scholarly journals Genome sequencing and analysis of the first spontaneous Nanosilver resistant bacterium Proteus mirabilis strain SCDR1

2016 ◽  
Author(s):  
Amr T. M. Saeb ◽  
Khalid A. Al-Rubeaan ◽  
Mohamed Abouelhoda ◽  
Manojkumar Selvaraju ◽  
Hamsa T. Tayeb
Keyword(s):  
Ulcer Patient ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Resistant Isolate ◽  
Diabetic Ulcer ◽  
Indwelling Catheters ◽  
Silver Colloids ◽  
Nano Silver ◽  
Successful Infection ◽  
Resistant Bacterial Strain

AbstractBackgroundP. mirabilis is a common uropathogenic bacterium that can cause major complications in patients with long-standing indwelling catheters or patients with urinary tract anomalies. In addition, P. mirabilis is a common cause of chronic osteomyelitis in Diabetic foot ulcer (DFU) patients. We isolated P. mirabilis SCDR1 from a Diabetic ulcer patient. We examined P. mirabilis SCDR1 levels of resistance against Nano-silver colloids, the commercial Nano-silver and silver containing bandages and commonly used antibiotics. We utilized next generation sequencing techniques (NGS), bioinformatics, phylogenetic analysis and pathogenomics in the characterization of the infectious pathogen.ResultsP. mirabilis SCDR1 is a multi-drug resistant isolate that also showed high levels of resistance against Nano-silver colloids, Nano-silver chitosan composite and the commercially available Nano-silver and silver bandages. The P. mirabilis -SCDR1 genome size is 3,815,621 bp. with G+C content of 38.44%. P. mirabilis-SCDR1 genome contains a total of 3,533 genes, 3,414 coding DNA sequence genes, 11, 10, 18 rRNAs (5S, 16S, and 23S), and 76 tRNAs. Our isolate contains all the required pathogenicity and virulence factors to establish a successful infection. P. mirabilis SCDR1 isolate is a potential virulent pathogen that despite its original isolation site, wound, it can establish kidney infection and its associated complications. P. mirabilis SCDR1 contains several mechanisms for antibiotics and metals resistance including, biofilm formation, swarming mobility, efflux systems, and enzymatic detoxification.ConclusionP. mirabilis SCDR1 is the first reported spontaneous Nanosilver resistant bacterial strain. P. mirabilis SCDR1 possesses several mechanisms that may lead to the observed Nanosilver resistance.

scholarly journals STRESS PASIEN DENGAN ULKUS KAKI DIABETIKUM DI AL HIJRAH WOUND CARE CENTER JOMBANG

2020 ◽  
Vol 6 (1) ◽  
pp. 128-136
Author(s):  
Fahruddin Kurdi ◽  
Anja Hesnia Kholis ◽  
Nurul Hidayah ◽  
Maya Fitriasari
Keyword(s):  
Diabetic Foot ◽  
Nuclear Family ◽  
Wound Care ◽  
Ulcer Patient ◽  
Care Center ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Ulcer ◽  
Psychological Burden ◽  
Diabetic Ulcers

ABSTRACT Diabetic foot ulcer is a complication of mellitus. The complication can cause psychological problems that cause stress for patient. The severity of diabetic foot ulcer will increase stress in patients. To deal with stress that needs to be overcome by reducing stress independently, besides the support system of the family is needed to help reduce stress and psychological burden. The purpose of this research is to explore how stress is experienced by diabetic foot ulcer patient.                 This research is a qualitative research with phenomenology approach. Participants were diabetic ulcer who come for wound care treatments at Al Hijrah wound care center, as well as the nuclear family as additional informants. Data is taken with a thorough interview, observation.                 The results obtained from two participants that stress due to diabetic ulcers is a condition related to physical and psychological conditions that cause participants to increase stress, such as: body image disorders, immobility, fear to amputation and cost difficulties.                 The main effort to reduce stress is pray, read the Al Quran, dzikr and ask for help to health services in the hope that the stress can reduced independently and does not cause worse complications. It is hoped that further research will examine more deeply the stress experienced by patients with diabetic ulcers.  

scholarly journals Genomic Insights into Biofilm-Forming Enterococcus faecalis SK460 Isolated from a Chronic Diabetic Ulcer Patient

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Karthika Suryaletha ◽  
Lekshmi Narendrakumar ◽  
Joby John ◽  
Dinesh Reghunathan ◽  
Manoj Prasannakumar ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Enterococcus Faecalis ◽  
Virulence Genes ◽  
Ulcer Patient ◽  
Draft Genome ◽  
Antibiotic Resistance Genes ◽  
Foot Ulcer ◽  
Tetracycline Resistance ◽  
Diabetic Foot Ulcer ◽  
Diabetic Ulcer

ABSTRACT Enterococcus faecalis is recognized as one of the leading pathogens causing nosocomial infections. Here we report a draft genome sequence of Enterococcus faecalis SK460, isolated from a chronic diabetic foot ulcer patient. This strain exhibits various biofilm-associated genes, virulence genes, and antibiotic-resistance genes related to aminoglycoside, macrolide, and tetracycline resistance.

scholarly journals A Lethal Case ofSphingomonas paucimobilisBacteremia in an Immunocompromised Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Nata Pratama Hardjo Lugito ◽  
Cucunawangsih ◽  
Andree Kurniawan
Keyword(s):  
Septic Shock ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Severe Infection ◽  
Venous Catheter ◽  
Multidrug Resistant ◽  
Premature Neonate ◽  
Hospital Environment ◽  
Indwelling Catheters ◽  
Stage Renal Disease

Sphingomonas paucimobilisis a yellow-pigmented, glucose nonfermenting, aerobic, Gram negative bacillus of low pathogenicity. This organism was found in the implantation of indwelling catheters, sterile intravenous fluid, or contaminated hospital environment such as tap and distilled water, nebulizer, ventilator, and hemodialysis device. A 55-year-old female was hospitalized for diabetic foot ulcer in the presence of multiple comorbidities: diabetes mellitus, colonic tuberculosis, end-stage renal disease, and indwelling catheters for central venous catheter and hemodialysis. The patient passed away on the 44th day of admission due to septic shock. The organism found on blood culture on the 29th day of admission was multidrug resistantS. paucimobilis. Severe infection and septic shock due toS. paucimobilishave been reported particularly in immunocompromised patients, but there has been only one reported case of death in a premature neonate with septic shock. This is the first reported lethal case ofS. paucimobilisbacteremia in an adult patient.

Empirical Antibiotic Treatment in Diabetic Foot Infection: A Study Focusing on the Culture and Antibiotic Sensitivity in a Population From Southern China

2017 ◽  
Vol 16 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Wen-xia Wu ◽  
Dan Liu ◽  
Yi-wen Wang ◽  
Chuan Wang ◽  
Chuan Yang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Southern China ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Severe Infection ◽  
Third Generation ◽  
Diabetic Ulcer ◽  
Significant Difference

Diabetic foot and subsequent diabetic ulcer infections are the most devastating complication of diabetes. This study was conducted to explore the bacterial spectrum, sensitivity of microbials, and analysis of the empirical antibiotic regimens in our health center. The study included patients with diabetic foot ulcer infection (DFI) seen from 2009 to 2014. The patients included had all information covering the physical examination, laboratory tests, and image examinations. We sent appropriately obtained specimens for culture prior to starting empirical antibiotic therapy in all participants. A total of 312 patients were included: 52, 112, 95 and 53 patients within uninfected, mild, moderate, and severe infection groups. The total percentages of Gram-positive cocci (GPCs) and Gram-negative rods (GNRs) were 54% and 48.8% ( P = 0.63). The most common GPC was Staphylococcus aureus (22.4%) and GNR was Pseudomonas aeruginosa (11.9%). Methicillin-resistant Staphylococcus aureus was isolated from 21 patients (6.7%). Even in the mild infection group, there was no significant difference between GPC and GNR infection, irrespective of recent antibiotic use ( P = 0.053). The most frequently used empirical antibiotics in our center were second-/third-generation cephalosporin ± clindamycin, both in the mild and moderate/severe infection groups. In our center, the amoxicillin/clavulanate or ampicillin/sulbactam (β-L-ase 1) and second-/third-generation cephalosporins were highly resistant to the common GNR (30%-60%). The ticarcillin/clavulanate, piperacillin/tazuobactam (β-L-ase 2), fluoroquinolone, and group 2 carbapenem had good sensitivity. This study presents a comprehensive microbiological survey of diabetic foot ulcers in inpatients and provides reliable evidence of the local microbial epidemiology and sensitivity of antibiotics, which may help us improve clinical outcomes in DFI patients.

scholarly journals A Rare Form of Melanoma Masquerading as a Diabetic Foot Ulcer: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Susan Thomas ◽  
Yuan-Xiang Meng ◽  
Vijaykumar G. Patel ◽  
Gregory Strayhorn
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Primary Care Clinic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Care Clinic ◽  
Acral Lentiginous Melanoma ◽  
Diabetic Ulcer ◽  
Formidable Challenge

Background. Acral lentiginous melanoma (ALM) is a less-common form of melanoma in US, and it accounts for about 5% of all diagnosed melanomas in US. ALM is often overlooked until it is well advanced because of the lesion’s location and its atypical appearance in the early stages. We present a case of ALM initially presented as a diabetic foot ulcer.Case Report. An 81-year-old man initially presented to the primary care clinic with a right foot diabetic ulcer. There was a large plantar, dark-colored ulcer that bled easy. Initial excision biopsy revealed Clark’s Level IV ALM. Subsequent definitive wide excision and sentinel node biopsy confirmed ALM with metastasis to inguinal lymph nodes (stage IIIb). The treatment included wide margin excision of the lesion with en bloc amputations of 4th and 5th toes, followed by adjuvant chemotherapy.Discussion. The development of ALM may potentially relate to diabetes as a reported higher prevalence of diabetes with ALM patients.Conclusion. The difficulty in early diagnosing of ALM remains as a formidable challenge particularly in diabetic patients who commonly develop plantar foot ulcers due to the diabetic neuropathy. This case reiterates the importance of a thorough foot exam in such patients.

scholarly journals Staged salvage of diabetic foot with Chopart amputation and intramedullary nailing

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110467
Author(s):  
Alexandre Leme Godoy-Santos ◽  
Fábio Correa Fonseca ◽  
Cesar de Cesar-Netto ◽  
Katrina Bang ◽  
Eduardo Araujo Pires ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Weight Bearing ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Gait Pattern ◽  
Distal Stump ◽  
Diabetic Ulcer ◽  
Pressure Therapy ◽  
Diabetic Foot Infections ◽  
Amputation Stump

We present a stepwise surgical approach that can be used, in lieu of a transtibial amputation, to preserve the lower limb in the setting of severe diabetic foot infections. A 63-year-old male status post left midfoot (Lisfranc’s) amputation presented to our hospital with a 4-year history of a left foot diabetic ulcer with associated purulent drainage and intermittent chills. On initial exam, the patient’s left foot amputation stump was plantarflexed, grossly erythematous, and edematous. The associated diabetic foot ulcer was actively draining purulent fluid. Following workup with radiography and ultrasound, the patient was diagnosed with a post-operative infection of the midfoot at the level of the amputation stump secondary to diabetic neuropathy. Our approach to management was a staged and included (1) surgical irrigation and debridement of the distal stump wound, (2) provisional negative pressure therapy, (3) a second-look procedure, and (4) a tibiotalocalcaneal fusion was performed using a lateral transfibular and plantar approach, after wound closure and resolution of active infection was achieved. At 36-month follow-up, the patient was fully weight-bearing in stiff sole sneakers with no gross overt alteration of gait pattern. The patient scored 79 points when assessed by the hindfoot American Orthopaedic Foot and Ankle Society Ankle-Hindfoot outcome score. In the patient with diabetes and cardiological restrictions, a Chopart amputation is preferred due to the decreased level of energy expenditure required for ambulation as compared to over more proximal levels of amputation.

scholarly journals “ ASSESSMENT OF SEVERITY OF DIABETIC FOOT ULCERS USING DIABETIC ULCER SEVERITY SCORE.”

2020 ◽  
pp. 19-21
Author(s):  
Aarushi Mishra ◽  
Anilkumar P. Bellad ◽  
M.I. Uppin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
The Past

INTRODUCTION : Diabetes mellitus is a common metabolic disorder, prevalence steadily increasing over the past few decades. The complications associated with it , hence , has also increased. Diabetic foot ulcer is one of the most serious complications , utilizing resources, significantly contributing to the morbidity of the patient. There is hence, a need to correctly identify the severity of the diabetic foot ulcer so as to plan the appropriate management and to help in counselling of such patients. AIM : To assess severity in diabetic foot ulcer using diabetic ulcer severity score. MATERIAL AND METHODOLOGY : This is a hospital based longitudinal study , conducted on 93 study subjects admitted with diabetic foot ulcers. Diabetic ulcer severity score was calculated for each patient . The score was calculated by adding scores of the respective parameters constituting site of ulcer, number of ulcers, presence/absence of pedal pulsations, presence/ absence of bone involvement. Each patient was followed up for a period of 6 months , or earlier in case of patient undergoing minor/major amputation. After the study was conducted , analysis was done by calculating various percentages of healing /amputation with respect to the score. RESULTS : Out of the total 93 study subjects , 74.2% were males. The mean age was calculated to be 59.6 years with maximum number of subjects being in 55-60 years of age group range. Majority of them had diabetic ulcer severity score of 2 (42%). Out of the total study subjects , 58% had a complete healing , 28% underwent minor amputation whereas 14% underwent major amputation. 100% of the study participants with score 0 had healing of ulcer which decreased to 85% for score 1 , 53.8% for score 2 , 6.25% for score 3 and 0% for score 4. This was suggestive of poorer chances of healing as the diabetic ulcer severity score increases. CONCLUSION : With the increasing incidence of patients diagnosed with diabetes mellitus , the rate of complications of diabetes has also increased over the past few decades including the risk and occurence of diabetic foot ulcers There is an increasing need for diabetic foot ulcer prognostication systems and universal use of the same. Thus ,we recommend the use of diabetic ulcer severity score as a prognostic tool to assess the severity of the diabetic foot which will further enhance communication and counselling of the patient and will help in providing the appropriate treatment to such patients.

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

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