A Comparative Study of Bacterial Species Isolated from Diabetic Foot in Al-Najaf Governorate
DOI:
https://doi.org/10.63939/rmzawh10Keywords:
isolated bacteria, Al-Najaf Al-Ashraf, diabetic footAbstract
The World Health Organization defines diabetic foot as "a condition of infection, ulceration, or destruction of the deep tissues of the feet, associated with neuropathy and varying degrees of peripheral vascular disease in the lower limbs of diabetic patients." The aim of this study was to determine the prevalence of microorganisms causing infections in patients diagnosed with diabetic foot who were treated at Al-Sadr Educational Hospital in Najaf Governorate during the year 2024. This study involved isolating and diagnosing the main bacterial species responsible for the contamination of diabetic foot ulcers. A total of 118 swab samples were collected from diabetic patients hospitalized at Al-Sadr Educational Hospital.
A descriptive, cross-sectional, and retrospective study was conducted from February 15 to December 15, 2024. A non-probability convenience sample was used for this study. It included 118 samples from diabetic patients reported as having diabetes. Regarding the distribution of participants by age groups, the highest results for women were in the age group 50-59 years, with 18 women, accounting for 29.50%. For men, the highest results were also in the same age group, with 17 men, accounting for 29.82%. As for the isolates, processing the isolates using a 3% potassium hydroxide solution resulted in the isolation of 87 Gram-negative isolates, constituting 73.7% of the total bacteria isolated. Additionally, 31 Gram-positive isolates were obtained, representing 26.3% of the total bacteria isolated in this study.
Regarding the sensitivity of Gram-positive bacteria to antibiotics, the highest sensitivity was observed with Vancomycin, which showed 100% sensitivity for Staphylococcus aureus. Oxacillin also recorded a high sensitivity rate of 99% for the same type. The highest resistance was seen with Erythromycin, which showed 100% resistance for Enterococcus spp. For the sensitivity of Gram-negative bacteria, the highest sensitivity was observed with Piperacillin, which showed 100% sensitivity for Staphylococcus aureus, indicating that this antibiotic is highly effective in treating infections caused by this type of bacteria. Imipenem also demonstrated good efficacy with 100% sensitivity towards Klebsiella pneumoniae. In contrast, Cefotaxime showed 0% sensitivity to Staphylococcus aureus, indicating it is completely ineffective against this type of bacteria. Similarly, Ampicillin recorded only 3.1% sensitivity for the same type.
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References
1. Isla Pera, P. (2012). Diabetes Mellitus, the pandemic of the 21st century. Recently Scientific Journal of Nursing, 5, 2–13.
2. Mandal, A. (2015). Diabetes and gangrene. News Medical. Retrieved May 24, 2017, from http://www.news-medical.net/health/Diabetesand-gangrene.aspx
3. International Diabetes Federation. (2015). What is diabetes. Brussels: International Diabetes Federation. Retrieved May 15, 2017, from https://www.idf.org/about-diabetes/what-is-diabetes.
4. Valencian Institute of the Foot. (2016). Diabetic foot. Valencia, Spain: Valencian Institute of the Foot. Retrieved March 18, 2017, from http://institutovalencianodelpie.es/podologiaavanzada/wound-healing/diabeticfoo.
5. Ribeiro Parisi, M.C. (2015). Chapter 05 - A syndrome diabetic disease, pathophysiology and practical aspects. Sao Paulo, Brazil: Sociedade Brazilian Diabetes. Updated January 23, 2017. Retrieved March 18, 2017, from http://www.diabetes.org.br/ebook/component/k2/item/42-a-pe-diabeticphysiopathology-syndromee-aspects-praticosituo
6. Cañarte-Alcívar, J., Intriago-Ganchozo, J., & Romero-Santillán, B. (2016). Prevalence of diabetic foot in patients treated at Hospital Santo Domingo of the Tsáchilas. Mastery of Sciences, 2(3), 201–212.
7. Flores-Moreno, R., Cárcamo-Mejía, S., Pavón-Núñez, D., Avilés, C. F. A., M-Díaz, C., & Giacaman-Abudoj, L. et al. (2016). Bacteriological profile in patients with diabetic foot who attend the National Institute of Diabetes, Tegucigalpa, Honduras, January 2013-December 2015. Archives of Medicine, 12(3), 1–8.
8. Arango Montes, G. (2015). Diabetic foot. Mexico: Faculty of Medical Sciences. Retrieved May 15, 2017, from http://www.facmed.unam.mx/apartments/family/af8(3)/pie-diabetico.html.
9. Soriano Pereira, P., & De Pablos Velazco, P. (2007). Epidemiology of diabetes mellitus. Revista de Endocrinología y Nutrición, 54(3), 2–7.
10. Commons R.J., Raby E., Athan E., Bhally H., Chen S., Guy S., Ingram P.R., Lai K., Lemoh C., Lim L.-L. Managing diabetic foot infections: A survey of Australasian infectious diseases clinicians. J. Foot Ankle Res. 2018; 11:13. doi: 10.1186/s13047-018-0256-3.
11. IDF diabetes atlas—8th edition. [(accessed on 1 October 2019)]; Available online: http://www.diabetesatlas.org/.
12. Raghav A., Khan Z.A., Labala R.K., Ahmad J., Noor S., Mishra B.K. Financial burden of diabetic foot ulcers to world: A progressive topic to discuss always. Ther. Adv. Endocrinol. Metab. 2018; 9:29–31. doi: 10.1177/2042018817744513.
13. Rhoads D.D., Wolcott R.D., Sun Y., Dowd S.E. Comparison of culture and molecular identification of bacteria in chronic wounds. Int. J. Mol. Sci. 2012; 13:2535–2550. doi: 10.3390/ijms13032535.
14. Lipsky B.A. Diabetic foot infections: Microbiology made modern? Array of hope. Diabetes Care. 2007; 30:2171–2172. doi: 10.2337/dc07-0935.
15. Lipsky B.A., Berendt A.R., Cornia P.B., Pile J.C., Peters E.J., Armstrong D.G., Deery H.G., Embil J.M., Joseph W.S., Karchmer A.W., et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin. Infect. Dis. 2012;54: e132–e173. doi: 10.1093/cid/cis346
16. Lipsky B.A., Aragón-Sánchez J., Diggle M., Embil J., Kono S., Lavery L., Senneville É., Urbančič-Rovan V., Van Asten S., Peters E.J. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab. Res. Rev. 2016; 32:45–74. doi: 10.1002/dmrr.2699.
17. Pellizzer G., Strazzabosco M., Presi S., Furlan F., Lora L., Benedetti P., Bonato M., Erle G., De Lalla F. Deep tissue biopsy vs. superficial swab culture monitoring in the microbiological assessment of limb-threatening diabetic foot infection. Diabet. Med. 2001; 18:822–827. doi: 10.1046/j.1464-5491.2001.00584. x.
18. Slater R., Lazarovitch T., Boldur I., Ramot Y., Buchs A., Weiss M., Hindi A., Rapoport M. Swab cultures accurately identify bacterial pathogens in diabetic foot wounds not involving bone. Diabet. Med. 2004; 21:705–709. doi: 10.1111/j.1464-5491.2004.01221. x.
19. Mutluoglu M., Uzun G., Turhan V., Gorenek L., Ay H., Lipsky B.A. How reliable are cultures of specimens from superficial swabs compared with those of deep tissue in patients with diabetic foot ulcers? J. Diabetes Its Complicat. 2012; 26:225–229. doi: 10.1016/j.jdiacomp.2012.03.015.
20. Huang Y., Cao Y., Zou M., Luo X., Jiang Y., Xue Y., Gao F. A comparison of tissue versus swab culturing of infected diabetic foot wounds. Int. J. Endocrinol. 2016;2016 doi: 10.1155/2016/8198714.
21. Senneville E., Melliez H., Beltrand E., Legout L., Valette M., Cazaubie M., Cordonnier M., Caillaux M., Yazdanpanah Y., Mouton Y. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: Concordance with ulcer swab cultures. Clin. Infect. Dis. 2006; 42:57–62. doi: 10.1086/498112.
22. Elamurugan T., Jagdish S., Kate V., Parija S.C. Role of bone biopsy specimen culture in the management of diabetic foot osteomyelitis. Int. J. Surg. 2011; 9:214–216. doi: 10.1016/j.ijsu.2010.11.011.
23. Nelson E.A., Wright-Hughes A., Brown S., Lipsky B.A., Backhouse M., Bhogal M.S., Ndosi M., Reynolds C., Sykes G., Dowson C., et al. Concordance in diabetic foot ulceration: A cross-sectional study of agreement between wound swabbing and tissue sampling in infected ulcers. Health Technol. Assess. 2016; 20:1–176. doi: 10.3310/hta20820.
24. Jneid J., Lavigne J., La Scola B., Cassir N. The diabetic foot microbiota: A review. Hum. Microbiome J. 2017; 5:1–6. doi: 10.1016/j.humic.2017.09.002.
25. Abdulrazak A., Bitar Z.I., Al-Shamali A.A., Mobasher L.A. Bacteriological study of diabetic foot infections. J. Diabetes Its Complicat. 2005; 19:138–141. doi: 10.1016/j.jdiacomp.2004.06.001.
26. El-Tahawy A. Bacteriology of diabetic foot. Saudi Med J. 2000; 21:344–347. [PubMed]
27. Lee J.S., Son S.T., Han S.-K. Risk factors of methicillin-resistant Staphylococcus aureus and Pseudomonas infection in diabetic foot ulcers in Korea. J. Wound Manag. Res. 2017; 13:29–34. doi: 10.22467/jwmr.2017.00164. Tascini C., Piaggesi A., Tagliaferri E., Iacopi E., Fondelli S., Tedeschi A., Rizzo L., Leonildi A., Menichetti F. Microbiology at first visit of moderate-to-severe diabetic foot infection with antimicrobial activity and a survey of quinolone monotherapy. Diabetes Res. Clin. Pract. 2011; 94:133–139. doi: 10.1016/j.diabres.2011.07.017.
28. Jneid J., Cassir N., Schuldiner S., Jourdan N., Sotto A., Lavigne J.-P., La Scola B. Exploring the microbiota of diabetic foot infections with culturomics. Front. Cell. Infect. Microbiol. 2018; 8:282. doi: 10.3389/fcimb.2018.00282.
29. Y.M. Hsu et al. MALDI-TOF MS identification of anaerobic bacteria: assessment of pre-analytical variables and specimen preparation techniques Diagn. Microbiol. Infect. Dis. (2014)
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