الفهرس 
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Abstract
This study aimed to investigate the etiologic agents of diabetic foot
infections, their antimicrobial resistance and biofilm formation ability, the role
of biofilm in resistance to antibiotics and the possible strategies to decrease this
resistance by the use of several antibiofilm agents either alone or in combination
with antibiotics.
Diabetic foot infections are considered as a common problem affecting
diabetic patients. Diabetic foot infections are responsible for severe morbidities,
and they are the major cause of diabetes-related hospitalization. Moreover, they
account for most cases of non-traumatic amputations. Fifty non-repetitive
samples were collected from diabetic foot patients admitted to the Surgery
Department of Zagazig University Hospitals during the period from June 2012
to December 2012. All specimens were collected aseptically and transported to
the microbiological laboratory, where they were immediately processed.
Negative cultures were found in 4 (8%) samples. Polymicrobial infections were
found in 23 (46%) samples. A total of 75 types of bacteria were isolated with an
isolation ratio of 1.63 bacteria per patient. Gram-positive cocci were observed in
14.67% of isolates and Gram-negative bacilli in 85.33% of isolates. The
organisms isolated were Proteus mirabilis (20%), Proteus vulgaris (4%), E. coli
and Pseudomonas aeruginosa (17.33% each), Pseudomonas mendocina
(1.33%), Klebsiella pneumoniae and Staphylococcus aureus (10.67% each). On
the other hand Staphylococcus epidermidis (2.67%), Enterococcus faecalis
(1.33%), Acientobacter baumanii and Citrobacter freundi (4%), Klebsiella
oznea and Klebsiella oxytoca (1.33% each), Klebsiella terrigena (4%).
Identification of clinical isolates were based mainly on the morphological,
culture characteristics and the biochemical tests.The isolates were tested for their ability to form biofilm by the tube
method and spectrophotometric method. Biofilm production was positive in 70
isolates (93.33%). Among these isolates 44.29% were assessed as strong biofilm
forming. Six gram-positive isolates (54.55%) and 25 isolates (39.06%) of gramnegative
bacilli were strong biofilm forming. Among the common isolated
pathogens, Proteus mirabilis was the predominant strong biofilm producer
(80%), followed by staphylococcus aureus (50%), Pseudomonas aeruginosa
(41.67%) and lastly E.coli (28.57%). Resistance to antibiotics was higher
among biofilm forming isolates than non-biofilm forming ones.