Antibiotic susceptibility and biofilm forming ability of Staphylococcus aureus isolated from Jordanian patients with diabetic foot ulcer

Dima Owais; Rania M. Al-Groom; Tareq Nayef AlRamadneh; Laila Alsawalha; Mohd Sajjad  Ahmad Khan; Omar H. Yousef; Shereen Z. Burjaq

doi:10.18502/ijm.v16i4.16303

Dima Owais Department of Allied Medical Sciences, Al-Balqa Applied University, Salt, Jordan
Rania M. Al-Groom Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, Zarqa University, Zarqa, Jordan
Tareq Nayef AlRamadneh Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, Zarqa University, Zarqa, Jordan
Laila Alsawalha Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, Zarqa University, Zarqa, Jordan
Mohd Sajjad Ahmad Khan Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Omar H. Yousef Department of Allied Medical Sciences, Zarqa University College, Al-Balqa Applied University, Salt, Jordan
Shereen Z. Burjaq Department of Medical Laboratory Sciences , Faculty of Science, Al-Balqa Applied University, Salt, Jordan

DOI: https://doi.org/10.18502/ijm.v16i4.16303

Keywords: Antimicrobial resistance; Biofilm; Diabetes; Diabetic foot; Staphylococcus aureus

Abstract

Background and Objectives: Microbial biofilm is characterized by the irreversible attachment of planktonic cells to a surface and is usually associated with high antimicrobial resistance with worsening the wound healing. The objective of the study was to determine the prevalence of Staphylococcus aureus in diabetic foot ulcers (DFUs) of diabetic patients and to in- vestigate antibiotic susceptibility patterns of these isolates. In addition to screen biofilm forming ability of isolated S. aureus.

Materials and Methods: A total of 112 non-healing wound swabs of diabetic foot patients were collected and cultured on different culture media to identify and characterize 98 isolates. The S. aureus isolates were examined for their antibiotic susceptibility to different antimicrobial agents. Furthermore, S. aureus isolates were evaluated for their biofilm production capability using the Tissue Culture Plate Method (TPC). The level of icaA gene expression was determined by RT-PCR.

Results: The results of this study showed that these non-healing wounds yield positive cultures, with an average of 1.67 or- ganisms per sample. The isolates showed highest resistance against oxacillin (95.2%) and lowest resistance against linezolid (3.7%). All isolates were biofilm producers and a significant association with the icaA gene expression level was recorded.

Conclusion: This study showed that S. aureus isolates have a great ability to produce biofilms that are associated with the chronicity of wounds in diabetic patients. Routine screening for biofilm formers in chronic wounds and their antibiotic sus- ceptibility testing will help in early treatment and prevent any other complications.