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

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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.