Identification of contributing factors, microorganisms and antimicrobial resistance involved in the complication of diabetic foot ulcer treatment.

Autor: Khan MS; Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan., Azam M; Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan. Electronic address: malihazam@gmail.com., Khan MN; Faculty of Biological Sciences, Department of Microbiology, Quaid-I-Azam University Islamabad, Pakistan., Syed F; Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan., Ali SHB; Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan., Malik TA; International Diabetic Foot Center Islamabad, Islamabad, Pakistan., Alnasser SMA; Department of Pharmacology and Toxicology, Unaizah College of Pharmacy, Qassim University, 51452, Saudi Arabia., Ahmad A; Department of Pharmacy Practice, College of Pharmacy, University of Hafr Al Batin, Hafr Al-Batin, 39524, Saudi Arabia., Karimulla S; Department of Pharmacy Practice, College of Pharmacy, University of Hafr Al Batin, Hafr Al-Batin, 39524, Saudi Arabia., Qamar R; Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan; Pakistan Academy of Sciences, Pakistan; Science and Technology Sector, Islamic World Educational, Scientific and Cultural Organization (ICESCO), Rabat, Morocco. Electronic address: raheelqamar@hotmail.com.
Jazyk: angličtina
Zdroj: Microbial pathogenesis [Microb Pathog] 2023 Nov; Vol. 184, pp. 106363. Date of Electronic Publication: 2023 Sep 18.
DOI: 10.1016/j.micpath.2023.106363
Abstrakt: Diabetic foot ulcer (DFU) is a neurological and peripherical complication of diabetes with unknown etiology that is often associated with polymicrobial infections. The present study was conducted to investigate the contributing factors in 285 DFU patients, which included 200 patients with diabetic foot infections (DFI). Identification and characterization of infecting bacterial isolates were done followed by assessment of their pattern of susceptibility to commonly used antibiotics. Among the studied subjects, type 2 diabetes mellitus (T2DM), ulcer type, depth, grade, loss of sensation, infection type, affected foot, recurrence, smoking status, Body Mass Index (BMI), and obesity levels revealed significant disease risk association. Ulcer grades 1 and 2 were more common in males while grade 3 in females. Recurrent infections were significantly higher in females (P = 0.03). Diabetic duration, hyperglycemia, ulcer type, infection type and BMI were positively correlated with delayed wound healing. In DFI samples, 40.2% consisted of gram-negative bacteria, with Pseudomonas aeruginosa (37.5%) being the most common, while in the 60% gram-positive isolates Staphylococcus aureus (40.5%) was the predominant species. Staphylococcus epidermidis was found more frequently in females (P = 0.05). The isolated bacterial strains presented higher resistance against the tested antibiotics; however, ceftriaxone was effective against most of the pathogens. In the current study T2DM along with diabetes duration, obesity, ulcer severity with polymicrobial infection was found to play a strong role in DFI development, where gender predisposition was also observed in ulcer grade and infection. DFI was correlated with loss of sensation, infection type, affected foot, smoking status, BMI and obesity levels.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
Externí odkaz: