Diabetic Foot Infection : Microbiological Causes with Special Reference to Their Antibiotic Resistance Pattern

Dwedar, Reham Ali; Ismail, Dalia Kadry; Abdulbaky, Amr

doi:10.12816/0024935

Cited by 18 publications

(21 citation statements)

References 22 publications

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“…In our study out of 100 patients, commonly affected than females and male to female ratio being 2.22:1 which is similar to the studies done by Yerat RC et al, Tiwari S et al and Dwedar R et al [3,9,10].…”

Section: Discussionsupporting

confidence: 91%

“…In our study majority of patients presented with diabetic foot ulcers belonged to Wagner grade 2 and 3 whereas in study done by Shanmugam P et al number of patients with infected diabetic foot ulcers In our study out of 100 patients, males were more commonly affected than females and male to female being 2.22:1 which is similar to the studies done et al, Tiwari [1,2,3]. The study done by Dwedar R et al showed that 49% of Gram negative bacilli were ESBL producers and 46.8% of staphylococci were MRSA [10]. In the study done by Chaudhry W. N. et al 66.66, 33.33, 66.7 and 50% of the Proteus spp., P. aeruginosa, K. pneumoniae and E. coli populations, respectively, were ESBL producers [11].…”

Section: Discussionsupporting

confidence: 87%

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Bacteriological profile of diabetic foot ulcer using hicrome UTI Agar

Chetana

2017

Trop J Pathol Microbiol

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Introduction: Foot ulcers are one of the common complications of diabetes mellitus. Diabetic foot ulcer infections are usually polymicrobial infections. For effective treatment, quick isolation and identification of causative organisms with appropriate antibiotic susceptibility testing is needed. Objective: Isolation and identification of bacteria using routine media and HiCrome UTI agar. Materials and Methods: Samples were taken from all Type II diabetes mellitus patients with foot ulcers attending hospital. Samples were collected from deeper portion of the ulcer using 2 sterile swabs and processed using conventional methods and HiCrome UTI agar. Antibiotic susceptibility testing was done on Mueller Hinton agar according to CLSI guidelines. Results: Among 100 samples tested, 138 organisms were isolated as 38% of samples yielded mixed growth. Conventional methods failed to detect 6 (4.3%) isolates form mixed cultures. HiCrome UTI agar isolated all organisms in the cultures including 4 isolates of enterococci and 2 isolates of MSSA, which were missed in conventional methods (p < 0.01). Pseudomonas (22.4%) was commonest organism isolated. Followed by Klebsiella spp. (18.8%), Proteus spp. (15.2%), MSSA (13%), Escherichia coli (11.5%), Citrobacter spp. (7.2%), MRSA (7.2%), Enterococcus spp. (4.3%). Conclusion: Gram negative organisms (75.3%) were predominantly isolated in the study. HiCrome UTI agar can be used for primary identification and quick isolation of organisms where facilities for routine culturing are not available. It is both sensitive and specific in isolating and identifying organisms as in polymicrobial infections.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Bacteriological profile of diabetic foot ulcer using hicrome UTI Agar

Chetana

2017

Trop J Pathol Microbiol

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“…13 In this study, antibiotic susceptibility was investigated for all the isolated S. aureus using the Kirby-Bauer disc diffusion method; all S. aureus strains were susceptible to vancomycin, which is in agreement with previous studies. 26,29,[31][32][33] Undeniably, vancomycin-resistant S. aureus strain was rarely reported. 34 Thus, the antibiotic vancomycin was found to be highly effective against Gram-positive organisms, and it still remains the drug of choice for serious infections.…”

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confidence: 99%

<p>Antimicrobial Susceptibility Testing and Phenotypic Detection of MRSA Isolated from Diabetic Foot Infection</p>

Anwar¹,

Hussein²,

Salih³

2020

IJGM

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Background: Diabetic foot infection (DFI) is a common and costly complication of diabetes that may be caused by various bacteria with multi-resistant genes. The aim of this study is to evaluate the efficacy of phenotypic methods for identification of methicillinresistant Staphylococcus aureus (MRSA) with genotypic detection of MRSA-related genes. Methods: In this cross-sectional study, swab samples were collected from patients with DFI from hospitals in Sulaimani/Iraq in April-July 2019. All the samples were processed for microbiological assessment and further MRSA phenotypic and genotypic testing. Results: A total of 46 swab samples were collected from diabetic foot ulcers of 29 males and 17 females. Most samples (93.5%) showed positive growth, with higher proportions of monomicrobial (23; 53.5%) than mixed-bacterial infections (20; 46.5%) and S. aureus as the predominant pathogen. Conventional methods of MRSA detection, such as cefoxitin disc diffusion, can predict methicillin resistance in 45.8% of the cases. Real-time/conventional PCR showed that 41.6% of Staphylococcus aureus were positive for the mecA gene, while none of the isolates was positive for PVL. Conclusion: Staphylococcus aureus was the predominant pathogen in DFI. Although cefoxitin and oxacillin disc diffusion methods can help in the prediction of MRSA, realtime PCR is a reliable method for MRSA detection and confirmation.

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“…16,18 A wide spectrum of aerobic and facultative anaerobic bacteria are found to be multidrug-resistant in this study, comparable to findings elsewhere in Africa and Asia. 19,20 A third of the S. aureus isolates were methicillin-resistant (MRSA). Though prevalence of MRSA appears to be rising in Africa, most of the countries have rates lower than 50%.…”

Section: Comparison Of Mean Values Was Done Using the Student's T mentioning

confidence: 99%

“…Types of multidrug-resistant bacteria in IDFU cases Escherichia coli (23)Klebsiella spp(19) Citrobacter spp(19) Enterobacter spp (11) P. aeruginosa(20) Acinetobacter spp (9) M. morganii(7) P. mirabilis(10) Hafnia alvei(5) S. maltophilia(1) Providencia spp (3) A. baumanni, **Specifically P. alcalifaciens, ***Carbapenemase-producing (Modified Hodge Test Positive), MRSA -methicillin-resistant Staphylococcus aureus, MRCoNS -methicillin-resistant coagulase negative Staphylococcus, VRSA -vancomycin-resistant Staphylococcus aureus, VREvancomycin-resistant Enterococcus, ESBL -extended-spectrum β-lactamase, AmpC -AmpC βlactamase. GPC -Gram-positive cocci, GNB -Gram-negative bacilli Discussion:Infected diabetic ulcers continue to be a polymicrobial infection involving aerobic as well as obligate anaerobic organisms.…”

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confidence: 99%

Multicenter Study of the Burden of Multidrug-Resistant Bacteria in the Etiology of Infected Diabetic Foot Ulcers

Adeyemo

Kolawole

Rotimi

et al. 2019

Preprint

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Background: Infected diabetic foot ulcer (IDFU) is a public health issue and a leading cause of non-traumatic limb amputation. Very few published data on IDFU is available in most West African countries. The objective of this study was to investigate the etiological agents of IDFU and the challenge of antibacterial drug resistance in the management of infections. Methods:This was a prospective cross-sectional hospital-based study involving three tertiary healthcare facilities. Consecutive eligible patients presenting in the facilities were recruited. Tissue biopsies and/or aspirates were collected and cultured on a set of selective and nonselective media and incubated in appropriate atmospheric conditions for 24 to 72 hours.Isolates were identified by established standard methods. Antibiotic susceptibility testing was performed using modified Kirby-Bauer disc diffusion method. Specific resistance determinants were investigated by polymerase chain reaction-based protocols. Data analysis was done with SPSS version 20. Results: Ninety patients with clinical diagnosis of DFI were studied between July 2016 and April 2017. A total of 218 microorganisms were isolated, comprising 129 (59.2%) Gramnegative bacilli (GNB), 59 (27.1%) Gram-positive cocci (GPC) and 29 (13.2%) anaerobic bacteria. The top five facultative/aerobic bacteria encountered were: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Citrobacter spp. isolates, in that order, respectively. The commonest anaerobes were Bacteroides spp., and Peptostreptococcus anaerobius which accounted for 7 (24.1%) and 6 (20.7%), respectively. Of the 93 IDFU cases, 74 (80%) were infected by multidrug-resistant (MDR) bacteria predominantly methicillin-resistant S. aureus, extended-spectrum β-lactamase-producing GNB, mainly of the CTX-M variety. Only 4 (3.1%) GNB were carbapenemase-producers 3 encoded by bla VIM . Factors associated with presence of MDR bacteria were peripheral neuropathy (r= 4.05, P= 0.042) and duration of foot infection >1 month(r= 7.63, P= 0.015). Conclusions: MDR facultative/aerobic bacteria are overrepresented amongst agents causing IDFU. A relatively low proportion of the etiological agents were anaerobic bacteria. This finding should help formulate empirical therapeutic options for managing IDFU.Furthermore, drastic reduction in inappropriate use of cocktail of antibiotics for IDFUs is advocated to combat infection by MDR bacteria in these patients.

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Diabetic Foot Infection : Microbiological Causes with Special Reference to Their Antibiotic Resistance Pattern

Cited by 18 publications

References 22 publications

Bacteriological profile of diabetic foot ulcer using hicrome UTI Agar

Bacteriological profile of diabetic foot ulcer using hicrome UTI Agar

<p>Antimicrobial Susceptibility Testing and Phenotypic Detection of MRSA Isolated from Diabetic Foot Infection</p>

Multicenter Study of the Burden of Multidrug-Resistant Bacteria in the Etiology of Infected Diabetic Foot Ulcers

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