Diabetic foot ulcers and biofilm formation- The culprits

Abstract

India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the diabetes capital of the world. DFIs are predominantly polymicrobial caused by a combination of Gram positives like Staphylococcus aureus, Enterococcus, Gram negatives like Pseudomonas aeruginosa, E. coli, Klebseillapneumoniae, Proteus species etc. and Anaerobes of which, most are multidrug resistant. A Biofilm is defined as a thin robust layer of mucilage adhering to a solid surface and containing a community of bacteria and other microorganisms. These biofilms pave way for the re-emergence of multi-drug resistant strains and result in treatment failure. Therefore proper screening of multi drug resistant organisms that are often associated with biofilms, is essential. Detection of biofilm formation is an easy, cost effective test that must be and can be performed as a routine in the laboratory in all these cases. Hence, liberal debridement in combination with appropriate antibiotics will help surgeons to effectively manage the situation and hereby decrease the incidence of emergence of multi drug resistant organisms thereby reducing mortality and the morbidity in patients.