Research Article
Volume 18 Issue 9 - 2022
Molecular Characterization of Multi Drug Resistant Bacteria Isolated from Diabetic Foot Infections in Jabir Abolez Diabetic Foot Center - Khartoum - Sudan
Samia S Mohamed Ismail1*, Elsheikh Mahgoub2, Khanssa M Elamin3 and Husham M Taha Aloob4
1Department of Clinical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Dongola University, Sudan
2Council of Clinical Microbiology and Infectious Diseases, Sudan Medical Specialization Board, Sudan
3Vesion and Endocrinologist Jabir Abolez Diabetic Foot Center, Khartoum, Sudan
4Department of Microbiology and Parasitology, Faculty of Medical Laboratory Sciences, Dongola University, Sudan
*Corresponding Author: Samia S Mohamed Ismail, Department of Clinical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Dongola University, Sudan.
Received: July 01, 2022; Published: August 18, 2022




Abstract

Background: Diabetic foot ulcers (DFU) are among major health problems which impact the socio-economic burden globally. Multi-drug resistance has become a major problem for the treatment of pathogenic bacterial infections.

Objective: The present study was aimed to determine the molecular characterization of multi drug resistance bacteria isolated from diabetic foot Infections patients with septic foot infection attending Jaber Abolez Diabetic Center from the 1st of February till the 31st of July 2021.

Methods: This descriptive cross-sectional study. Wound swabs were collected from each wound after the wound had been cleansed and debrided. Antibiotic susceptibility tests were performed by Kirby-Bauer disc diffusion and B-lactamase genes were detected used PCR.

Results: The most common isolated bacteria were Proteus mirabilis (80.0% of cases) followed by Enterococcus faecalis (63% of cases) and Staphylococcus aureus (36% of cases). The isolated bacteria were 43% aerobic Gram negative, 21% aerobic gram positive, 19% anaerobic gram positive and anaerobic gram negative. Most of the isolated bacteria were resistant to multiple antibiotics especially for ciprofloxacin (100% of the isolated bacteria) and cephalosporins and ampicillin (98% of the isolated bacteria). The lowest cases of resistance were to meropenem. The commonest multi-drug resistance gram negatives of the B-lactamase genes using PCR was extended spectrum (ESBL) bla SHV which detected in 83% of isolated gram-negative bacteria followed by extended spectrum (ESBL) bla CTXM-1 and Carbapenemase gene bla NDM; 66% and 61% respectively.

Conclusion: Multidrug-resistant facultative anaerobic bacteria are overrepresented as agents of DFU. High rates of resistance toward most of the tested antibiotics were reported. Gram-negative organisms expressed high rates of extended spectrum B-lactamase genes. BlaSHV was the most detected gene.

Keywords: Bacteria; Diabetic Foot; Multi Drug Resistance; PCR; β-Lactamase; Sudan

References

  1. Anandi C., et al. “Bacteriology of diabetic foot lesions”. Indian Journal of Medical Microbiology 22 (2004): 175-178.
  2. Khanolkar MP., et al. “The diabetic foot”. QJM: An International Journal of Medicine 101 (2008): 685-695.
  3. Ritu Ga RG., et al. “Anaerobic Bacteriological Profile of Infected Diabetic Foot Ulcers with their Antimicrobial Susceptibility Pattern: Need of the Hour”. National Journal of Laboratory Medicine3 (2017): MO01-MO04.
  4. Singh N., et al. “Preventing foot ulcers in patients with diabetes”. The Journal of the American Medical Association 293 (2005): 217-228.
  5. Alavi SM., et al. “Bacteriologic study of diabetic foot ulcer”. Pakistan Journal of Medical Sciences 23 (2007): 681-684.
  6. Rao N and Lipsky BA. “Optimising antimicrobial therapy in diabetic foot infections”. Drugs 67 (2007): 195-214.
  7. Mellitus D. “Diagnosis and classification of diabetes mellitus”. Diabetes CareSS37 (2005): S5-S10.
  8. Ozer B., et al. “Infections and aerobic bacterial pathogens in diabetic foot”. African Journal of Microbiology Research 4 (2010): 2153-2160.
  9. Abdulrazak A., et al. “Bacteriological study of diabetic foot infection S”. Journal of Diabetes and its Complications 19 (2005): 138-141.
  10. Turhan V., et al. “Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers”. Journal of Infection in Developing Countries 15 (2015): 707-712.
  11. Jneid J., et al. “The diabetic foot microbiota: A review”. Human Microbiome Journal 5 (2017): 1-6.
  12. Dowd SE., et al. “Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP)”. PLoS ONE 3 (2008): e3326.
  13. Fatemah Sadeghpour Heravi., et al. “Bacterial Diversity of Diabetic Foot Ulcers: Current Status and Future Prospectives”. Journal of Clinical Medicine 8 (2019): 1935.
  14. De Gatta MF., et al. “Pharmacokinetics of amikacin in intensive care unit patients”. Journal of Clinical Pharmacy and Therapeutics6 (1996): 417-421.
  15. Scott Bergman Pharm.D., et al. “BCPS ACSAP 2016 Book 3”. Infection Primary Care, Diabetic Foot Infections (2016).
  16. Baker-Austin C., et al. “Antibiotic resistance in the shellfish pathogen Vibrio parahaemolyticus isolated from the coastal water and sediment of Georgia and South Carolina, USA”. Journal of Food Protection12 (2008): 2552-2558.
  17. Zheng B., et al. “Producing enterobacteriaceae isolates from bacteremia in china: A multicentre epidemiological, microbiological, and genetic study. Engineering”. Genomic and Phenotypic Diversity of Carbapenemase (2020).
  18. Performance standards for antimicrobial susceptibility testing; 21st informational supplement. CLSI document M100-S21”. Wayne: Clinical and Laboratory Standards Institute; (2011).
  19. Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2015”. CLSI (2008).
  20. Clinical and Laboratory Standards Institute (CLSI). “Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard, 9th edition, M7- A9”. Wayne, PA: Clinical and La (2012).
  21. Chen L., et al. Multiplex real-time PCR assay for detection and classification of Klebsiella boratory Standards Institute (2011).
  22. Du J., et al. “Phenotypic and Molecular Characterization of Multidrug Resistant Klebsiella pneumoniae Isolated from a University Teaching Hospital, China”. PLoS ONE4 (2014): e95181.
  23. Atlas IDFD. Idf diabetes atlas (2019).
  24. Ramirez-Acuña J., et al. “Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments”. Antibiotics4 (2019): 193.
  25. Almobarak AO., et al. “Prevalence of diabetic foot ulceration and associated risk factors: an old and still major public health problem in Khartoum”. Sudan? 5.17 (2017): 1-7.
  26. Raja NS. “Microbiology of diabetic foot infections in a teaching hospital in Malaysia: a retrospective study of 194 cases”. Journal of Microbiology, Immunology and Infection 1 (2007): 39-44.
  27. Zubair M., et al. “Clinico-microbiological study and antimicrobial drug resistance profile of diabetic foot infections in North India”. The Foot 1 (2011): 6-14.
  28. Ismail A., et al. “Microbial profile, antimicrobial resistance, and molecular characterization of diabetic foot infections in a university hospital”. GERMS 1 (2021): 39-51.
  29. A Clinico-microbiological Study of Diabetic Foot Ulcers in an Indian Tertiary Care 29.8 (2006).
  30. Choucair J., et al. Journal of Infectious Diseases and Epidemiology of the Diabetic Foot Infection in a Tertiary Care Hospital in the Lebanon: A Retrospective Study between 2000 and 2011 .6 (2011): 1-5.
  31. Joshi A. Common pathogens isolated in diabetic foot infection in Bir Hospital (2018).
  32. Mendes JJ., et al. Clinical and bacteriological survey of diabetic foot infections in Lisbon (2011): 5.
  33. Citron DM., et al. Bacteriology of Moderate-to-Severe Diabetic Foot Infections and In Vitro Activity of Antimicrobial Agents 45 (2007): 2819-2828.
  34. Badawi MM., et al. Genotypic and Phenotypic Drug Resistance of Bacteria Associated with Diabetic Septic Foot Infections among Sudanese (2019): 228-236.
  35. Taher M., et al. Bacteriological Profile of Diabetic Foot Infections and its Antibiotic Resistance Pattern in Alexandria Main University Hospital 8 (2019): 1432-1442.
  36. Abouelwaf M and Ab M. all of Microbiology Antibacterial resistance pattern of aerobic bacteria isolated from patients with diabetic foot ulcers in Egypt 8 (2014): 2947-2954.
  37. Article O. “Bacteriological Profile of Diabetic Foot Ulcer with Special (2017).
  38. Alodaini HA and Shoeib AA. An overview of epidemiology and aetiology of bacteria associated with diabetic injuries and their dominant infection at Central Region, Riyadh, Saudi Arabia 10 (2018): 6-14.
  39. Ako-nai AK., et al. Characterization of bacterial isolates from diabetic foot infections in Ile-Ife”. Southwestern Nigeria 16 (2006): 158-164.
  40. Shahi SK and Kumar A. Isolation and Genetic Analysis of Multidrug Resistant Bacteria from Diabetic Foot Ulcers 6 (2016): 1-13.
  41. Shabhay A., et al. Antibiotic Resistance in Aerobic Bacterial Isolates From Infected Diabetic Foot Ulcers in North Eastern Tanzania: An Urgent Call to Establish A Hospital Antimicrobial Stewardship Committee (2021).
  42. Mathangi T., et al. Isolation, molecular characterization and antibiogram of bacteria Antibiotic Resistance in Aerobic Bacterial Isolates From Infected Diabetic Foot Ulcers in North Eastern Tanzania: An Urgent Call to Establish A Hospital Antimicrobial isolated from diabetic foot ulcers 1.1 (2013): 17-25.
  43. Tiwari S., et al. “Microbiological and clinical characteristics of diabetic foot infections in northern India”. The Journal of Infection in Developing Countries 04 (2012): 329-332.
  44. Dalela G. Prevalence of Extended Spectrum Beta Lactamase (ESBL) Producers among Gram Negative Bacilli from Various Clinical Isolates in a Tertiary Care Hospital at Jhalawar, Rajasthan, India 6.2 (2012): 182-187.
  45. Seyed Mohammad Alavi., et al. “Bacteriologic study of diabetic foot ulcer”. Pakistan Journal of Medical Sciences5 (2007): 684-684.
Citation: Samia S Mohamed Ismail., et al. “Molecular Characterization of Multi Drug Resistant Bacteria Isolated from Diabetic Foot Infections in Jabir Abolez Diabetic Foot Center - Khartoum - Sudan”. EC Microbiology 18.9 (2022): 06-18.

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