Association between biofilm and multi/extensive drug resistance in diabetic foot infection. Issue 3 (30th January 2018)

• Record Type: Journal Article
• Authors: Vatan, Aslı; Saltoglu, Nese; Yemisen, Mucahit; Balkan, Ilker Inanc; Surme, Serkan; Demiray, Tayfur; Mete, Birgul; Tabak, Fehmi
• Is Part Of: International journal of clinical practice. Volume 72:Issue 3(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-01-30
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.13060
• Languages: English
• ISSNs: 1368-5031

Abstract

Summary: Purpose: We aimed to determine significant risk factors for biofilm production and to investigate the association between antimicrobial resistance profile and biofilm formation in the bacterial isolates obtained from patients with diabetic foot infection (DFI). Methods: Demographic, clinical, laboratory and outcome data of 165 patients, prospectively recorded and followed between January 2008 and December 2015 by a multidisciplinary committee, were analysed. Standard microbiological methods were adopted. Risk factors associated with biofilm were determined by univariate and multivariate analyses. Results: The overall rate of biofilm production among 339 wound isolates was 34%. The biofilm production rate was significantly higher in Gram‐negative micro‐organisms (39%) in comparison with Gram positives (21%) ( P = .01). A. baumannii presented the highest biofilm production (62%), followed by P. aeruginosa (52%) and Klebsiella spp . (40%). On univariate analysis, significant factors associated with biofilm were antibiotic use within last 3 months (OR:2.94, CI: 1.5‐5.75, P = .002), recurrent DFI within last 6 months (OR:2.35, CI: 1.23‐4.53, P = .01), hospitalisation within last 3 months due to ipsilateral recurrent DFI (OR:2.44, CI: 1.06‐5.58, P = .03), presence of amputation history (OR: 2.20, CI: 1.14‐4.24, P = .01), multidrug‐resistant (MDR) micro‐organism (OR: 7.76, CI: 4.53‐13.35, P <.001) and extensively drug‐resistant (XDR) micro‐organism (OR:11.33, CI:4.97‐26.55, P <.001). Multivariate regression analysis revealed two variables to be significant factors associated with biofilm: MDR micro‐organism (OR: 3.63, CI: 1.58‐8.33, P = .002) and XDR micro‐organism (OR:4.06, CI: 1.25‐13.1, P = .01). Conclusions: Multi/extensive drug resistance and previous recurrent DFIs were significantly associated with biofilm formation in patients with diabetic foot.