Antibiotic Susceptibility Profiles of Bacteria from Diabetic Foot Infections in Selected Teaching Hospitals in Southwestern Nigeria

Phenotypic profile and antibiogram of biofilm-producing bacteria isolates from diabetic foot ulcers in Zaria, Nigeria

Background

Diabetic foot ulcers (DFUs) present with high morbidity and reduce patient's quality of life. There is a gross paucity of data on biofilm-producing bacteria in DFU Infection in North-Western Nigeria. The study sought to determine the biofilm-forming ability of bacteria isolates from DFUs and determine their antimicrobial susceptibility pattern in Zaria, North-Western Nigeria.

Materials and Methods

This hospital-based cross-sectional study of patients with DFUs was conducted from June 2018 to February 2020. Consecutive biopsies were aseptically collected. Bacteria were isolated and identified using a Microgen kit. Biofilm forming ability and antibiogram of isolates were determined using microtitre plate and disk diffusion methods, respectively.

Results

Of the 225 participants enrolled, males constituted the majority, 144 (64.0%) with 88 (36.0%) females, the median age of participants was 54 (48-60) years, and the age range was 36-77 years. A total of 172 bacteria were isolated, and 123 (71.5%) were biofilm producers. Staphylococcus aureus (26.7%) was the highest biofilm producer, while Citrobacter freundii and Stenotrophomonas maltophilia were the least biofilm producers, 1 (0.6%) each. A disproportionate resistance pattern was demonstrated among the biofilm and non-biofilm producers against the cephalosporins tested, ceftazidime (68% vs. 18%), ceftriaxone (50% vs. 8.0%) and cefotaxime (21% vs. 0.0%). About 46% and 68% of the biofilm producers were resistant to gentamycin and ciprofloxacin, respectively. While only 2% of the non-biofilm producers were resistant to imipenem, 11% of the biofilm producers were resistant to it.

Conclusion

These findings revealed a high proportion of biofilm-producing bacteria and were more resistant than non-biofilm producers.

Prevalence and interrelationships of foot ulcer, risk-factors and antibiotic resistance in foot ulcers in diabetic populations: A systematic review and meta-analysis

BACKGROUND

Diabetic foot ulceration (DFU) is the prime health concern globally. It accounts for the major burden related to disease mortality and morbidity and economic cost. The timely and early recognition of the DFU can help present its occurrence and improve clinical outcomes.

AIM

To evaluate interrelationships between foot ulcers, risk factors, and antibiotic resistance among diabetic patients having ulcers in their foot.

METHODS

The databases such as PubMed, ERIC, Medline, and Google Scholar were extensively used for the extraction of studies. The selected studies were published within the time-period of 2014-2018. Ten studies were selected, which were found to be completely relevant to the current study.

RESULTS

The prevalence of diabetic foot ulcers among the population was evaluated, and the associated risk factors with its prevalence. Moreover, few studies also reported on the bacteria that are found to be most prevailing among diabetic patients. A narrative discussion was drawn through this analysis, which was used to highlight the specific area of research through selected studies, extraction of the significant information that matched with the topic of research, and analysis of problem through the findings of the selected articles. The results helped in assessing significant knowledge regarding the risk factors of diabetic foot ulcers and the role of antimicrobial resistant in its treatment.

CONCLUSION

The gram-negative bacteria were found to be the most common reason for diabetic foot ulcers. The study only included 10 studies that are not sufficient to produce generalized results, and no information was reported on the tests required to analyze antimicrobial susceptibility that can guide clinicians to propose better and sound treatment plans. It is evident that most study results depicted that the most common risk factors were found to be hypertension and neuropathy.