Vatan A, et al. - Physicians designed this study to determine significant risk factors for biofilm production. They further examined the association between antimicrobial resistance profile and biofilm formation in the bacterial isolates obtained from patients with diabetic foot infection (DFI). Among patients with diabetic foot, multi/extensive drug resistance and previous recurrent DFIs were significantly correlated with biofilm formation.

Methods

• Physicians examined demographic, clinical, laboratory and outcome data of 165 patients, prospectively recorded and followed between January 2008 and December 2015 by a multidisciplinary committee.
• They adopted standard microbiological methods.
• Univariate and multivariate analyses were used to determine risk factors associated with biofilm.

Results

• Among 339 wound isolates, the overall rate of biofilm production was 34%.
• In Gram-negative micro-organisms (39%), the biofilm production rate was significantly higher in comparison with Gram positives (21%) (P=.01).
• Followed by P. Aeruginosa (52%) and Klebsiella spp. (40%), A. baumannii presented the highest biofilm production (62%).
• 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) were significant factors associated with biofilm, in univariate analysis.
• In multivariate regression analysis, two variables found to be significant factors associated with biofilm were 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).