الفهرس 
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Abstract
Diabetic foot ulcer (DFU) is one of the chronic wound infection and leads to 90% of non-traumatic lower limb amputation. One of the virulence factors for chronicity might be due to biofilm phenotype exhibited by more than one microorganism. The present study is to detect the biofilm formation and estimate its prevalence among the isolates obtained from patients with diabetic foot infection in Zagazig University Hospitals.
This study was carried out over a period of one year from June 2013 to May 2014. Informed consent was obtained. Pus swabs were collected from 75 patients. All the pus swabs were brought to microbiology laboratory soon after collection and processed by standard procedure. Identified isolates were subjected to antimicrobial susceptibility testing to know the drug sensitivity pattern. Biofilm forming potential of the isolates were identified by microtitre plate method. There were 27 strong biofilm producing organisms isolated from 21 patients. Debrided tissues collected from these patients were examined for biofilm using Scanning Electron Microscopy and were photographed. A total of 130 isolates were obtained from pus swab of 75 patients with DFU. The majority (60%) of isolates were gram negative bacilli. 70.8% (92/130) isolates were biofilm producers. Out of 75 diabetic foot patients, 58 (77.3%) cases were biofilm positive. Multi-drug resistant organisms (MDROs) were noted in 48.1 % of gram positive cocci (25/52) and 96.2% of gram negative bacilli (75/78). Our study shows that 80% of the MDROs are biofilm producers. Proper screening of MDROs and detection of biofilm among various clinical isolates from DFU might help to manage and modify the antibiotic treatment policies in future.