Aerobic bacteria associated with diabetic foot ulcers and their susceptibility pattern

Abstract

Background: Foot ulcers in diabetes mellitus subjects cause morbidity and mortality and lead to non-traumatic amputations worldwide. Knowledge of the microbial burden in the ulcers may improve patients' care and management. Objectives: This prospective study was designed to isolate, identify and carry out antibiotic susceptibility testing on bacterial isolates associated with diabetic foot ulcers among subjects in University of Calabar Teaching Hospital. Methods: Subjects with diabetic foot ulcer were recruited after obtaining ethical clearance from the Research Committee and informed consent from the subjects. Samples were obtained from subjects using sterile swabs and subjected to microscopy and culture. Isolates were identified using standard bacteriological techniques. Kirby-Bauer method was used for susceptibility testing. Results: Out of the 50 subjects recruited, 19 (38.1%) were males and 31 (62.0%) were females with mean age of 55.4 ± 10.1 and a minimum age of 40.0 years. All the subjects had grade 4 wounds. The study recorded 100% infection rates among subjects with 70.0% polymicrobial infections. A total of 97 isolates were obtained from the 50 subjects accounting for the average of 1.94 isolates per subject. The most prevalent isolate was Staphylococcus aureus (32 (32.9%)), while the least isolated pathogen was Klebsiella pneumonia (10 (20.4%)). Females harboured more isolates (61 (62.9%)) than males (36 (37.1%)), but infection rates were not significantly associated with gender (χ² = 15.0, p ≥ 0.05). Erythromycin was the most effective antibiotic agent (65.6%) against S. aureus while gram-negative bacteria were more susceptible to augmentin (87.5%) and ciprofloxacin (75.0%). Conclusion: The multiple antibiotic resistance of the bacterial isolates calls for the need to monitor resistance. The best practice is to perform antibiotic susceptibility testing before treatment. Wounds should be evaluated for bacterial agents before treatment is instituted. Information on the mi.uction of morbidity and amputation rates on the patients.

Assessment role of phagocytic neutrophil cells among different Wagner’s grades of diabetic foot ulcers infections

“…This study showed high level resistance of bacterial isolates to ampicillin 95%, this ratio showed in other studies reported 92.4% [44], 94.9% [47,48], and 50% [35]. This increased of resistance may be attributed to the fact that ampicillin has been widely abused and frequently implicated in selfmedication [47].…”

Methicillin-Resistant Staphylococcus aureus Diabetic Foot Crossed Infection: A Case Report

“…The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in DFI is 16.78% [ 10 ]. However, subsequent studies have reported higher rates in accordance with geographic variables [ 6 , 7 , 9 ].…”

“…Several studies have revealed that DFIs are polymicrobial, including bacterial flora ( Staphylococcus aureus , Streptococcus epidermidis , Peptococcus, and Bacteroides fragilis ) [ 6 , 7 ]. Staphylococcus aureus is the most commonly isolated microorganism [ 6 , 7 , 8 , 9 ], but the extended spectrum beta-lactamases Klebsiella and Pseudomonas aeruginosa can also be detected in small concentrations, increasing the risk of limb amputation [ 6 , 7 , 8 ].…”

Opportunistic Microorganisms Identification Using a Modern Laboratory Technique

“…We found that the infection in most diabetic foot lesions was polymicrobial. This pathogen isolation rate per lesion is 1.97 reported by Sarita Otta et al [16] and 2.37 reported by Carvalho et al [17] The predominance 75.6 per cent of gram-negative organisms has been noted in several studies [18]. However, certain studies [19,20] have established a higher proportion of gram-positive organisms.…”