article · Frontiers in Endocrinology
An investigation conducted across selected hospitals in Addis Ababa, Ethiopia, examined bacterial pathogens isolated from diabetic foot ulcers and evaluated their antimicrobial resistance patterns. Between November 2020 and May 2021, clinical teams collected ulcer swabs and pus samples, identifying bacterial species through laboratory culture, Gram-staining, and biochemical tests before evaluating antibiotic resistance using the Kirby-Bauer disk diffusion method. The study found that 92.9 percent of the 127 isolates were multi-drug resistant. Gram-positive isolates remained susceptible to chloramphenicol, clindamycin, and amikacin, while Gram-negative isolates showed sensitivity to chloramphenicol, aztreonam, and amikacin. The findings demonstrate that multi-drug resistant bacteria are widespread in diabetic foot infections within these settings, highlighting the critical need for prompt pathogen identification and susceptibility profiling before clinicians administer antimicrobial therapies.
Infected diabetic foot ulcers are a leading cause of lower limb amputations and can rapidly progress from soft tissue damage to severe bone infections. Widespread multi-drug resistance among causative bacteria complicates standard treatments, demonstrating that empirical antibiotic prescribing risks treatment failure unless clinicians first identify the specific pathogens and their susceptibility profiles.
The findings provide local resistance data that can assist hospital committees and clinicians in updating treatment protocols and antibiotic formularies for diabetic wound care. Developers of point-of-care diagnostics could also use these susceptibility patterns to tailor rapid testing panels. As observational hospital surveillance, this evidence is directly applicable to institutional clinical practice, though it does not describe a commercial product.
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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: 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.
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DOI: 10.3389/fendo.2022.987487
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