title: Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections.
abstract: While virulence factors and the biofilm-forming capabilities of microbes are the key regulators of the wound healing process, the host immune response may also contribute in the events following wound closure or exacerbation of non-closure. We examined samples from diabetic and non-diabetic foot ulcers/wounds for microbial association and tested the microbes for their antibiotic susceptibility and ability to produce biofilms. A total of 1074 bacterial strains were obtained with staphylococci, Pseudomonas, Citrobacter and enterococci as major colonizers in diabetic samples. Though non-diabetic samples had a similar assemblage, the frequency of occurrence of different groups of bacteria was different. Gram-negative bacteria were found to be more prevalent in the diabetic wound environment while Gram-positive bacteria were predominant in non-diabetic ulcers. A higher frequency of monomicrobial infection was observed in samples from non-diabetic individuals when compared to samples from diabetic patients. The prevalence of different groups of bacteria varied when the samples were stratified according to age and sex of the individuals. Several multidrug-resistant strains were observed among the samples tested and most of these strains produced moderate to high levels of biofilms. The weakened immune response in diabetic individuals and synergism among pathogenic micro-organisms may be the critical factors that determine the delicate balance of the wound healing process.
authors.affiliation: School of Life Sciences, Manipal University, Manipal, India.
authors.forename: Thokur S
authors.initials: TS
authors.lastname: Murali
authors.affiliation: School of Life Sciences, Manipal University, Manipal, India.
authors.forename: Shettigar
authors.initials: S
authors.lastname: Kavitha
authors.affiliation: School of Life Sciences, Manipal University, Manipal, India.
authors.forename: Jain
authors.initials: J
authors.lastname: Spoorthi
authors.affiliation: School of Life Sciences, Manipal University, Manipal, India.
authors.forename: Deepika V
authors.initials: DV
authors.lastname: Bhat
authors.affiliation: School of Life Sciences, Manipal University, Manipal, India.
authors.forename: Alevoor S Bharath
authors.initials: ASB
authors.lastname: Prasad
authors.affiliation: Tissue Repair and Regeneration Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
authors.forename: Zee
authors.initials: Z
authors.lastname: Upton
authors.affiliation: Kasturba Medical College, Manipal, India.
authors.forename: Lingadakai
authors.initials: L
authors.lastname: Ramachandra
authors.affiliation: Kasturba Medical College, Manipal, India.
authors.forename: Raviraj V
authors.initials: RV
authors.lastname: Acharya
authors.affiliation: School of Life Sciences, Manipal University, Manipal, India.
authors.forename: Kapaettu
authors.initials: K
authors.lastname: Satyamoorthy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000382:microbiology*; D018407:Bacterial Physiological Phenomena; D018441:Biofilms / Q000254:growth & development; D017719:Diabetic Foot / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014456:Ulcer / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents