Microbial profile, antimicrobial resistance, and molecular characterization of diabetic foot infections in a university hospital

Ismail, Azza; Meheissen, Marwa Ahmed; elaaty, Talaat Abd; Abd-Allatif, Nermine E; Kassab, Heba Sadek

doi:10.18683/germs.2021.1239

Cited by 16 publications

(19 citation statements)

References 15 publications

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“…These results far exceed previous reports, which showed that methicillin-susceptible isolates of Staphylococcus aureus were susceptible to clindamycin, vancomycin, and ciprofloxacin. However, these results are consistent with studies previously reported in Ethiopia, 31 Egypt, 25,34 and Sudan. 35…”

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 73%

“…This finding is in line with the study documented in Arbaminch, Ethiopia (82.3%) and Eretria 72%. 31,32 However, the present prevalence rate is higher than the study documented previously in Egypt 10.1%, 15.8%. 25,34 In this study, nearly 50% of the isolates screened for MRSA were sensitive to amikacin and chloramphenicol.…”

Section: Discussioncontrasting

confidence: 72%

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Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Woldeteklie¹,

Biazin²,

Abdela³

et al. 2022

IDR

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Background Infectious diabetic foot ulcers (IDFU) are a widespread health issue that affects people all over the world. IDFU, like other medical disorders, can have negative implications if drug resistance develops. Clinicians will be able to choose the optimal antibiotics to treat impacted patients based on the antibiotic susceptibility pattern of bacterial strains. In this project, we attempted to evaluate the levels of extended-spectrum beta-lactamase (ESBL), carbapenemase, and MRSA in patients with diabetic foot ulcers. Methods A sterile swab was used to collect a sample from the leg ulcer, while a sterile needle was used to collect the aspirated pus. Bacteria identification and antibiotic susceptibility tests are carried out based on conventional bacterial culture. The double-disc inactivation method and modified carbapenem (meropenem) were used to screen the production of ESBL and carbapenemase. Results Of the 76 isolates tested, 53.9% (41/76) were phenotypically ESBL producers. K. pneumoniae 75% (6/8), Acinetobacter species 75% (9/12), Serratia species 75% (3/4), Pseudomonas species 64.3% (14/9), E. coli 57.8% (11/19), Citrobacter species 50% (2/4) and Proteus mirabilis 25% (1/4) had the highest frequency of ESBL production. Of the 68 GNB isolates tested, 27.9% (19/68) were carbapenemase-producing organisms. K. pneumoniae 62.5% (5/8), Serratia 50% (3/6), Acinetobacter species 40% (4/10), Pseudomonas species 23.5% (4/17) and E. coli 15.8% (3/19) are the top five major carbapenemase producers. In this study, 32 isolates of Staphylococcus aureus were tested for methicillin resistance. Among them, 81.3% (26/32) were methicillin-resistant Staphylococcus aureus (MRSA), and 18.7% (6/32) of the remaining isolates were methicillin-sensitive Staphylococcus aureus (MSSA). Conclusion The result draws attention to the management of diabetic foot ulcer infections based on the results of microbiological analysis and drug susceptibility testing.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 73%

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Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Woldeteklie¹,

Biazin²,

Abdela³

et al. 2022

IDR

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“…Developing a robust system for the stratification of ulcers is essential for treatment and study. Several studies have performed comparisons between ulcers, based on stratification by clinical classification, but often do not account for the influence of bacterial activity on the local microenvironment [21,39–42]. For example, a previous study of infected ulcers identified increased expression of GADD45B , a DNA damage and stress response protein [36], (also identified in the present study) with IDSA/PEDIS scores of 4 [21].…”

Section: Discussionmentioning

confidence: 68%

“…Our findings suggest rather that this gene and others are expressed only in a subset of samples with an IDSA/PEDIS score of 4, specifically those with high bacterial activity. Similarly, a previous study found no differences between microbiological data including presence of gram‐negative organisms or monomicrobial/polymicrobial infections among different grades of infection [42]. This is not to say that there is no difference in these parameters for severe infections, rather that high variability among samples with the same grade may lead to decreased statistical power to detect these differences.…”

Section: Discussionmentioning

confidence: 92%

Transcriptomic fingerprint of bacterial infection in lower extremity ulcers

Fritz

Bier-Kirkegaard

Nielsen

et al. 2022

APMIS

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Clinicians and researchers utilize subjective, clinical classification systems to stratify lower extremity ulcer infections for treatment and research. The purpose of this study was to examine whether these clinical classifications are reflected in the ulcer's transcriptome. RNA sequencing (RNA‐seq) was performed on biopsies from clinically infected lower extremity ulcers (n = 44). Resulting sequences were aligned to the host reference genome to create a transcriptome profile. Differential gene expression analysis and gene ontology (GO) enrichment analysis were performed between ulcer severities as well as between sample groups identified by k‐means clustering. Lastly, a support vector classifier was trained to estimate clinical infection score or k‐means cluster based on a subset of genes. Clinical infection severity did not explain the major sources of variability among the samples and samples with the same clinical classification demonstrated high inter‐sample variability. High proportions of bacterial RNA were identified in some samples, which resulted in a strong effect on transcription and increased expression of genes associated with immune response and inflammation. K‐means clustering identified two clusters of samples, one of which contained all of the samples with high levels of bacterial RNA. A support vector classifier identified a fingerprint of 20 genes, including immune‐associated genes such as CXCL8, GADD45B, and HILPDA, which accurately identified samples with signs of infection via cross‐validation. This study identified a unique, host‐transcriptome signature in the presence of infecting bacteria, often incongruent with clinical infection‐severity classifications. This suggests that stratification of infection status based on a transcriptomic fingerprint may be useful as an objective classification method to classify infection severity, as well as a tool for studying host–pathogen interactions.

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Assessment of diabetic small‐fiber neuropathy by using short‐wave infrared hyperspectral imaging

Sheen

Sheu

Wang

et al. 2021

Journal of Biophotonics

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Among patients with type 2 diabetes mellitus (T2DM), the association between hyperspectral imaging (HSI) examination and diabetic neuropathy (DN) is ascertained using HSI of the feet using four types of spectral difference measurements. DN was evaluated by traditional Michigan Neuropathy Screening Instrument (MNSI), evaluation of painful neuropathy (ID-Pain, DN4) and sudomotor function by measuring electrochemical skin conductance (ESC). Of the 120 T2DM patients and 20 healthy adults enrolled, T2DM patients are categorized into normal sudomotor (ESC >60 μS)and sudomotor dysfunction (ESC ≤ 60 μS) groups. Spectral difference analyses reveal significant intergroup differences, whereas traditional examinations cannot distinguish between the two groups. HSI waveform reflectance gradually increases with disease severity, at 1400 to 1600 nm. The area under the curve (AUC) of receiver operating characteristic (ROC) analysis for abnormal ESC is ≥0.8 for all four HSI methods. HSI could be an objective, sensitive, rapid, noninvasive and remote approach to identify early small-fiber DN.diabetic neuropathy (DN), electrochemical skin conductance (ESC), hyperspectral imaging (HSI), short-wave infrared (SWIR), type 2 diabetes mellitus (T2DM)

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Microbial profile, antimicrobial resistance, and molecular characterization of diabetic foot infections in a university hospital

Cited by 16 publications

References 15 publications

Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Transcriptomic fingerprint of bacterial infection in lower extremity ulcers

Assessment of diabetic small‐fiber neuropathy by using short‐wave infrared hyperspectral imaging

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