudomonas aeruginosa in rats

The role of the microbiome in nonhealing diabetic wounds

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