scholarly journals Isolation and Antibiotic Susceptibility of the Microorganisms Isolated from Diabetic Foot Infections in Nemazee Hospital, Southern Iran

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mojtaba Anvarinejad ◽  
Gholamreza Pouladfar ◽  
Aziz Japoni ◽  
Shahram Bolandparvaz ◽  
Zeinab Satiary ◽  
...  

Background. Diabetic foot infections (DFIs) are a major public health issue and identification of the microorganisms causing such polymicrobial infections is useful to find out appropriate antibiotic therapy. Meanwhile, many reports have shown antibiotic resistance rising dramatically. In the present study, we sought to determine the prevalence of microorganisms detected on culture in complicated DFIs in hospitalized patients and their antibiotic sensitivity profiles.Methods. A cross-sectional study was conducted for a period of 24 months from 2012 to 2014 in Nemazee Hospital, Shiraz, Iran. The demographic and clinical features of the patients were obtained. Antimicrobial susceptibility testing to different agents was carried out using the disc diffusion method.Results. During this period, 122 aerobic microorganisms were isolated from DFIs. Among Gram-positive and Gram-negative bacteria,Staphylococcusspp. andE. coliwere the most frequent organisms isolated, respectively. Of the isolates, 91% were multidrug while 78% ofS. aureusisolates were methicillin resistant. 53% of Gram-negative bacteria were positive for extended-spectrumβ-lactamase.Conclusion. Given the involvement of different microorganisms and emergence of multidrug resistant strains, clinicians are advised to consider culture before initiation of empirical therapy.

2021 ◽  
Vol 12 (1) ◽  
pp. 16-20
Author(s):  
Samiah Hamad S Al-Mijalli

Diabetic foot infections (DFIs) are a significant health issue and a common complication among patients with diabetes. To develop antibiotic therapy for these high-risk patients, the current study evaluates the scope of DFIs and identifies the causing microbes. It also measures spectrum and antibiotic susceptibility of the pathogens isolated from adults with DFIs in Saudi Arabia. To achieve the study objectives, a cross-sectional study was implemented and the baseline characteristics for 44 patients with DFIs were defined. Optimal aerobic and anaerobic microbiological techniques were utilized to culture specimens isolated from infected foot ulcers. The standard microbiological methods were employed to identify the bacterial isolates and antibiotic susceptibility testing was conducted following the procedures of the Clinical and Laboratory Standards Institute (CLSI). Results showed that 12 microorganisms were isolated from the participants’ diabetic foot ulcers. Staphylococcus Aureus was ranked first because it appeared in 29 (65.9%) cases. Streptococcus Agalactiae was ranked second and multi-microbial infections were also found. Most of the organisms were susceptible to Vancomycin, Ciprofloxacin, and Cefalexin, but they were resistant to Methicillin, Gentamicin, and Ampicillin antibiotics. Staphylococcus Aureus was most sensitive to Ciprofloxacin, while it was resistant to Methicillin. About 10% of the isolates were multidrug-resistant. The study concludes that while Vancomycin should be used empirically for Gram-positive isolates, Ciprofloxacin can be taken into consideration for most of the Gram-negatives aerobes. Based on including various microorganisms and the advent of multidrug-resistant strains, proper culture and sensitivity testing are necessary prior to the empirical therapy.


2020 ◽  
Vol 7 (8) ◽  
pp. 2512
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian ◽  
Sudha Selvam

Background: Diabetic foot ulcer is one of the major surgical problem leading to hospital admission. Diabetic foot ulcer patients with uncontrolled diabetes may end up in forefoot amputation. Early aggressive debridement, control of blood sugar and empirical antibiotic therapy would reduce the morbidities in patients with diabetic foot ulcer. Further the knowledge of commonly isolated microbes and their antibiotic sensitivity pattern would be helpful to start empirical therapy. The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents.Methods: This cross-sectional study was conducted in 115 patients admitted with diabetic foot ulcer over a period of 9 months from October 2015 to June 2016 at the department of general surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Tissue scrapping samples were collected and processed as per standard guidelines.Results: 167 organisms were isolated from 115 patients. 52% of culture showed polymicrobial growth. There was increased prevalence of gram-negative organisms 53% compared to gram positive organisms 47%. When comes to individual isolate, Staphylococcus aureus was the most common organism isolated 24.6% followed by Pseudomonas aeruginosa 21%. All gram-positive aerobes were sensitive to vancomycin and gram-negative isolates were sensitive to amikacin, piperacillin-tazobactum, gentamycin and cefotaxime.Conclusions: Staphylococcus aureus and Pseudomonas were the common pathogens isolated. This study recommends use of vancomycin along with piperacillin-tazobactum as an empirical therapy along with adequate blood sugar control and early debridement of devitalized tissues in patients with diabetic foot infections.


2020 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Aso Nasih Qadir ◽  
Bakhtiar Mohamed Mahmoud ◽  
Taha Othman Mahwi ◽  
Delman Mohammed Raoof Arif Al-Attar ◽  
Safeen Othman Mahmood

Background: Diabetic foot ulcers (DFUs) are responsible for days of costly hospitalization and are the major cause of medical lower limb amputations. Determining the appropriate antimicrobial therapy for DFUs is highly dependent on recognizing the microorganisms that cause them. Many reports have indicated that there has been a remarkable increase in antibiotic resistance. Objectives: The present study examined various cultures of patients with DFUs to detect the prevalence of microorganisms and their antibiotic sensitivity profiles. Methods: This cross-sectional study was carried out on 92 patients with DFUs admitted to Shar Teaching Hospital and Shahid Hemin Teaching Hospital. Wagner Classification was used to assess the severity and location of the DFUs. Patients were asked questions about their practices of foot care and hygiene, and their answers were recorded. Samples required for testing were taken using sterile swabs. Results: A total of 100 microorganisms were isolated from 92 patients with DFUs, 10 of which were polymicrobial and 2 were culture-negative. There was a highly significant association between the isolated gram-negative microorganisms and higher grades of DFU (P<0.001). A highly significant association was also observed between bad patient knowledge of hygiene practices and gram-negative microorganisms (P<0.001). Osteomyelitis was present in 40 (43.4%) patients. Conclusion: Among gram-positive and gram-negative bacteria, Staphylococcus spp. and E. coli were, respectively, the most frequent organisms isolated. The antibiotic imipenem was found to be effective against microorganisms. Tetracycline, erythromycin, and ceftriaxone, however, were highly resistant to antibiotics. To sum up, since different microorganisms are involved and multidrugresistant strains might emerge, clinicians are recommended to take cultures into account before they initiate empirical therapy.


Author(s):  
M. Y. Iliyasu ◽  
I. Mustapha ◽  
H. Yakubu ◽  
H. M. Shuaibu ◽  
A. F. Umar ◽  
...  

Background of Study: Many virulence determinants contribute to the pathogenicity of Gram negative bacteria, like Escherichia coli, which is the most common cause of many infections worldwide such as urinary tract infection (UTI), profuse diarrhoea and septicaemia. Aim: To determine the genotypic characteristics of adhesin-producing E. coli isolates from clinical specimens. Place and Duration of Study: Conducted at the Infectious diseases hospital Bayara, Bauchi state, Nigeria, between February to March, 2019. Methods: A total of twelve (12) Gram negative bacterial isolates were selected based on the ability to grow on Luria-Bertani (LB) agar medium containing 100 µg/ml ampicillin. The isolates were from urine, stool, and blood specimens. The isolates were screened for multidrug resistant pattern according to Kirby-Bauer disc diffusion method. Adhesion factors, Fimbrial adhesin (fimH) and Invasive plasmid adhesin (ipaH) was genotyped by conventional PCR and sequenced. Results: All the isolates were resistant to Ampicillin, Cephalothin, Erythromycin, Fusidic acid, Novobiocin and Oxacillin, but sensitive to Augmentin, Colistin sulphate and Imipenem. Presence of fimH and ipaH genes were observed in nine isolates that expressed strong relationship with. Multidrug resistance (MDR). The fimH was the most prevalent found in urine, stool and blood isolates. Most of the adhesion genes sequence (61.8%) in this study had significant alignment (95 to 100% homology) with E.coli genome in the NCBI database. Conclusion: This study revealed the role of adhesin as virulence markers in MDR Gram negative bacteria and FimH is one of the commonest gene in MDR E.coli pathotypes.


2020 ◽  
Author(s):  
saada Mohamed nour ◽  
Maowia Mukhtar ◽  
Mohamed Elmakk ◽  
Elshibli Mohamed Elshibli ◽  
Walyeldin Elnour Elfakey ◽  
...  

Abstract Background Diabetic foot ulcer infection cause great morbidity and mortality among diabetic patients and is a major cause of lower extremity amputation worldwide. This study aimed to determine the profile of aerobic bacteria and their antibiotic sensitivity patterns in diabetic foot infections (DFI) among different Wagner's grades. Methods This study was conducted during December 2017 - March 2018 in a Diabetic Center, Sudan. A total of 152 diabetic patients with different grades of foot ulcers were randomly enrolled in the study. The patients were grouped using Wagner's classification. Tissue biopsies and deep swabs were collected from the ulcers for aerobic cultures. The cultured isolates were identified using phenotypic and biochemical properties and their sensitivity to commonly used antibiotics, Colistin, Aikacin, Ciprofloxacin, Augmentin, Ceftazideme, Gentamicin, Clindamycin, Ceftriaxone Meropenum. Cotrimoxazole, Erythomycin, Oxacillin and Vancomycin. Fusidic acid, Imepenem, and Piperacillin was tested using the Kirby Bauer disk diffusion method. Results The mean age of the patients was 54.31 (SD ± 12.1) years, male to female ratio of 8: 1. The mean duration of diabetes was 14 (SD ± 8) years. The ulcers varied in duration from 1 day to 10 years. of 152 samples 181 aerobic bacteria were isolated. Cultures yielded 1-3 isolate per culture. The maximum number was isolated from grade 3 group followed by long standing ulcer LSU group 50.8% and 28% respectively. Polymicrobial infection was higher in LSU (30.4%). The isolates were mostly Gram-negative bacteria. The most frequent were proteus spp. (35.3%), S. aureus MRSA 14.4% and Coliform 12.2% respectively. The most common isolates in grade 3 were P. Mirablis, Staphylococcus and Coliform and in long standing ulcers were P. Mirablis, S. aureus MRSA and Coagulase negative staphylococcus respectively. Conclusion Gram-negative bacteria were more prevalent and the most frequent pathogens were Proteus spp. The most common polymicrobial infections were due to P. mirablis with; P. aerginosa, S. MRSA and Coliform respectively . Gram negative rods were sensitive to Amikacin, (80.6) %) while the highest sensitivity of Gram positive was to Imepnem (85%). Most of the isolates were sensitive to Meropenem. No significant relation between Wagner grades and neuropathy was detected.


2013 ◽  
Vol 7 (10) ◽  
pp. 707-712 ◽  
Author(s):  
Vedat Turhan ◽  
Mesut Mutluoglu ◽  
Ali Acar ◽  
Mustafa Hatipoglu ◽  
Yalcın Onem ◽  
...  

Introduction: In the present study, we sought to identify the bacterial organisms associated with diabetic foot infections (DFIs) and their antibiotic sensitivity profiles. Methodology: We retrospectively reviewed the records of wound cultures collected from diabetic patients with foot infections between May 2005 and July 2010. Results: We identified a total of 298 culture specimens (165 [55%] wound swab, 108 [36%] tissue samples, and 25 [9%] bone samples) from 107 patients (74 [69%] males and 33 [31%] females, mean age 62 ± 13 yr) with a DFI. Among all cultures 83.5% (223/267) were monomicrobial and 16.4% (44/267) were polymicrobial. Gram-negative bacterial isolates (n = 191; 61.3%) significantly outnumbered Gram-positive isolates (n = 121; 38.7%). The most frequently isolated bacteria were Pseudomonas species (29.8%), Staphylococcus aureus (16.7%), Enterococcus species (11.5%), Escherichia coli (7.1%), and Enterobacter species (7.1%), respectively. While 13.2% of the Gram-negative isolates were inducible beta-lactamase positive, 44.2% of Staphylococcus aureus isolates were methicillin resistant. Conclusions: Our results support the recent view that Gram-negative organisms, depending on the geographical location, may predominate in DFIs.


2017 ◽  
Vol 66 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Fevronia Kolonitsiou ◽  
Matthaios Papadimitriou-Olivgeris ◽  
Anastasia Spiliopoulou ◽  
Vasiliki Stamouli ◽  
Vasileios Papakostas ◽  
...  

The aim of the study was to assess the epidemiology, the incidence of multidrug-resistant bacteria and bloodstream infections’ (BSIs) seasonality in a university hospital. This retrospective study was carried out in the University General Hospital of Patras, Greece, during 2011–13 y. Blood cultures from patients with clinical presentation suggestive of bloodstream infection were performed by the BacT/ALERT System. Isolates were identified by Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the disk diffusion method and E-test. Resistance genes (mecA in staphylococci; vanA/vanB/vanC in enterococci; blaKPC/blaVIM/blaNDM in Klebsiella spp.) were detected by PCR. In total, 4607 (9.7%) blood cultures were positive from 47451 sets sent to Department of Microbiology, representing 1732 BSIs. Gram-negative bacteria (52.3%) were the most commonly isolated, followed by Gram-positive (39.5%), fungi (6.6%) and anaerobes bacteria (1.8%). The highest contamination rate was observed among Gram-positive bacteria (42.3%). Among 330 CNS and 150 Staphylococcus aureus, 281 (85.2%) and 60 (40.0%) were mecA-positive, respectively. From 113 enterococci, eight were vanA, two vanB and two vanC-positives. Of the total 207 carbapenem-resistant Klebsiella pneumoniae (73.4%), 202 carried blaKPC, four blaKPC and blaVIM and one blaVIM. A significant increase in monthly BSIs’ incidence was shown (R2: 0.449), which may be attributed to a rise of Gram-positive BSIs (R2: 0.337). Gram-positive BSIs were less frequent in spring (P < 0.001), summer (P < 0.001), and autumn (P < 0.001), as compared to winter months, while Gram-negative bacteria (P < 0.001) and fungi (P < 0.001) were more frequent in summer months. BSIs due to methicillin resistant S. aureus and carbapenem-resistant Gram-negative bacteria increased during the study period. The increasing incidence of BSIs can be attributed to an increase of Gram-positive BSI incidence, even though Gram-negative bacteria remained the predominant ones. Seasonality may play a role in the predominance of Gram-negative’s BSI.


2020 ◽  
Author(s):  
Carine Laurence YEHOUENOU ◽  
Arsène A. KPANGON ◽  
Dissou AFFOLABI ◽  
Hector RODRIGUEZ-VILLALOBOS ◽  
Françoise Van Bambeke ◽  
...  

Abstract Background: Surgical site infections are related to high morbidity, mortality and healthcare costs. As the emergence of multidrug-resistant bacterial pathogens in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in surgical site infections and their susceptibility pattern in six public hospitals in Benin. Methods: Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. The antibiotic susceptibility test firstly used the Kirby-Bauer disc diffusion method. The secondary test by microdilution used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results: We included 304 patients (mean age 32 ± 11 years), whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics S. aureus (28.5%, n=42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery. The most dominant being E.coli (38.4%, n=31). Overall, 90.8% (n=208) of aerobic bacteria were multidrug resistant. Two-third of S. aureus (65.3%, n= 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n=43/62) and 83.3% of K. pneumoniae (n=25/30). Overall, twelve Gram negative bacteria (5.24%) isolates showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype.Conclusion: This study shows the alarming prevalence of multidrug resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of these multidrug-resistant bacteria, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.


2020 ◽  
Vol 11 (1) ◽  
pp. 23-30
Author(s):  
Muhammad Iqbal Khan ◽  
Riffat Arbab. ◽  
Abdullah Khan ◽  
Maria Mehmood ◽  
Aisha Arshad ◽  
...  

Abstract BACKGROUND & OBJECTIVE: To determine the commonly isolated organism in ulcers of diabetic foot and its sensitivity to antibiotics. METHODOLOGY: A total of 167 patients of diabetic foot were included in this descriptive Crosssectional study. All the patients were informed and consent was obtained according to ethical criteria approved by the ethical committee. The use of antibiotics in last 72 hours was strictly observed. The samples were obtained under aseptic conditions by applying the swap slightly to the exudate or base of the ulcer and were then carefully transferred in to the container and were then sent to the laboratory on the same date. The culture sensitivity was performed. Data was analyzed using SPSS. 20. RESULTS: A total of 140 samples were positive for 8 types of bacteria out of 167. 94 samples were monomicrobial were as 46 were polymicrobial. Over all Staphylococcus aureus 63(40.3%) was the most commonly isolated bacteria followed by Pseudomonas aeruginosa 40 (25.6%). S. aureus was most sensitive to imipenem/ meropenem (79.3%) followed by vancomycin (71%), linezolid (69.8%) and moxifloxacin (69.8%). P. aeruginosa was sensitive to impenem/ meropeneum (90%) followed by Ticarcilline/ clavulante (92.5%), amikacin (87.5%) and pipracilline / tazobactom (80%). Most of the gram positive and negative bacteria were resistant to commonly available antibiotic like ampiciline/ cloxacillin, amoxicilline/ clavulante and cephradine.  CONCLUSION: Most of the commonly used antibiotics had developed resistance. was S. aureus most common bacteria from the isolates and was sensitive to impenem/meropenem, vancomycin and linezolid. Gram-negative bacteria showed sensitivity to impenem/meropeneum, pipracilline/ tazobactom, Ticarcilline/ clavulante and amikacin.


Author(s):  
Adam Mustapha ◽  
Mustafa Alhaji Isa ◽  
Ibrahim Yusuf Ngoshe ◽  
Hashidu Bala

Aim: Prevalence of multidrug resistant bacteria on apparently health animals has turned antibiotic resistance to multifaceted process and threatens global food security and public health. The aim of the present study was to investigate the resistance profile of isolates from apparently healthy cattle in Maiduguri, Nigeria. Methodology: A total of 120 nasal swab samples were collected from cattle. Colony identification was according to the guidelines of Bergey’s Manual of Determinative Bacteriology. The susceptibility pattern of the isolates was conducted on the identified isolates according to the Modified Kirby-Baur disc diffusion method on Muller-Hilton agar and interpreted according to the procedures of Clinical Laboratory Standards Institute (CLSI, 2018) guidelines. Multiple Antibiotic Resistance Index (MARI) was calculated using the formula, MARI=a/b where “a” is the number of antibiotic resisted and “b” is the total number of antibiotic used in the study. Results: Of the total samples (120) from cattle 96 (80%) detected the following isolates; E. coli was the most commonly recovered isolates (33, 34.4%), followed by Klebsiella spp (28, 29.2%), Salmonella spp (21, 21.9%) and Pseudomonas aeruginosa (14, 14.5%). In this study, all the recovered isolates were found to be multidrug resistant gram negative bacteria, with highest resistance was shown by Salmonella spp. The high MARI observed in all the isolates in this study ranging from 0.7 to 0.9. MARI value of 0.2 > is suggests multiple antibiotic resistant bacteria and indicate presence of highly resistant bacteria. Conclusion: The study indicates highly resistant bacteria are carried by healthy food animals. Thus, there is need for continued monitoring of antibiotics use in animal husbandry to prevent further spread of resistance in Maiduguri, Nigeria.


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