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Category: Volume 08 Issue 07 July 2020
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Title: Clinico Microbiological Spectrum of Diabetic Foot Ulcer with Multidrug Resistant Organisms at Tertiary Care Hospital, Jaipur

Authors: Kavita Mourya, Rajni Sharma, Aruna Vyas, Hari Om Khoja, Nitya Vyas

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.18

Abstract

Background: Diabetes is one of the major health problems that have become a big burden in all over the world. Amongst the diabetic population, about 8– 20% experience foot ulcer in life time. DFIs are predominantly polymicrobial and multidrug-resistant (MDR) with the ability to form biofilm, which is an important virulence factor and results in treatment failure.

Objective: To determine the bacteriological profile and susceptibility pattern of organisms and to assess the magnitude of infection by Multidrug resistant organisms (MDRO’S) like Extended spectrum beta lactamase (ESBL) and Methicillin- resistant Staphylococcus aureus (MRSA)

Materials and Methods: A total of 73 pus and exudates sample were collected from diabetic foot patients. Specimens were collected with a sterile swab stick from each patient. Significant isolates were identified by conventional methods according to the standard laboratory protocol. The antibiotic sensitivity test along with screening for MRSA and ESBL producing GNB were done.

Results: The maximum number of diabetic foot cases 30(46.15%) were seen between age of 51-60 years. A total of 90 organisms were isolated from 65 clinical samples out of which 65(68.39%) were gram negative bacilli and 25(31.56%) gram positive cocci. Pseudomonas species (25.65%) was predominant among gram negative bacilli and Staphylococcus aureus (16.84%) was the predominant among gram positive cocci. Gram negative organisms showed highest sensitivity to Polymixin B (100%), Gram positive organisms showed highest sensitivity to Vancomycin (100%). Out of 65 isolates 16(24.6%) were ESBL producers. Out of 16 isolates 7(43.7%) were MRSA. Multidrug resistance was seen in 88.8% of isolates.

Conclusion: Early identification of the risk factors and timely institution of appropriate treatment indispensable to avoid amputations. There is a need for continuous surveillance of resistant bacteria to provide the basis for empirical therapy and reduce the risk of complications.

Keywords:  Diabetic foot ulcers, Extended spectrum beta lactamase, Methicillin- resistant Staphylococcus aureus, Multidrug resistant organisms.

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Corresponding Author

Rajni Sharma

SMS Medical College, Jaipur, Rajasthan, India