Clinical Study of Antibiotics Resistance of Bacterial Pathogens Associated with Diabetic Foot Ulcers

Abstract

Background: Diabetic foot ulcer (DFU) is characterized by a classical triad of neuropathy, ischemia, and infection. It occurs in approximately 15% patients, 6% of them hospitalized due to infection or other ulcer-related complication and about 20% need an amputation.

Objective: Present study was carried to find major bacterial pathogens and antibiotic sensitivity pattern of these bacterial associated with Diabetic foot ulcer (DFU).

Methodology: About 90 patients including male and female, infected with DFU were included in the study. Demographic data was obtained through a questionnaire. Tissues samples were obtained for bacterial profiling (aerobic and anaerobic) and antimicrobial sensitivity. Clinical samples for culture were collected and antimicrobial susceptibility tests were performed to assess the isolated organism against various antibiotics in vitro by Kirby-Bauer disc diffusion method.

Results: In the present study, ninety clinical samples from patient with age in between 30 to 85 were included, in which 59 were male and 31 were female having diabetic foot ulcer. There was a positive correlation between DFU and patient’s history and duration of diabetes. Furthermore, classifying the types of wound according to Wagner scale, it was found that out of ninety samples, 11 participants had wound of grade 0 with superficial wound, whereas there were only 2 participants with grade 4 with extensive gangrene. From the bacterial isolation, 46.67% were gram positive and 46.67% were gram negative, respectively, including Staphylococcus aureus, in 48 (53.3%) patients and Actinomycyetes spp., in 1 (1.1%) patient, Pseudomona aeruginosa in 3 (3.3%) patients, Escherichia coli in 24 (26.7%) patients, Proteus mirabilis in 16 (17.8%) patients, Morgenella Morganni in 2 (2.2%) patients and Proteus vulgaris in 2(2.2%) patients. Antibiotic spectrum against gram positive showed that there is highest sensitivity Vancomycin in 38 patients and highest resistance for ampicillin with value of 43. Antibiotic spectrum against gram negative showed that sensitivity of 35 for imipenam and it was seen that ampicillin was highly resistant with value of 39.

Conclusion: This study showed that Staphylococcus aureus was the most predominant microorganism. Ampicillin was highest resistant antibiotic among both gram positive and negative bacteria. These observations would be helpful for health professionals, for patient management and development of empirical use antibiotic.

Keywords: Diabetic foot ulcer, antibiotic resistance, microbial infection, antimicrobial susceptibility.