Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Background

Infectious diabetic foot ulcers (IDFU) are a widespread health issue that affects people all over the world. IDFU, like other medical disorders, can have negative implications if drug resistance develops. Clinicians will be able to choose the optimal antibiotics to treat impacted patients based on the antibiotic susceptibility pattern of bacterial strains. In this project, we attempted to evaluate the levels of extended-spectrum beta-lactamase (ESBL), carbapenemase, and MRSA in patients with diabetic foot ulcers.

Methods

A sterile swab was used to collect a sample from the leg ulcer, while a sterile needle was used to collect the aspirated pus. Bacteria identification and antibiotic susceptibility tests are carried out based on conventional bacterial culture. The double-disc inactivation method and modified carbapenem (meropenem) were used to screen the production of ESBL and carbapenemase.

Results

Of the 76 isolates tested, 53.9% (41/76) were phenotypically ESBL producers. K. pneumoniae 75% (6/8), Acinetobacter species 75% (9/12), Serratia species 75% (3/4), Pseudomonas species 64.3% (14/9), E. coli 57.8% (11/19), Citrobacter species 50% (2/4) and Proteus mirabilis 25% (1/4) had the highest frequency of ESBL production. Of the 68 GNB isolates tested, 27.9% (19/68) were carbapenemase-producing organisms. K. pneumoniae 62.5% (5/8), Serratia 50% (3/6), Acinetobacter species 40% (4/10), Pseudomonas species 23.5% (4/17) and E. coli 15.8% (3/19) are the top five major carbapenemase producers. In this study, 32 isolates of Staphylococcus aureus were tested for methicillin resistance. Among them, 81.3% (26/32) were methicillin-resistant Staphylococcus aureus (MRSA), and 18.7% (6/32) of the remaining isolates were methicillin-sensitive Staphylococcus aureus (MSSA).

Conclusion

The result draws attention to the management of diabetic foot ulcer infections based on the results of microbiological analysis and drug susceptibility testing.

Efficacy of Praziquantel Treatment and Schistosoma Mansoni Infection among Primary School Children in Kemisse Town, Northeast Ethiopia

Background

Schistosoma mansoni infection is endemic in Ethiopia. The epidemiology of S. mansoni and the efficacy of praziquantel among schoolchildren have not been well documented in different parts of the country including our study area. Therefore, this study aimed to determine the status of S. mansoni infection and evaluate the therapeutic efficacy of praziquantel among school children in northeast Ethiopia.

Methods

A comparative cross-sectional study was conducted among 499 children of two preschool children. Stool specimens were collected and microscopically examined using Kato-Katz (41.7 gram) methods. Positive children were treated with a single oral dose of praziquantel at 40 mg/kg body weight. Egg reduction and cure rates were assessed 4 weeks post-treatment to evaluate the therapeutic efficacy of praziquantel against S. mansoni infection.

Results

The overall prevalence of S. mansoni infection among the schoolchildren was 52.1% with a mean intensity of 546 eggs per gram of stool. Majorities of the S. mansoni infections were moderate to heavy intensity, with only 5.0% light infections. Praziquantel administered at a single oral dose of 40 mg/kg achieved a cure rate of 91.7% and reduced the egg rate by 86.8%. Twenty-one schoolchildren remained infected at 4 weeks post-treatment, among which 6 and 15 children had moderate and light infections, respectively.

Conclusions

S. mansoni prevalence among primary school children in Northeast Ethiopia was high, highlighting the need to implement school-based chemotherapy with annual frequency. The efficacy of praziquantel at 40 mg/kg is sufficient to permit continued use in treating S. mansoni-infected schoolchildren.

Bacterial isolates from diabetic foot ulcers and their antimicrobial resistance profile from selected hospitals in Addis Ababa, Ethiopia

INTRODUCTION

Infected diabetic foot ulcer (IDFU) is a worldwide problem associated with diabetes mellitus. It could lead from soft tissue infection to bone infection and is a leading cause of lower limb amputation. Gram-negative and Gram-positive bacteria, including anaerobic bacteria and fungi, are considered potential causes of infection. The early diagnosis of DFU infection and appropriate treatment based on the identification of the pathogens and their antimicrobial susceptibility pattern is important for good prognosis. Therefore, the purpose of this study was to isolate the bacteria that infect foot ulcers in selected Hospitals and determine their antimicrobial resistance profile.

METHOD

An institutional-based multicenter, cross-sectional study was conducted in selected Hospitals in Addis Ababa, Ethiopia, from November 2020 to May 2021. A sterile swab was used to collect samples from the foot ulcer and a sterile needle to collect pus. Isolates were identified by culture, Gram-staining, and a series of biochemical tests. For each bacterial species identified, the antibiotic profiling was determined by the Kirby-Bauer disk diffusion method.

RESULTS

one hundred and twenty-seven pathogenic bacteria were isolated from samples taken from 130 patients with a diabetic foot ulcer. Sixty-eight percent had growth of multiple microorganisms. Two-thirds (66.7%) of the isolates were gram-negative bacteria. The predominant bacterial species were S. aureus 25.19% (32/127), Pseudomonas species 18.89% (24/127), and Escherichia coli 16.53% (21/127). Overall, 92.9% (118/127) of the isolates were identified as multi-drug resistant. Gram-positive isolates were susceptible to chloramphenicol, clindamycin, and amikacin. Gram-negative isolates were also sensitive to chloramphenicol, aztreonam, and amikacin.

CONCLUSION

The majority of bacteria isolated from patients presenting with Diabetic foot ulcer infections were found to be multi-drug resistant in the study sites of the current study. The results demonstrate the importance of timely identification of infection of diabetic foot ulcers, proper sample collection for identification of the pathogens and for determining their antibiotic susceptibility pattern before initiating antimicrobial treatment.