Diabetic Foot Infections: Antibiotic Susceptibility Patterns and Determination of Antibiotic Cross-Resistance in Clinical Isolates of Enterococcus Species During 2012 - 2014 in Shiraz, Iran

Anvarinejad, Mojtaba; Pouladfar, Gholamreza; Japoni, Aziz; Bolandparvaz, Shahram; Satiary, Zeinab; Mardaneh, Jalal

doi:10.5812/pedinfect.37680

Cited by 13 publications

(14 citation statements)

References 19 publications

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“…Vancomycin resistance in Staphylococcus aureus among diabetic patients with foot lesion was also reported by Oates et al [26]. However, different susceptibility patterns to antibiotics have been shown by other studies and, mostly, vancomycin, amikacin and linezolid have shown good activity against the strains [27] - [30], which is in agreement with findings of the present study. The challenge of antibiotic resistance is a major public health concern, due to its global dimension and alarming magnitude, although the epidemiology of resistance can exhibit remarkable geographical variability and rapid temporal evolution.…”

Section: Microbiological Analysissupporting

confidence: 93%

Antibiotic Susceptibility Profiles of Bacteria from Diabetic Foot Infections in Selected Teaching Hospitals in Southwestern Nigeria

et al. 2018

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One of the serious complications associated with diabetes is foot ulcer and this condition affects the quality of life in patients in all classes, races and ages. Chronic wounds are prone to colonization by wide array of microorganisms which could be extremely hazardous to patients if effective and timely therapeutic intervention is not made. This study was conducted to determine the antibiotic susceptibility profiles of bacteria from diabetic foot infections in southwestern Nigeria. Samples were collected from a total of 142 diabetic foot ulcer patients with moistened sterile cotton swabs. Nutrient agar, Mac-Conkey agar, blood agar and mannitol salt agar media were used for the isolation of total viable bacteria, Gram-negative non-spore forming lactose fermenters, fastidious bacteria and staphylococci, respectively. Morphological and biochemical characteristics of pure cultures were determined in accordance with standard laboratory criteria. API 20 E and API 20 NE were used for the confirmation of identity of the bacterial isolates. The disc diffusion technique was employed for the determination of antibiotic susceptibility of bacterial isolates in accordance with standard procedures. The antibiotics investigated included amikacin, amoxicillin, ampicillin, ceftazidime, cefazolin, ceftriaxone, chloramphenicol, ciprofloxacin, clindamycin, gentamicin, imipenem, linezolid, methicillin, netilmicin, ofloxacin, oxacillin, penicillin, piperacilin, sulfamethoxazole, trimethoprim and vancomycin. One hundred and seventy-seven isolates were encountered and these were characterized into eleven bacterial species. These included Staphylococcus aureus (22.03%), Pseudomonas aeruginosa (16.95%), Staphylococcus epidermidis (12.43%), Proteus mirabilis (8.48%), Klebsiella pneumoniae (7.91%), E. coli (7.35%), Staphylococcus saprophyticus (6.78%), Streptococcus pyogenes (5.65%), Morganella morganii (5.09%), Citrobacter freundii (4.52%) and Acinetobacter baumannii (2.83%). Gram-negative bacteria showed 76.99% susceptibility to the antibiotics while 22.85% was resistant. Gram-positive bacteria showed 93.75% susceptibility and 5.01% resistance to the antibiotics. This study revealed that there is no definite aetiologic bacterial agent for diabetic foot infections and many of the associated bacteria are sensitive to certain antibiotics.

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Section: Microbiological Analysissupporting

confidence: 93%

Antibiotic Susceptibility Profiles of Bacteria from Diabetic Foot Infections in Selected Teaching Hospitals in Southwestern Nigeria

et al. 2018

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“…During the initial database search, a total of 150 articles were found. After exclusion of the articles according to our criteria, a total of 44 articles were included in the analysis [3] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] . Among these 44 articles, 24 were associated with general patients (3071 isolates), 12 studies assessed their enterococcal populations on the basis of species (3906 isolates) and eight investigated colonization of enterococci among complicated patients with specific underlying conditions (589 isolates).…”

Section: Resultsmentioning

confidence: 99%

Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: a review

Asadollahi

Razavi

Asadollahi

et al. 2018

New Microbes and New Infections

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IntroductionThe clinical significance of enterococci is mostly related to its antibiotic resistance which contributes to colonization and infection, in particular amongst the hospitalized patients. The present review has examined the literature to provide a comprehensive data on enterococci antibiotic resistance during the last 20 years in Iran.MethodsSearch engines such as Google Scholar and PubMed were used to identify all Persian and English-language articles investigating enterococci in Iran from 1996 to 2017. The search terms were “enterococci”, “enterococcal”, “enterococcus”, “Iran”, “bacterial resistance”, “antibiotic resistance” and “resistance”.ResultsDecrease in the resistance trend against ampicillin, gentamycin and ciprofloxacin was observed over a period of 15 years (2001 to 2016) in Iran. During a 10 years period from 2001 to 2015, the rate of resistance among Enterococcus faecalis species was less than Enterococcus faecium. The resistancerate, however, was considerably increased for both species during this period. The mean resistance rates for vancomycin, gentamicin, ciprofloxacin, erythromycin, nitrofurantoin, chloramphenicol, trimethoprim-sulfametoxazol, imipenem and teicoplanin were higher among complicated cases (patients with underlying debilitating disorders) compared to general cases (hospitalized or outpatients with no specific underlying disorder).ConclusionsE. faecalis and E. faecium showed a rise in the mean resistance against all the antibiotics during a 10-year period from 2010 to 2015. With the exception of penicillin and ampicillin, resistance to all antibiotics was higher amongst complicated cases compared to general patients.

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“…Diabetic foot (DF) is a chronic form of diabetes mellitus (DM) associated with high economic and social problems worldwide 1,2 . Approximately 15% of all diabetic patients eventually have a foot ulcer that is highly susceptible to bacterial infections 3 .…”

Section: Introductionmentioning

confidence: 99%

“…These can spread rapidly and often lead to permanent tissue damage. Several bacteria can cause DFIs: Non-spore forming Gram-positive cocci (e.g., Enterococci) are the most common bacteria 2,6 .…”

Section: Introductionmentioning

confidence: 99%

“…One of the biggest problems facing diabetic foot patients is the isolation of a large number of microbes' that are resistant to various antibioticsespecially vancomycin-resistant Enterococci and methicillin-resistant Staphylococcus aureus 2 . The increased frequency of Enterococcus in DFIs is a main cause of hospitalization in Saudi hospitals perhaps because of increased antibiotic use.…”

Section: Introductionmentioning

confidence: 99%

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Highlight on Multidrug Resistance of Enterococcus faecalis Recovered from Diabetic Foot Patients

ALbeloushi¹,

Elbehiry²,

Marzouk³

et al. 2019

J Pure Appl Microbiol

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Diabetic foot infections (DFIs) are a progressively serious health problem worldwide. Enterococcus faecalis (E. faecalis) is one of the most frequent bacteria in DFIs. The antibiotic resistance patterns of this bacterium remain a significant tool for monitoring infection. Therefore, our study aimed to determine the susceptibility of E. faecalis recovered from the wounds of hospitalized diabetic foot patients to various antimicrobial drugs. Fifty-two E. faecalis strains were recovered from 630 diabetic foot patients. All isolates were identified biochemically by a Vitek® 2 system and via a mass spectrometer (MALDI Biotyper). Antimicrobial sensitivity testing used Vitek 2 cards and Kirby-Bauer as the reference method. The findings indicated that the susceptibility of E. faecalis was 100% for ampicillin, ampicillin-sulbactam, benzylpenicillin, norfloxacin, and ofloxacin; 92% for nitrofurantoin, teicoplanin, and vancomycin; 87% for imipenem; 81% for kanamycin (high concentration) and tetracycline; 73% for levofloxacin; and 52% for streptomycin (high concentrations). The resistance was 100% for clindamycin and quinupristin-dalfopristin, 96% for cefuroxime, 90% for ciprofloxacin and erythromycin, 86% for trimethoprim-sulfamethoxazole, 54% for gentamicin (high concentration), and 48% for streptomycin (high concentration). All E. faecalis strains were resistant against numerous antibiotics with a multiple antibiotic resistance (MAR) index of 0.20-0.60. The mean value of MAR indices for all tested E. faecalis species was 0. 373. The high levels of antimicrobial resistance patterns to E. faecalis seen here are important because they restrict treatment possibilities and adversely affect the health of diabetic foot patients. Consequently, our findings should be carefully considered in public health and awareness programs.

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Diabetic Foot Infections: Antibiotic Susceptibility Patterns and Determination of Antibiotic Cross-Resistance in Clinical Isolates of Enterococcus Species During 2012 - 2014 in Shiraz, Iran

Abstract: Background: Diabetic foot infections (DFIs) are an increasingly common public health problem and are associated with mortality and morbidity. The incidence of Enterococci in DFIs, a leading cause of hospital admission in Iran, has been increasing, possibly due to previous antibiotic use.

Cited by 13 publications

References 19 publications

Antibiotic Susceptibility Profiles of Bacteria from Diabetic Foot Infections in Selected Teaching Hospitals in Southwestern Nigeria

Antibiotic Susceptibility Profiles of Bacteria from Diabetic Foot Infections in Selected Teaching Hospitals in Southwestern Nigeria

Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: a review

Highlight on Multidrug Resistance of Enterococcus faecalis Recovered from Diabetic Foot Patients

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