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235940

Measuring the minimum biofilm eradication concentration for bacterial isolates from diabetic foot infections

Article

Last updated: 22 Jan 2023

Subjects

-

Tags

Antimicrobial resistance
Clinical microbiology

Abstract

Background: Diabetic foot infection (DFI) is considered the most common cause of diabetes-related hospitalization. Diabetic foot ulcers are subjected to bacterial colonization with biofilm forming organisms which are difficult to eradicate. The aim of this study was to identify the spectrum of bacteria associated with DFI and their ability to form biofilm, to evaluate differences in antibiotic susceptibility pattern between planktonic and biofilm phases, and to determine the antibiotics which are active on the organism in the biofilm phase. Methods: The study comprised 50 patients with DFI. A deep swab was collected from each patient and cultured. All isolates were identified and screened for biofilm formation. Biofilm forming isolates were further subjected to minimum biofilm eradication concentration (MBEC) assays to determine resistance to different antimicrobials while in the biofilm phase. Results: Seventy-one isolates were identified, (14.1%) were Gram positive cocci, (83.1%) were Gram negative bacilli, and (2.8%) were Candida species. The most frequently isolated organism was Klebsiella spp. (18/71, 25.4%), followed by Proteus spp. (14/71, 19.7%). The prevalence of biofilm forming isolates was 38%. All the studied isolates showed MBEC higher than the MIC for all tested antimicrobials. Conclusions: The substantial discrepancy between MIC and MBEC results observed in this study emphasizes the lack of reliability of the routine antimicrobial susceptibility testing in case of biofilm formation. Among all tested antimicrobials; cefoperazone/sulbactam, gentamicin, and vancomycin demonstrated activity against bacteria in the biofilm phase.

DOI

10.21608/mid.2022.132116.1271

Keywords

Diabetic foot infection, Biofilm, MBEC, Antimicrobial resistance

Authors

First Name

Manal

Last Name

Ismail Hassan

MiddleName

-

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Egypt.

Email

mahassan2000@yahoo.com

City

-

Orcid

-

First Name

Wael

Last Name

Shaalan

MiddleName

El-Sayed

Affiliation

Department of Surgery, Faculty of Medicine, Alexandria University, Egypt.

Email

wael.shaalan@alexmed.edu.eg

City

-

Orcid

-

First Name

Amel

Last Name

Afifi

MiddleName

Refat Gouda

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Egypt.

Email

amelrefat@live.com

City

-

Orcid

-

First Name

Shams

Last Name

Arafa

MiddleName

Abd El-Fattah

Affiliation

Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Egypt.

Email

shams.arafa@alexmed.edu.eg

City

-

Orcid

0000-0002-9683-4530

Volume

3

Article Issue

3

Related Issue

35766

Issue Date

2022-08-01

Receive Date

2022-04-08

Publish Date

2022-08-01

Page Start

675

Page End

686

Print ISSN

2682-4132

Online ISSN

2682-4140

Link

https://mid.journals.ekb.eg/article_235940.html

Detail API

https://mid.journals.ekb.eg/service?article_code=235940

Order

19

Type

Original Article

Type Code

1,157

Publication Type

Journal

Publication Title

Microbes and Infectious Diseases

Publication Link

https://mid.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023