Banu Asima, Noorul Hassan Mir Mohammad, Rajkumar Janani, Srinivasa Sathyabheemarao
Department of Microbiology, Bangalore Medical College and Research Institute, Bangalore, India.
Department of Surgery, Bangalore Medical College and Research Institute, Bangalore, India.
Australas Med J. 2015 Sep 30;8(9):280-5. doi: 10.4066/AMJ.2015.2422. eCollection 2015.
India has the world's largest number of diabetics. Non-traumatic lower limb amputation is the most common devastating complication of diabetes, primarily due to diabetic foot ulcers (DFU) and diabetic foot infections (DFI). In India, the incidence of foot ulcers ranges from 8-17 per cent. DFIs are predominantly polymicrobial and multidrug-resistant (MDR) with the ability to form biofilm, which is an important virulence factor and results in treatment failure.
The main objectives of the study are to identify the spectrum of multidrug-resistant bacteria associated with these infections, their antibiotic sensitivity pattern, and to detect the biofilm formation.
This was a prospective study at a tertiary care hospital. One hundred patients over the age of 18, having chronic diabetic foot ulcer, and attending the surgery outpatient department were included. Samples of pus were collected from deep wounds and processed using standard techniques for culture and sensitivity. Biofilm detection was done. Results were compiled and statistically analysed.
One hundred samples were processed and 82 yielded positive cultures. Staphylococcus aureus was the predominant organism, followed by Pseudomonas aeruginosa. Biofilm formation was seen in 38 (46.34 per cent) of the organisms. Biofilms were formed predominantly by Staphylococcus aureus (20 per cent).
The organisms causing chronic diabetic foot ulcers were commonly multidrug-resistant; this was also observed among biofilm formers. Therefore, screening for biofilm formation, along with the usual antibiogram, needs to be performed as a routine procedure in chronic diabetic ulcers to formulate effective treatment strategies for these patients.
印度是世界上糖尿病患者人数最多的国家。非创伤性下肢截肢是糖尿病最常见的严重并发症，主要原因是糖尿病足溃疡（DFU）和糖尿病足感染（DFI）。在印度，足部溃疡的发病率在8%至17%之间。DFI主要是多微生物和多重耐药（MDR）的，具有形成生物膜的能力，这是一种重要的毒力因子，会导致治疗失败。
本研究的主要目的是确定与这些感染相关的多重耐药菌谱、它们的抗生素敏感性模式，并检测生物膜的形成。
这是一项在三级护理医院进行的前瞻性研究。纳入了100名年龄在18岁以上、患有慢性糖尿病足溃疡且到外科门诊就诊的患者。从深部伤口采集脓液样本，并使用标准技术进行培养和药敏试验。进行生物膜检测。对结果进行汇总和统计分析。
共处理了100个样本，82个培养结果呈阳性。金黄色葡萄球菌是主要病原体，其次是铜绿假单胞菌。38种（46.34%）病原体中可见生物膜形成。生物膜主要由金黄色葡萄球菌形成（20%）。
引起慢性糖尿病足溃疡的病原体通常具有多重耐药性；在形成生物膜的病原体中也观察到了这一点。因此，在慢性糖尿病溃疡中，除了常规的抗菌谱检测外，还需要进行生物膜形成的筛查，作为常规程序，以便为这些患者制定有效的治疗策略。
