The Prevalence of Biofilm in Diabetic Foot Patients in Zagazig University Hospital, Egypt

Background Biofilms have been associated with chronic infections in diabetic foot leading to resistance to host mechanisms and antimicrobial interventions. Objective The Aim of this study is to estimate the prevalence of biofilm in diabetic foot patients and identification of the causative bacteria. Methods 75 patients suffering from Diabetic foot were admitted to the surgical department during the one year period of the study, 48 males and 27 females, aged 37 - 80 ys. Swab samples from the foot lesions were studied for Bacteriological culture, antibiotic sensitivity, detection of Biofilms by Tissue Culture Plate test, Scanning Electron Microscopy and routine blood investigations. Results Out of 75 diabetic foot patients, 58 (77.3 %) cases were biofilm positive, while 17 (22.7 %) cases were biofilm negative so, the prevalence of biofilm formation was 77.3 %.130 isolates from pus swab of 75 patients were obtained, an average of 1.73 organisms per specimen was estimated. The association between the number of isolated microorganisms and biofilm production is statistically significant (p= 0.026). Most of cases 44 (58.6 %) showed mixed infection. The Gram negative bacilli were highly prevalent (60 %) than Gram positive cocci (40 %). The Multi Drug Resistance isolates were present in 100 (76.9 %) of organisms, the majority of them were Gram negative bacilli mostly Escherichia coli and Klebsiella pneumoniae. As regard Gram positive cocci, Staphylococcus aureus considered the highest organism producing Multi Drug Resistance pattern. Conclusion The prevalence of Biofilm among diabetic foot patients in Zagazig University Hospitals was 77.3 %, with predominance in gram negative bacilli.