Impact of biofilm production in methicillin resistant Staphylococcus aureus among diabetic foot patient

Background: Diabetic Foot Infection poses many problems in clinical practice. It is usually polymicrobial, and Staphylococcus aureus is the most common pathogen isolated

Objective: To determine the prevalence of methicillin resistant S. aureus [MRSA] and MRSA biofilm production among diabetic patients with chronic leg ulcers

Methodology: This study included 150 patients suffering from infected diabetic foot ulcers. We used VITEK 2 system to identify isolated bacteria. Colonies of S. aureus were screened for resis¬tance to methicillin on Mueller–Hinton agar supplemented with oxacillin at 4 µg/mL Antibiotic sensitivity test was investigated using Kirby Bauer Disc Diffusion method. Investigation of biofilm formation was performed by tissue culture plate method. Detection of icaA and icaD genes was investigated by PCR

Results:S. aureus was isolated from 70 [46.6%] patients. Among the 70 S. aureus, 34 [22.6%] were [MRSA], Pseudomonas aeruginosa 36[24.0%], Klebseilla pneumoniae 25[16.6%] and E.coli were 19[12.6%]. Twenty eight out of 34 tested MRSA [82.35%] were able to form biofilm.Twenty five isolates [73.3%] were strong biofilm former, 3 isolates [8.8%] were moderate biofilm producer and 6 isolates [17.6%] were non biofilm producers. Twenty two were positive for both icaA and icaD genes, On the other hand eight isolates were negative for both genes

Conclusion: A high prevalence of biofilm producing MRSA was detected in S. aureus isolated from patients with Diabetic foot

Diagnosis of renal osteodystrophy in children with chronic renal failure

This study aimed to evaluate the potential of determining bone density using digital radiography in the detection of the bone changes of renal osteodystrophy as compared to biochemical findings [serum calcium, phosphorous and alkaline phosphatase]. This study included twenty five children with CRF aged 6 to 12 years of variable etiology; 14 of them were on dialysis and compared with 10 age and sex matched healthy controls. They were examined using digital radiography together with blood samples to measure serum calcium, phosphorous and alkaline phosphatase. 3 aluminium step wedges were attached to the film cassette to give a reference image on the radiograph. Panoramic radiographs were digitalized, stored and processed by a computer. A geometrically standardized rectangular area of interest was measured for each radiograph. Bone density using digital radiography adequately demonstrated bone status by determining bone density more conspicuously than do the biochemical findings. There were no significant differences detected between dialyzed and non-dialyzed patients so they were poured as one group. While, there was significant decrease in serum calcium and significant increase in serum phosphorous and alkaline phosphatase in patients group compared to controls group. Also, reduction of bone mineral density was detected in patients group compared to controls group and positive correlation was found between bone density of the whole sample and their serum calcium levels. No meaningful correlation could be established between bone mineral density and duration of dialysis. The study concluded that bone density using digital radiography is a potentially useful tool for evaluating the hone density and consequently the bone status of renal osteodystrophy