- Visibility 135 Views
- Downloads 105 Downloads
- Permissions
- DOI 10.18231/j.ijmr.33816.1758360749
-
CrossMark
Correlation of antimicrobial resistance, biofilm production of bacteria infecting grade 2 and 3 diabetic foot ulcers
- Author Details:
-
MasoodAhmed Tahashildar
-
Sheetal Harakuni *
-
Shrishail Metgud
-
Basavaraj M Kajagar
-
Manoj Togale
MasoodAhmed Tahashildar
Sheetal Harakuni *
Shrishail Metgud
Background: Diabetes is a notorious metabolic disorder characterized by long-term complications such as chronic diabetic foot ulcers (DFUs). DFUs pathogenesis is a product of complex factors lead by long-term diabetic mellitus. The ulcers usually get infected and make treatment complicated.
Objective: The present study aimed to explore the connection between patterns of antimicrobial sensitivity, biofilms formation, as well as severity in chronic foot ulcers.
Materials and Methods: A total of 86 wound/pus sample collected from patients presenting with grade-2 and grade-3 chronic DFUs, were processed for microbial identification and antibiotic sensitivity (CLSI – 2022 guidelines). All isolated bacteria were subjected to biofilm detection test by microtiter plate method. Spearman’s correlation coefficient calculated for each pair of variables to investigate the relationships between biofilm formation, resistance score and diabetic foot ulcer grades.
Results: Out of 110 isolates, biofilm detection assay found five strong biofilm formers, 9 medium biofilm formers, and 22 isolates found to be low biofilm formers. The Spearman’s correlation analysis between antibiotic resistance and biofilm formation was found to be positive, there was a weak relationship between ulcer grades and biofilm formation. However, there was no significant relationship between resistant score and ulcer grades.
Conclusion: Biofilm forming ability needs to be screened among the isolates from a chronic diabetic wound as they facilitate antibiotic resistance. Thus, there is a need for reconsideration of treatment modalities, implementation of effective infection control practices, novel therapies and patient education.
References
- Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367–75.
- Long I. Insight of the pathophysiology of diabetic foot ulcer. In: Raghav A, editor. Diabetic Foot - Recent Advances [Internet]. IntechOpen; 2023 [cited 2024 Aug 13]. Available from: https://www.intechopen.com/chapters/84511
- Kim J. The pathophysiology of diabetic foot: a narrative review. J Yeungnam Med Sci. 2023;40(4):328–34.
- Peng Z, Lavigne JP. Pathogenesis of diabetic foot ulcers. Front Pharmacol. 2023;14:1218201.
- Eckert AJ, Zimny S, Altmeier M, Dugic A, Gillessen A, Bozkurt L, et al. Factors associated with diabetic foot ulcers and lower limb amputations in type 1 and type 2 diabetes supported by real‐world data from the German/Austrian DPV registry. J Diabetes. 2024;16(2):e13531.
- Nawaz AD, Zaidi A, Elsayed B, Jemmieh K, Eledrisi M. Perspective chapter: epidemiology and risk factors of diabetic foot ulcer. In: Chowdhury EH, Zughaier SM, Hasan A, Alfkey R, editors. Diabetic foot ulcers - Pathogenesis, innovative treatments and AI Applications [Internet]. IntechOpen; 2024 [cited 2024 Aug 13]. Available from: https://www.intechopen.com/chapters/1166144
- Hu L, Liu W, Yin L, Yi X, Zou Y, Sheng X. Analysis of factors influencing the recurrence of diabetic foot ulcers. Skin Res Technol. 2024;30(7):e13826.
- Schultz G, Bjarnsholt T, James GA, Leaper DJ, McBain AJ, Malone M, et al. Consensus guidelines for the identification and treatment of biofilms in chronic nonhealing wounds. Wound Rep Reg. 2017;25(5):744–57.
- Biswas SK, Roy SR, Paul AR. Bacterial isolates from diabetic foot ulcer with antibiotic sensitivity pattern. Community Based Med J. 2024;13(1):89–94.
- Baral P, Afnan N, Ahmad Zahra M, Akter B, Rabia Prapti S, Muazzam Hossan M, et al. Bacteriological analysis and antibiotic resistance in patients with diabetic foot ulcers in Dhaka. PLoS One. 2024;19(5):e0301767.
- Zafer MM, Mohamed GA, Ibrahim SRM, Ghosh S, Bornman C, Elfaky MA. Biofilm-mediated infections by multidrug-resistant microbes: a comprehensive exploration and forward perspectives. Arch Microbiol. 2024;206(3):101.
- Parija SC. Textbook of Practical Microbiology. 2nd ed. Delhi: Tarun Ahuja, Ahuja Publishing House; 2018. p. 308.
- Wang X, Yuan CX, Xu B, Yu Z. Diabetic foot ulcers: classification, risk factors and management. World J Diabetes. 2022;13(12):1049.
- Wayne PK. Performance Standards for Antimicrobial Susceptibility Testing. Clinical and Laboratory Standards Institute; 2022.
- Mir R, Salari S, Najimi M, Rashki A. Determination of frequency, multiple antibiotic resistance index and resistotype of Salmonella spp. in chicken meat collected from southeast of Iran. Vet Med Sci. 2022;8(1):229–36.
- Stepanović S, Vuković D, Hola V, Bonaventura GD, Djukić S, Ćirković I, et al. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS. 2007;115(8):891–9.
- Malik A, Mohammad Z, Ahmad J. The diabetic foot infections: biofilms and antimicrobial resistance. Diabetes Metab Syndr Clin Res Rev. 2013;7(2):101–7.
- Premanath R, Suresh S, Alva PP, S KA. Biofilm forming abilities of microorganisms associated with diabetic wound infection: a study from a tertiary care hospital. Biomed Pharmacol J. 2019;12(2):669–
- Coşkun B, Ayhan M, Ulusoy S, Guner R. Bacterial profile and antimicrobial resistance patterns of diabetic foot infections in a major research hospital of Turkey. Antibiotics. 2024;13(7):599.
- Moya-Salazar J, Chamana JM, Porras-Rivera D, Goicochea- Palomino EA, Salazar CR, Contreras-Pulache H. Increase in antibiotic resistance in diabetic foot infections among peruvian patients: a single-center cross-sectional study. Front Endocrinol. 2023;14:1267699.
- Ahmed A, Alvi SA, Aftab IB, Akhtar F. Bacterial diversity with emerging antimicrobial resistance of diabetic foot ulceration and current detection techniques: a review. Electron J Gen Med. 2021;18(6):em323.
- Mamdoh H, Hassanein KM, Eltoony LF, Khalifa WA, Hamed E, Alshammari TO, et al. Clinical and bacteriological analyses of biofilm-forming staphylococci isolated from diabetic foot ulcers. Infect Drug Resist. 2023;16:1737–50.
- Neut D, Tijdens-Creusen EJ, Bulstra SK, Van Der Mei HC, Busscher HJ. Biofilms in chronic diabetic foot ulcers—a study of 2 cases. Acta Orthop. 2011;82(3):383–5. Cite this article: Tahashildar M, Harakuni S, Metgud S, Kajagar BM, Togale M. Correlation of antimicrobial resistance, biofilm production of bacteria infecting grade 2 and 3 diabetic foot ulcers. Indian J Microbiol Res. 2025;12(3):376–380.