ISOLATION, IDENTIFICATATION, AND DETERMINATION OF THE ANTIBIOTIC SUSCEPTIBILITY PATTERN OF BACTERIA ASSOCIATED WITH DIABETIC FOOT ULCER

MWALIMU RAPHAEL JILANI; HAIDER HAMZHA BAAYWI

doi:10.22159/ajpcr.2023.v16i10.48025

Authors

MWALIMU RAPHAEL JILANI Department of Biotechnology, Vel Tech Rangarajan and Dr. Sagunthala R&D Institute of Science and Technology, Chennai, Tamil Nadu, India. https://orcid.org/0009-0009-7594-1079
HAIDER HAMZHA BAAYWI Department of Microbiology, UCS, Osmania University, Hyderabad, Telangana, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i10.48025

Keywords:

Diabetes, Diabetic foot ulcer, Diabetic foot infection, Antibiotic sensitivity

Abstract

Objective: This study involved isolating, identifying, and determining the susceptibility patterns of bacteria from diabetic patients who were hospitalized for diabetic foot ulcers.

Methods: The specimen was collected using a deep swabbing approach from the feet of forty hospitalized patients with diabetes. The two sample swabs were delivered to the microbiology laboratory as soon as they were collected. One swab was used for microscopic examinations, and the other was utilized for culture. Three aseptically prepared agars – chocolate, MacConkey, and sheep blood were used for culture. In accordance with accepted clinical standards, the pathogens were identified. By performing the Kirby–Bauer disc diffusion method on Mueller–Hinton Agar medium, the isolates’ antibiotic sensitivity patterns were examined.

Results: Twenty-five patients had microorganisms in their foot ulcers, whereas 15 patients had sterile samples (no pathological growth). Gram-negative (10) and positive (15) bacteria were recovered, with some patients having both types. Pseudomonas aeruginosa (32%), Klebsiella species (8%), and methicillin-resistant (10), sensitive (2), and coagulase-negative (3) strains of Staphylococcus aureus were identified.

Conclusion: Imipenem was the antibiotic most sensitive to almost all of the isolates, whereas Penicillin G had more resistance to all of the isolates, and the other antibiotics had more variation. Our findings lead us to recommend that patients with diabetes be empirically given imipenem.

Downloads

Download data is not yet available.

References

Pitocco D, Spanu T, Di Leo M, Vitiello R, Rizzi A, Tartaglione L, et al. Diabetic foot infections: A comprehensive overview. Eur Rev Med Pharmacol Sci 2019;23 2 Suppl:26-37. doi: 10.26355/eurrev_201904_17471, PMID 30977868

Hurlow JJ, Humphreys GJ, Bowling FL, McBain AJ. Diabetic foot infection: A critical complication. Int Wound J 2018;15:814-21. doi: 10.1111/iwj.12932, PMID 29808598

Del Core MA, Ahn J, Lewis RB 3rd, Raspovic KM, Lalli TA, Wukich DK. The evaluation and treatment of diabetic foot ulcers and diabetic foot infections. Foot Ankle Surg 2018;3:24730114231193418. doi: 10.1177/2473011418788864

Lipsky BA, Senneville É, Abbas ZG, Aragón-Sánchez J, Diggle M, Embil JM, et al. Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev 2020;36 Suppl 1:e3280. doi: 10.1002/dmrr.3280, PMID 32176444

Chang M, Nguyen TT. Strategy for treatment of infected diabetic foot ulcers. Acc Chem Res 2021;54:1080-93. doi: 10.1021/acs. accounts.0c00864, PMID 33596041

Boulton AJ. The diabetic foot. Medicine 2019;47:100-5. doi: 10.1016/j. mpmed.2018.11.001

Ghotaslou R, Memar MY, Alizadeh N. Classification, microbiology and treatment of diabetic foot infections. J Wound Care 2018;27:434-41. doi: 10.12968/jowc.2018.27.7.434, PMID 30016139

Macdonald KE, Boeckh S, Stacey HJ, Jones JD. The microbiology of diabetic foot infections: A meta-analysis. BMC Infect Dis 2021;21:770.

Bandyk DF. The diabetic foot: Pathophysiology, evaluation, and treatment. Semin Vasc Surg 2018;31:43-8. doi: 10.1053/j. semvascsurg.2019.02.001, PMID 30876640

Saeed K, Esposito S, Akram A, Ascione T, Bal AM, Bassetti M, et al. Hot topics in diabetic foot infection. Int J Antimicrob Agents 2020;55:105942. doi: 10.1016/j.ijantimicag.2020.105942, PMID 32194153

Mahon CR, Lehman DC. Textbook of Diagnostic Microbiology, E-book. Netherlands: Elsevier Health Sciences; 2022.

Gilardi GL. Identification of miscellaneous glucose nonfermenting gram-negative bacteria. In: Glucose Nonfermenting Gram-negative Bacteria in Clinical Microbiology. Boca Raton: CRC Press; 2020. p. 45-65.

Devi U, Bora R, Das JK, Mahanta J. Extended-spectrum β-lactamase and carbapenemase-producing Gram-negative bacilli in neonates from a tertiary care Centre in Dibrugarh, Assam, India. Indian J Med Res 2018;147:110-4. doi: 10.4103/ijmr.IJMR_1288_16, PMID 29749369

Anand KB, Agrawal P, Kumar S, Kapila K. Comparison of cefoxitin disc diffusion test, oxacillin screen agar, and PCR for mecA gene for detection of MRSA. Indian J Med Microbiol 2009;27:27-9. doi: 10.1016/S0255-0857(21)01748-5, PMID 19172055

Yang X, Wang D, Zhou Q, Nie F, Du H, Pang X, et al. Antimicrobial susceptibility testing of Enterobacteriaceae: Determination of disk content and Kirby-Bauer breakpoint for ceftazidime/avibactam. BMC Microbiol 2019;19:240. doi: 10.1186/s12866-019-1613-5, PMID 31675928