Open AccessAssociation between biofilm and multi/extensive drug resistance in diabetic foot infection
Author(s) -
Vatan Aslı,
Saltoglu Nese,
Yemisen Mucahit,
Balkan Ilker Inanc,
Surme Serkan,
Demiray Tayfur,
Mete Birgul,
Tabak Fehmi
Publication year - 2018
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13060
Subject(s) - medicine , biofilm , multiple drug resistance , diabetic foot , antibiotics , drug resistance , univariate analysis , microbiology and biotechnology , antimicrobial , acinetobacter baumannii , antibiotic resistance , multivariate analysis , pseudomonas aeruginosa , diabetes mellitus , bacteria , biology , genetics , endocrinology
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 DFI s were significantly associated with biofilm formation in patients with diabetic foot.