Journal of Diseases and Medicinal Plants

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Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon)

Received: 18 August 2015    Accepted: 28 August 2015    Published: 2 September 2015
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Abstract

Introduction. Foot infections are a major complication of diabetes mellitus and eventually lead to development of gangrene and lower extremity amputation. Many studies reported the bacteriology of Diabetic Foot Infections (DFIs) over the past 25 years, but the results have been varied and often contradictory. Aims and Objectives. This study was carried out to determine the bacterial profiles of infected ulcers and the antibiotic resistance pattern of the isolates at the endocrinology and metabolic diseases unit of the Yaoundé Central Hospital. Materials and Methods. Samples were collected from 59 patients with diabetic foot ulcers by using sterile swabs and they were processed. Results. A total of 148 bacterial isolates were obtained from 56 positive cultures, with an average of 2.5 organisms per case. The age group of these patients ranged from 14 to 75 years and the maximum number of patients was in the age group of 51 to 60 years. Gram negative bacilli were more prevalent (65.5%) than gram positive cocci (36.4%). Polymicrobial growth was observed in 84.48% of the specimen, Monomicrobial growth in 18.59% and sterile growth in 6.25% of the isolates. The commonest isolates among the gram negative bacteria’s were Proteus spp. (21.6%), Escherichia coli (18.9%), Klebsiella. spp (16.9%) and Pseudomonas aeruginosa (8.1%) while among the gram positive bacteria’s Staphylococcus aureus was predominant (17.6%), followed by Staphylococcus epidermidis (10.1%) then by Streptococcus pyogenes (6.8%). Antimicrobial susceptibility results showed that Gram negative bacterial isolates were 100% sensitive to Imipenem and 86.5% resistance to Ampicillin, while for the Gram positive bacterial, they were 44.5% sensitive to Ciprofloxacin and 46.8% resistance to Oxacillin. Conclusion. This study showed a preponderance of gram negative bacilli among the isolates from the diabetic foot ulcers. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining adequate drugs for the empirical treatment of diabetic ulcers.

DOI 10.11648/j.jdmp.20150104.11
Published in Journal of Diseases and Medicinal Plants (Volume 1, Issue 4, October 2015)
Page(s) 53-58
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetic Foot Ulcer, Bacterial Profile, Antibiotic Sensitivity

References
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[2] S Shakil, AU Khan. Infected foot ulcers in male and female diabetic patients: A clinico-bioinformative study. Ann Clin Microbiol Antimicrob. 2010;9:1–10
[3] U Sivaraman, S Kumar, NM Joseph, JM Easow, G Kandhakumari. Microbiological study of diabetic foot infections. Indian J Med Specialities. 2011;2(1):12–17.
[4] DM Citron, EJC Goldstein, VC Merriam, BA Lipsky. Bacteriology of moderate to severe diabetic foot infections and invitro activity of antimicrobial agents. J Clin Microbiol. 2007;45(9):2819–28.
[5] M Zubair, A Malik, J Ahmad. Clinico-bacteriology and risk factors for the diabetic foot infection with multidrug resistant microorganisms in North India. Biol Med. 2010;2(4):22–34.
[6] SE Dowd, DW Randall, Yan Sun, T McKeehan, E Smith. Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP) PLoS ONE. 2008;3(10):e3326–32.
[7] N Ahmed. (2005). Advanced glycation end products--role in pathology of diabetic
[8] VK Sharma, PB Khadka, A Joshi, R Sharma. Common pathogens isolated in diabetic foot infection in Bir Hospital. Kathmandu Univ Med J (KUMJ). 2006 Jul-Sep;4(3):295-301.
[9] J. Vimalin Hena, Lali Growther, Studies On Bacterial Infections Of Diabetic Foot Ulcer. 2010. Afr. J. cln. Exper. Microbiol 11(3): 146-149
[10] AS Ayat, A H Khan., N Masood, N Shaikh, 2011. Study for microbiological pattern and in vitro antibiotic susceptibility in patients having diabetic foot infections at Tertiary Care Hospital in Abbottabad. World Appl. Sci. J., 12: 123 131
[11] V Viswanathan, JJ Jasmine, C Snehalatha, A Ramachandran. Prevalence of pathogens in diabetic foot infection in South Indian type 2 diabetic patients. J Assoc Physicians India. 2002 Aug;50:1013-6.
[12] Gadepalli R, Dhawan B, Sreenivas V, Kapil A, Ammini AC. A clinicomicrobiological study of diabetic foot ulcers in an Indian tertiary care hospital. DiabetesCare. 2006;29(8):1727–32.
[13] AK Ako-Nai, IC Ikem, OO Akinloye, AO Aboderin, RT Ikem, OO Kassim, 2006. Characterization of bacterial isolates from diabetic foot infections in IleIfe, Southwestern Nigeria. The Foot, 16 (3): 158-164.
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[17] E Bansal, A Garg, S Bhatia, AK Attri, J Chander. Spectrum of microbial flora in diabetic foot ulcers. Indian J Pathol Microbiol. 2008 Apr-Jun;51(2):204-8.
[18] C Anandi, D Alaguraja, V Natarajan, M Ramanathan, CS Subramaniam, M Thulasiram, S Sumithra, Bacteriology of diabetic foot lesions. Indian J Med Microbiol 2004;22:175-8
[19] P Ramakant, AK Verma, R Misra, KN Prasad. Changing Microbiological profile of pathogenic bacteria in diabetic foot infections: time to rethink on which empirical therapy to choose? Diabetologica. 2011;54(1):58–64
[20] AK Pappu, A Sinha, A Johnson. Microbiological profile of diabetic foot ulcer. Calicut Med Journal. 2011;9(3):e1–4.
[21] DM Citron, EJC Goldstein, VC Merriam, BA Lipsky. Bacteriology of moderate to severe diabetic foot infections and invitro activity of antimicrobial agents. J Clin Microbiol. 2007;45(9):2819–28
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[23] F A Orji, N C Nwachukwu, and E C Udora, Bacteriological evaluation of diabetic ulcers in Nigeria, African Journal of Diabetes Medicine. 2009 DI-416 Orji.indd.
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    Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje. (2015). Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). Journal of Diseases and Medicinal Plants, 1(4), 53-58. https://doi.org/10.11648/j.jdmp.20150104.11

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    Lilian Akwah; Fokunang Ntungwen Charles; Elias Nukenine Nchinwan; Emmanuel Kagning Tsinda; Armel Herve Nwabo Kamdje. Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). J. Dis. Med. Plants 2015, 1(4), 53-58. doi: 10.11648/j.jdmp.20150104.11

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    AMA Style

    Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje. Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). J Dis Med Plants. 2015;1(4):53-58. doi: 10.11648/j.jdmp.20150104.11

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  • @article{10.11648/j.jdmp.20150104.11,
      author = {Lilian Akwah and Fokunang Ntungwen Charles and Elias Nukenine Nchinwan and Emmanuel Kagning Tsinda and Armel Herve Nwabo Kamdje},
      title = {Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon)},
      journal = {Journal of Diseases and Medicinal Plants},
      volume = {1},
      number = {4},
      pages = {53-58},
      doi = {10.11648/j.jdmp.20150104.11},
      url = {https://doi.org/10.11648/j.jdmp.20150104.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jdmp.20150104.11},
      abstract = {Introduction. Foot infections are a major complication of diabetes mellitus and eventually lead to development of gangrene and lower extremity amputation. Many studies reported the bacteriology of Diabetic Foot Infections (DFIs) over the past 25 years, but the results have been varied and often contradictory. Aims and Objectives. This study was carried out to determine the bacterial profiles of infected ulcers and the antibiotic resistance pattern of the isolates at the endocrinology and metabolic diseases unit of the Yaoundé Central Hospital. Materials and Methods. Samples were collected from 59 patients with diabetic foot ulcers by using sterile swabs and they were processed. Results. A total of 148 bacterial isolates were obtained from 56 positive cultures, with an average of 2.5 organisms per case. The age group of these patients ranged from 14 to 75 years and the maximum number of patients was in the age group of 51 to 60 years. Gram negative bacilli were more prevalent (65.5%) than gram positive cocci (36.4%). Polymicrobial growth was observed in 84.48% of the specimen, Monomicrobial growth in 18.59% and sterile growth in 6.25% of the isolates. The commonest isolates among the gram negative bacteria’s were Proteus spp. (21.6%), Escherichia coli (18.9%), Klebsiella. spp (16.9%) and Pseudomonas aeruginosa (8.1%) while among the gram positive bacteria’s Staphylococcus aureus was predominant (17.6%), followed by Staphylococcus epidermidis (10.1%) then by Streptococcus pyogenes (6.8%). Antimicrobial susceptibility results showed that Gram negative bacterial isolates were 100% sensitive to Imipenem and 86.5% resistance to Ampicillin, while for the Gram positive bacterial, they were 44.5% sensitive to Ciprofloxacin and 46.8% resistance to Oxacillin. Conclusion. This study showed a preponderance of gram negative bacilli among the isolates from the diabetic foot ulcers. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining adequate drugs for the empirical treatment of diabetic ulcers.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon)
    AU  - Lilian Akwah
    AU  - Fokunang Ntungwen Charles
    AU  - Elias Nukenine Nchinwan
    AU  - Emmanuel Kagning Tsinda
    AU  - Armel Herve Nwabo Kamdje
    Y1  - 2015/09/02
    PY  - 2015
    N1  - https://doi.org/10.11648/j.jdmp.20150104.11
    DO  - 10.11648/j.jdmp.20150104.11
    T2  - Journal of Diseases and Medicinal Plants
    JF  - Journal of Diseases and Medicinal Plants
    JO  - Journal of Diseases and Medicinal Plants
    SP  - 53
    EP  - 58
    PB  - Science Publishing Group
    SN  - 2469-8210
    UR  - https://doi.org/10.11648/j.jdmp.20150104.11
    AB  - Introduction. Foot infections are a major complication of diabetes mellitus and eventually lead to development of gangrene and lower extremity amputation. Many studies reported the bacteriology of Diabetic Foot Infections (DFIs) over the past 25 years, but the results have been varied and often contradictory. Aims and Objectives. This study was carried out to determine the bacterial profiles of infected ulcers and the antibiotic resistance pattern of the isolates at the endocrinology and metabolic diseases unit of the Yaoundé Central Hospital. Materials and Methods. Samples were collected from 59 patients with diabetic foot ulcers by using sterile swabs and they were processed. Results. A total of 148 bacterial isolates were obtained from 56 positive cultures, with an average of 2.5 organisms per case. The age group of these patients ranged from 14 to 75 years and the maximum number of patients was in the age group of 51 to 60 years. Gram negative bacilli were more prevalent (65.5%) than gram positive cocci (36.4%). Polymicrobial growth was observed in 84.48% of the specimen, Monomicrobial growth in 18.59% and sterile growth in 6.25% of the isolates. The commonest isolates among the gram negative bacteria’s were Proteus spp. (21.6%), Escherichia coli (18.9%), Klebsiella. spp (16.9%) and Pseudomonas aeruginosa (8.1%) while among the gram positive bacteria’s Staphylococcus aureus was predominant (17.6%), followed by Staphylococcus epidermidis (10.1%) then by Streptococcus pyogenes (6.8%). Antimicrobial susceptibility results showed that Gram negative bacterial isolates were 100% sensitive to Imipenem and 86.5% resistance to Ampicillin, while for the Gram positive bacterial, they were 44.5% sensitive to Ciprofloxacin and 46.8% resistance to Oxacillin. Conclusion. This study showed a preponderance of gram negative bacilli among the isolates from the diabetic foot ulcers. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining adequate drugs for the empirical treatment of diabetic ulcers.
    VL  - 1
    IS  - 4
    ER  - 

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Author Information
  • Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon

  • Department of Pharmacotoxicology and Pharmacokinetics, University of Yaounde I, Yaounde, Cameroon

  • Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon

  • Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon

  • Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon

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