DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20175103

Diabetes a risk for antimicrobial resistance?

Vasavi Gedela, Sree Lakshmi Gosala

Abstract


Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.

Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.

Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).

Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections.


Keywords


Ampicillin resistance, Anti-microbial resistance, Antibiotic susceptibility, Diabetes, Foot ulcer, Kirby-Bauer disc diffusion method, Non- diabetics, Pseudomonas

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References


WHO. Prevention and control of Diabetes Mellitus, Report of an Inter country workshop, Dhaka, Bangladesh; 1998:27-30. April 1998, SEA/NCD/40.

Goldstein EJ, Citron DM, Nesbit CA. Diabetic foot infections: bacteriology and activity of 10 oral antimicrobial agents against bacteria isolated from consecutive cases. Diabetes care. 1996;19(6):638-41.

Basu S, Ramchuran PT, Bali ST, Gulati AK, Shukla VK. A prospective, descriptive study to identify the microbiological profile of chronic wounds in outpatients. Ostomy/wound management. 2009;55(1):14-20.

Tenover FC. Mechanisms of antimicrobial resistance in bacteria. The American journal of medicine. 2006;119(6):S3-10.

McGowan JE, Jr. Economic impact of antimicrobial resistance. Emerg Infect Dis. 2001;7:286-92.

Gibbons GW, Eliopoulos GM. Infection of the diabetic foot. In: Kozak GP, Hoar GS, Rowbottam JL, Wheelock FC, Campel D, editors. Management of diabetic foot problems. Philadelphia (USA): WB Saunders; 1984:97-102.

Mowat A, Baum J. Chemotoxis of polymorphnuclear leucocytes from patients with diabetes mellitus. N Engl J Med. 1971;284:621-7.

Bybee JD, Rogers DE. The phagocytic activity of polymorphnuclear leucocytes obtained from patients with diabetes mellitus. J Lab Clin Med. 1964;64:1-13.

Tan JS, Anderson JL, Watanakunakorn G, Phair JP. Neutrophil dysfunction in diabetes mellitus. J Lab Clin Med. 1975;85:26-33.

Shankar EM, Mohan V, Premalatha G, Srinivasan RS, Usha AR. Bacterial etiology of diabetic foot infections in South India. EFIM. 2005;16(8):567-70.

Diabetes mellitus in itself is not a risk factor for antibiotic resistance in Escherichia coli isolate from patients with bacteriuria. Meiland R, Geerlings SE, De Neeling AJ, Hoepelman AI. Diabet Med. 2004;21(9):1032-4.