University of Khartoum

Bacterial Agents Associated with Diabetic Foot Infection in Patients Attending Khartoum and Omdurman Teaching Hospitals

Bacterial Agents Associated with Diabetic Foot Infection in Patients Attending Khartoum and Omdurman Teaching Hospitals

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Title: Bacterial Agents Associated with Diabetic Foot Infection in Patients Attending Khartoum and Omdurman Teaching Hospitals
Author: Adam, Zubieda Mohammed Ibrahim
Abstract: Bacteriological investigations were carried out for fifty patients presented with diabetic foot wounds, during Dec.2014 – Mar.2015 at the Omdurman and Khartoum teaching hospitals. Swab samples were collected from 50 patient’s wounds before debridement. Superficial swabs were collected from wounds surface and deep swabs were obtained from the deep wound surfaces. A total of 81 clinical bacterial isolates were identified to the species level on the bases of microscopical examination, Gram –reaction, cultural characteristics and biochemical tests. These isolates represented 22 different bacterial genera includingfourteen genera Gram-negative (63.63%)and the other eight genera of Gram-positive (36.36%). Poly-microbial infection was obtained in 27 patients (54%) ofdiabetic foot wounds and only 19 patients (38%) of diabetic wounds had mono-microbial etiology and no growth in 4 patients (8%) of diabetic foot wounds. Poly-microbial infection contained 2 to 5 isolates. Pseudomonas spp and Staphylococcus spp were isolated at the rate of 18.5% and13.5% respectively. They represented the most common causes of diabetic foot infection in this study. The Gram-negative isolates included Proteus Spp (11.1%),Pasteurella Spp (4.9%),Aeromonas Spp(3.7%),Klebsiella pneumonia (2.46%),Shewanellaputrefaciens (1.2%), Legionella oakridgensis (1.2%), Agrobacterium tumefaciens (1.2%), Streptobacillus moniliformis (1.2%), Salmonella pullorum (1.2%),Bordetella parapertussis (1.2%) , Branhamella catarrhalis (1.2%), Acinetobacter calcoaceticus (1.2%), Citrobacter freundii (1.2%).The Gram-positive isolates includedMicrococcus Spp (12.3%),Bacillus Spp (11.1%), Corynebacterium Spp (4.9%), Rothia dentocariosa(2.46%),Arcanobacterium hemolyticum (1.2%), leuconostoc Spp (1.2%) and kurthia zopfii (1.2%). There was 53.8% of isolate were sensitive to ceftizoxime and 95.2% of our isolate were resistant to ¬¬¬¬metronidazol , 88.9% were resistant toceftriaxone, and 84.6% were resistant to cefuroxime.. All S.aureus,Rothia dentocariosa, Kurthia zopfii, Shewanellaputrefaciens, Salmonella pullorum and P. haemolytica were resistant to the all antibiotics used. It is concluded that most patients with DSF seek care late and present with advance grade lesions. Lacks of self-care of foot and poly microbial infection are the risk factors of DSF. And 31 of patients are male and 19 female. I recommended that early aggressive surgical debridement may yields less microbiologically complex infections that might be controlled with less expensive narrow spectrum antibiotic therapy that may result in a less complex hospital course and improve the outcome.
Description: 86 Pages
URI: http://khartoumspace.uofk.edu/123456789/24398


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