CANCER Resistance Surveillance Program: Initial Results from Hematology–Oncology Centers in North America

2003 ◽  
Vol 37 (1) ◽  
pp. 47-56 ◽  
Author(s):  
Alan H Mutnick ◽  
Jeffrey T Kirby ◽  
Ronald N Jones ◽  
Keyword(s):  
North America ◽  
Clinical Laboratory ◽  
National Committee ◽  
Surveillance Program ◽  
Cancer Resistance ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Cutaneous Infections ◽  
Cancer Program ◽  
Klebsiella Spp

OBJECTIVE The CANCER (Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance) surveillance program was initiated to collect culture data on antimicrobial and antifungal agents in hospitals treating neutropenic patients in North America, as a means to monitor the development of microbial resistance. METHODS A total of 2042 isolates from bloodstream, respiratory, urinary, and cutaneous infections in 2000–2001 were submitted by 33 oncology centers, clinics, and hospitals in North America, sent to a central laboratory, and tested by National Committee for Clinical Laboratory Standards methods against 42 different antimicrobials. RESULTS Staphylococcus aureus, Escherichia coli, coagulase-negative staphylococci, Enterococcus spp., and Klebsiella spp. represented the most frequently isolated pathogens during the initial benchmark year. The incidence of extended-spectrum β-lactamase–producing phenotypes ranged from 1.6% to 4.6% among E. coli and Klebsiella spp. Amikacin, tobramycin, polymyxin B, and piperacillin/tazobactam provided the highest susceptibility rates against Pseudomonas aeruginosa isolates. Yeast bloodstream isolates demonstrated complete susceptibility to amphotericin B, but 14% of strains were considered to have high-level fluconazole resistance. CONCLUSIONS Elevated resistance rates when compared to general hospital strains were not observed in the CANCER program during the baseline year of this novel longitudinal, resistance surveillance program. The prevalence of gram-positive pathogens, although representing more than 50% of all bacterial isolates, was slightly lower than that reported previously by other investigators. Continued evaluation for antimicrobial resistance as well as changes in the prevalence of gram-positive pathogens requires the use of longitudinal surveillance programs such as the CANCER program. Such initiatives allow the development of therapeutic strategies for coping with changes in resistance and pathogen prevalence in this dynamic at-risk patient environment.

scholarly journals Investigation of Antimicrobial Susceptibilities Among Bacteria Isolated from Blood Cultures in Hospitalized Patients, Tehran, Iran

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Shadi Aghamohammad ◽  
Maryam Nouri ◽  
Fatemeh Ashrafian ◽  
Mohtaram Sadat Kashi ◽  
Mehrdad Gholami ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Antimicrobial Agents ◽  
Clinical Laboratory ◽  
Blood Cultures ◽  
Multi Drug Resistance ◽  
National Committee ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Cross Sectional

Background: Bacteremia is the status, which is detected via a positive blood culture test with no contamination. Centers for Disease Control and Prevention (CDC) indicates that direct medical procedures and total costs are significantly high. Antibiotic resistance can play a major role in the costs, which are related to the long duration of treatment. Objectives: The aim of this study was to investigate the rate and profiles of antimicrobial susceptibility of blood culture isolates from Tehran, Iran. Methods: In the current cross-sectional study, a total of 5,000 blood culture samples were collected from patients hospitalized in the Loghman General Hospital, Tehran, Iran, with positive blood culture results from 2012 to 2013. Susceptibility to antimicrobial agents was analyzed using National Committee for Clinical Laboratory Standards guidelines. Results: Coagulase-negative staphylococci (38.8%), Staphylococcus aureus (20.5%), Acinetobacter (11.9%), and Escherichia coli (11.7%) were the most frequent bacteria isolated from the blood cultures, collectively accounting for > 80% of the isolates. Of isolated microorganisms, 63.75% and 36.24% belonged to Gram-positive and Gram-negative bacteria, respectively. Moreover, 88% of the isolates were MRSA (oxacillin-/methicillin-resistant), and 7% were VRE (vancomycin-resistant). Conclusions: The most frequent isolated organisms were Gram-positive bacteria, and the rate of MDR (multi-drug resistance) was high. The results of the current study obviously indicate the misuse of antibiotic in society. National surveillance studies in Iran will be useful for clinicians to choose the right empirical treatment and will help control and prevent infections caused by resistant organisms.

scholarly journals Ceftobiprole Activity against Bacteria from Skin and Skin Structure Infections in the United States from 2016 through 2018

2020 ◽  
Vol 64 (6) ◽  
Author(s):  
Robert K. Flamm ◽  
Leonard R. Duncan ◽  
Kamal A. Hamed ◽  
Jennifer I. Smart ◽  
Rodrigo E. Mendes ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Generation Cephalosporin ◽  
Clinical Isolates ◽  
Surveillance Program ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Content Type ◽  
Skin Structure ◽  
Highly Active

ABSTRACT Ceftobiprole medocaril is an advanced-generation cephalosporin prodrug that has qualified infectious disease product status granted by the US FDA and is currently being evaluated in phase 3 clinical trials in patients with acute bacterial skin and skin structure infections (ABSSSIs) and in patients with Staphylococcus aureus bacteremia. In this study, the activity of ceftobiprole and comparators was evaluated against more than 7,300 clinical isolates collected in the United States from 2016 through 2018 from patients with skin and skin structure infections. The major species/pathogen groups were S. aureus (53%), Enterobacterales (23%), Pseudomonas aeruginosa (7%), beta-hemolytic streptococci (6%), Enterococcus spp. (4%), and coagulase-negative staphylococci (2%). Ceftobiprole was highly active against S. aureus (MIC50/90, 0.5/1 mg/liter; 99.7% susceptible by EUCAST criteria; 42% methicillin-resistant S. aureus [MRSA]). Ceftobiprole also exhibited potent activity against other Gram-positive cocci. The overall susceptibility of Enterobacterales to ceftobiprole was 84.8% (>99.0% susceptible for isolate subsets that exhibited a non-extended-spectrum β-lactamase [ESBL] phenotype). A total of 74.4% of P. aeruginosa, 100% of beta-hemolytic streptococci and coagulase-negative staphylococci, and 99.6% of Enterococcus faecalis isolates were inhibited by ceftobiprole at ≤4 mg/liter. As expected, ceftobiprole was largely inactive against Enterobacterales that contained ESBL genes and Enterococcus faecium. Overall, ceftobiprole was highly active against most clinical isolates from the major Gram-positive and Gram-negative skin and skin structure pathogen groups collected at U.S. medical centers participating in the SENTRY Antimicrobial Surveillance Program during 2016 to 2018. The broad-spectrum activity of ceftobiprole, including potent activity against MRSA, supports its further evaluation for a potential ABSSSI indication.

scholarly journals Study of the Comparative Activity of Piperacillin/Tazobactam with Currently Available Antibiotics against 8206 Aerobic Isolates

1997 ◽  
Vol 8 (3) ◽  
pp. 147-153 ◽  
Author(s):  
Kevin R Forward ◽  
Donald E Low ◽  
Michel Laverdiere ◽  
Robert Rennie ◽  
Andrew E Simor ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
National Committee ◽  
Community Hospitals ◽  
Gram Positive ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Disk Diffusion Testing ◽  
Extended Spectrum Beta Lactamases ◽  
Gram Positive Cocci

OBJECTIVES: To compare the activity of piperacillin-tazobactam with piperacillin and other parenterally administered antibiotics against aerobic Gram-negative bacilli and Gram-positive cocci isolated from across Canada, and to determine the prevalence of resistance mediated by extended-spectrum cephalosporinases.METHODS: Sixty-one laboratories participated. Disk diffusion testing was performed in accordance with methods outlined by the National Committee for Clinical Laboratory Standards. Susceptibilities were performed on 8206 strains.Escherichia coliandKlebsiella pneumoniaewith reduced susceptibilities to third-generation cephalosporins were screened for extended-spectrum beta-lactamases (ESBLs).RESULTS: Piperacillin-tazobactam was active against 92% of the strains, piperacillin against 81% and ticarcillin-clavulanic acid against 88%. Few differences were observed in the relative susceptibility of strains from teaching or community hospitals, from different anatomic sites or from different regions of the country. Aerobic Gram-negative bacilli tested tended to be more susceptible to all the agents than was recently reported in a similar American study. Only 43% ofEnterococcus faeciumwere susceptible to ampicillin and 42% to piperacillin piperacillin with and without tazobactam. Only two enterococcal strains were resistant to vancomycin, and 19 had intermediate zone sizes. Of the 10 strains ofE coliand eight strains ofK pneumoniaewith reduced susceptibility to extended spectrum cephalosporins, only one demonstrated typical ESBL activity.CONCLUSIONS: Canadian aerobic Gram-positive cocci and Gram-negative bacilli remain highly susceptible to many currently available antibiotics. The findings confirm a broad spectrum of activity of piperacillin-tazobactam and indicate that the pattern of susceptibility is quite uniform from different body sites, in both teaching and community hospitals, and across the country.

scholarly journals Methods for Improved Detection of Oxacillin Resistance in Coagulase-Negative Staphylococci: Results of a Multicenter Study

1999 ◽  
Vol 37 (12) ◽  
pp. 4051-4058 ◽  
Author(s):  
Fred C. Tenover ◽  
Ronald N. Jones ◽  
Jana M. Swenson ◽  
Barbara Zimmer ◽  
Sigrid McAllister ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Reference Method ◽  
Disk Diffusion ◽  
National Committee ◽  
Broth Microdilution ◽  
Pcr Assay ◽  
Coagulase Negative Staphylococci ◽  
Oxacillin Resistance ◽  
Disk Diffusion Testing ◽  
Single Disk

A multilaboratory study was undertaken to determine the accuracy of the current National Committee for Clinical Laboratory Standards (NCCLS) oxacillin breakpoints for broth microdilution and disk diffusion testing of coagulase-negative staphylococci (CoNS) by using a PCR assay for mecA as the reference method. Fifty well-characterized strains of CoNS were tested for oxacillin susceptibility by the NCCLS broth microdilution and disk diffusion procedures in 11 laboratories. In addition, organisms were inoculated onto a pair of commercially prepared oxacillin agar screen plates containing 6 μg of oxacillin per ml and 4% NaCl. The results of this study and of several other published reports suggest that, in order to reliably detect the presence of resistance mediated bymecA, the oxacillin MIC breakpoint for defining resistance in CoNS should be lowered from ≥4 to ≥0.5 μg/ml and the breakpoint for susceptibility should be lowered from ≤2 to ≤0.25 μg/ml. In addition, a single disk diffusion breakpoint of ≤17 mm for resistance and ≥18 mm for susceptibility is suggested. Due to the poor sensitivity of the oxacillin agar screen plate for predicting resistance in this study, this test can no longer be recommended for use with CoNS. The proposed interpretive criteria for testing CoNS have been adopted by the NCCLS.

scholarly journals Correlation of Oxacillin MIC with mecAGene Carriage in Coagulase-Negative Staphylococci

2000 ◽  
Vol 38 (2) ◽  
pp. 752-754 ◽  
Author(s):  
Zafar Hussain ◽  
Luba Stoakes ◽  
Viki Massey ◽  
Deb Diagre ◽  
Viivi Fitzgerald ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Clinical Laboratory ◽  
National Committee ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Mueller Hinton ◽  
Mueller Hinton Agar ◽  
Agar Dilution

The National Committee for Clinical Laboratory Standards has recently changed the oxacillin breakpoint from ≥4 mg/liter to ≥0.5 mg/liter to detect methicillin-resistant coagulase-negative staphylococci (CoNS) because the previous breakpoint lacked sensitivity. To determine the correlation between the new oxacillin breakpoint and the presence of themecA gene, 493 CoNS of 11 species were tested. The presence of the mecA gene was determined by PCR, and oxacillin susceptibility was determined by the agar dilution method with Mueller-Hinton agar containing 2% NaCl and oxacillin (0.125 to 4.0 mg/liter). The new breakpoint correctly classified all CoNS strains with mecA as methicillin resistant and strains ofStaphylococcus epidermidis, S. haemolyticus, and S. hominiswithout mecA as methicillin susceptible. The breakpoint of ≥0.5 mg/liter was not specific for S. cohnii, S. lugdunensis, S. saprophyticus, S. warneri, and S. xylosus, in that it categorized 70 of 74 strains of these species withoutmecA (94.6%) as methicillin resistant. The results of this study indicate that the new oxacillin breakpoint accurately identifies strains of CoNS with mecAbut is not specific for strains of certain species of CoNS withoutmecA.

scholarly journals Evaluation of Screening and Commercial Methods for Detection of Methicillin Resistance in Coagulase-Negative Staphylococci

1998 ◽  
Vol 36 (1) ◽  
pp. 273-274 ◽  
Author(s):  
Zafar Hussain ◽  
Luba Stoakes ◽  
Robert Lannigan ◽  
Susan Longo ◽  
Barbara Nancekivell
Keyword(s):  
Clinical Laboratory ◽  
Methicillin Resistance ◽  
Disk Diffusion ◽  
National Committee ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Resistant Strains ◽  
Time To Detection ◽  
Combination Of Methods ◽  
The Times

The National Committee for Clinical Laboratory Standards recommends 48 h of incubation by the oxacillin salt agar screen (OSAS) method for the detection of methicillin-resistant coagulase-negative staphylococci (CoNS). An earlier identification of methicillin resistance is desirable. The time to detection of the mecAgene by PCR was compared with the times to detection by OSAS, by the oxacillin disk diffusion (ODD) method, and with MicroScan Gram Positive Combo type 6 panels (MicroScan Inc. Sacramento, Calif.) and Vitek GPS-SA cards (bioMérieux Vitek Inc., Hazelwood, Mo.). The combination of the Vitek card and the ODD method detected 92 of 99 methicillin-resistant strains of CoNS at 24 h; however, 6mecA-positive strains were phenotypically methicillin susceptible. We conclude that most methicillin-resistant CoNS can be detected and the results can be reported after overnight incubation by a combination of methods.

scholarly journals In Vitro Activities of Terbinafine against Cutaneous Isolates of Candida albicans and Other Pathogenic Yeasts

1998 ◽  
Vol 42 (5) ◽  
pp. 1057-1061 ◽  
Author(s):  
Neil S. Ryder ◽  
Sonja Wagner ◽  
Ingrid Leitner
Keyword(s):  
Candida Albicans ◽  
Clinical Laboratory ◽  
Pathogenic Fungi ◽  
Clinical Isolates ◽  
National Committee ◽  
Cryptococcus Laurentii ◽  
Dimorphic Fungi ◽  
Cutaneous Infections ◽  
Wide Range

ABSTRACT Terbinafine is active in vitro against a wide range of pathogenic fungi, including dermatophytes, molds, dimorphic fungi, and some yeasts, but earlier studies indicated that the drug had little activity against Candida albicans. In contrast, clinical studies have shown topical and oral terbinafine to be active in cutaneous candidiasis and Candida nail infections. In order to define the anti-Candida activity of terbinafine, we tested the drug against 350 fresh clinical isolates and additional strains by using a broth dilution assay standardized according to the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS) M27-A assay. Terbinafine was found to have an MIC of 1 μg/ml for reference C. albicans strains. For 259 clinical isolates, the MIC at which 50% of the isolates are inhibited (MIC50) of terbinafine was 1 μg/ml (fluconazole, 0.5 μg/ml), and the MIC90 was 4 μg/ml (fluconazole, 1 μg/ml). Terbinafine was highly active against Candida parapsilosis(MIC90, 0.125 μg/ml) and showed potentially interesting activity against isolates of Candida dubliniensis,Candida guilliermondii, Candida humicola, andCandida lusitaniae. It was not active against theCandida glabrata, Candida krusei, andCandida tropicalis isolates in this assay.Cryptococcus laurentii and Cryptococcus neoformans were highly susceptible to terbinafine, with MICs of 0.06 to 0.25 μg/ml. The NCCLS macrodilution assay provides reproducible in vitro data for terbinafine against Candidaand other yeasts. The MICs for C. albicans and C. parapsilosis are compatible with the known clinical efficacy of terbinafine in cutaneous infections, while the clinical relevance of its activities against the other species has yet to be determined.

scholarly journals In Vitro Activity of Omadacycline and Comparator Compounds Against Gram-positive Isolates Collected in the USA During 2016 as Part of a Global Surveillance Program

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S374-S374
Author(s):  
Michael D Huband ◽  
Michael a Pfaller ◽  
Helio S Sader ◽  
Robert K Flamm
Keyword(s):  
Resistance Mechanisms ◽  
Vitro Activity ◽  
Surveillance Program ◽  
Ionization Mass ◽  
In Vitro Activity ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Resistant Strains ◽  
Research Grant

Abstract Background Omadacycline (OMC) is a broad spectrum aminomethylcycline antibacterial in late stage clinical development (PO and IV formulations) for treatment of acute bacterial skin and skin structure infections (ABSSSI) and community-acquired bacterial pneumonia (CABP). OMC has potent in vitro activity against gram-positive (GP) pathogens expressing common resistance mechanisms to penicillins, tetracyclines, fluoroquinolones and macrolides. Methods A total of 4,122 GP isolates were collected in 2016 from 30 USA medical centers and included 2,366 staphylococci, 1,252 streptococci and 504 enterococci. A single isolate/patient/infection episode was included. Identifications were confirmed by matrix-assisted laser desorption/ionization mass spectrometry and susceptibility (S) testing was performed using reference broth microdilution methods. Results OMC was equally active against methicillin-susceptible (55.1% MSSA) and -resistant (44.9% MRSA) Staphylococcus aureus (SA; MIC50/90, 0.12/0.25 µg/mL). All SA were S to daptomycin (DAP), linezolid (LZD) and vancomycin (VAN). In MRSA, S was lower for levofloxacin (LEV; 28.2%), clindamycin (CLI; 69.9%), and erythromycin (ERY; 10.9%). OMC (MIC50/90, 0.12/0.5 µg/mL) and tigecycline (TGC; MIC50/90, 0.06/12 µg/mL) were the most active agents against coagulase-negative staphylococci (CoNS) and methicillin-R CoNS. S. pneumoniae (including penicillin- [12.8% resistant], ceftriaxone- and ERY-resistant strains), viridans group streptococci (VGS) and β-hemolytic streptococci (including ERY and tetracycline resistant strains) were inhibited by low levels of OMC (MIC50/90 0.06/0.06–0.12 µg/mL) and TGC (MIC50/90 0.03–0.06/0.06–0.12 µg/mL). OMC was highly potent against enterococci (MIC50/90 0.12/0.25 µg/mL) including vancomycin-R isolates. Vancomycin resistance rates were 4.3% and 66.5% in E. faecalis and E. faecium, respectively. Conclusion OMC demonstrated potent activity against susceptible and resistant GP pathogens often associated with ABSSSI and CABP including staphylococci, S. pneumoniae, β-hemolytic streptococci, VGS and enterococci. These data support further omadacycline clinical studies, especially in infections where resistant GP isolates occur. Disclosures M. D. Huband, Paratek Pharma, LLC: Research Contractor, Research grant; M. A. Pfaller, Paratek Pharma, LLC: Research Contractor, Research grant; H. S. Sader, Paratek Pharma, LLC: Research Contractor, Research grant R. K. Flamm, Paratek Pharma, LLC: Research Contractor, Research grant

scholarly journals Evaluation of bacterial pathogens in neonatal sepsis and their susceptibility pattern: A Hospital Based Study

2014 ◽  
Vol 3 (1) ◽  
pp. 35-40
Author(s):  
Biplob Kumar Raha ◽  
Nasim Jahan ◽  
Md Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Antimicrobial Agents ◽  
Clinical Laboratory ◽  
Blood Cultures ◽  
Diffusion Method ◽  
National Committee ◽  
Gram Negative Bacteria ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative

Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries. Epidemiology and surveillance of neonatal sepsis helps in implementation of rational empirical antibiotic strategy. A cross-sectional prospective study was conducted in the special care baby unit under department of Paediatrics and Neonatology, BIRDEM General Hospital during the period of November 2008 to September 2009 to determine the pattern of bacterial agents causing neonatal sepsis and their susceptibility pattern to various antimicrobial agents. Blood cultures were performed on admitted newborn babies (0-28 days) to rule out sepsis. Antimicrobial susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Out of 720 screened blood cultures, 64 (8.9%) reported as positive and the gram positive and gram negative bacteria accounted for 6 (9.4%) and 58 (90.6%) respectively. The most common gram positive organisms were Staphylococcus aureus (6.3%) and Enterococci (3.1%) & gram negative organisms were Klebsiella pneumoniae (37.5%), Serratia (25%), Pseudomonas aeruginosa (10.9%), Citrobacter (10.9%) and Acinetobacter (6.3%). The susceptibilities were remarkably low to Ampicillin (3.12 %) & Cefotaxim (10.9%) for both gram positive & gram negative isolates. Gram positive group had susceptibilities of 66.7% to Ciprofloxacin and Imipenem, 83.3% to Gentamicin, & 100% to Amikacin & Vancomycin. Gram negative isolates showed higher sensitivities to Imipenem (94.8%), Ciprofloxacin (89.7%), Amikacin (72.4%) respectively. Gram-negative bacteria showed high level of resistance to commonly used antibiotics (Ampicillin, Ceftazidim and Cefotaxim). Gentamicin, Amikacin, Imipenem and Ciprofloxacin were the most effective drugs compared to others. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care. CBMJ 2014 January: Vol. 03 No. 01 P: 35-40

scholarly journals DIABETIC FOOT ULCERS

2009 ◽  
Vol 16 (01) ◽  
pp. 53-60
Author(s):  
HAJI KHAN KHOHARO ◽  
SHUAIB ANSARI ◽  
FATIMA QURESHI
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Clinical Laboratory ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
National Committee ◽  
Diabetic Foot Ulcers ◽  
Gram Positive ◽  
College Hospital ◽  
Bacteriological Study

(SUMMARY) Aim: To determine common pathogens isolated in diabetic foot ulcers & in vitro antimicrobial activity. Setting:Muhammad Medical College Hospital, Mirpurkhas and Liaquat University of Medical & Health Sciences Jamshoro. Period: 1s t November2007 to 30th June 2008. Research Methodology: Pus samples for bacterial culture were collected from 60 patients admitted with diabeticfoot infections. Anti-microbial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommendedby the National Committee for Clinical Laboratory Standards. Microbroth dilution test was arranged for susceptibility of anaerobic organismsto metronidazole and amoxicillin/clavulanate. A vancomycin screen agar (6 Lig/ml) was used to detect vancomycin intermediate isolatesof Staphylococci. Results: Clinical grading and bacteriological study of 60 patients revealed, 44 (73.33%) patients had gram-negativeorganisms, & Pseudomonas aeruginosa was the most common. While 16 (26.66%) patients had gram-positive organisms & Staphylococciwas the most common organism. Infection with anaerobes was observed in one patient (1.66%). Both gram-positive and -negative organismswere seen in 8 (13.33%). Pseudomonas aeruginosa & S.aureus exhibited a high frequency of resistance to the antibiotics tested. All theisolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin. Conclusions: Pseudomonas aeruginosa,Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis and Proteus were the most common causes of diabetic foot infectionsin this study. And the rate of antibiotic resistance was 66.66% among the isolates. All the isolates were uniformly susceptible to fosfomycin,levofloxacin, amikacin and vancomycin.

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