Microbiology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh.
Biotechnology Program, Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh.
PLoS One. 2024 May 17;19(5):e0301767. doi: 10.1371/journal.pone.0301767. eCollection 2024.
The primary objective of this study was to isolate bacteria from diabetic foot ulcers and subsequently assess their antibiotic resistance capabilities. Seventy-five patients diagnosed with diabetic foot ulcers were investigated. A number of these patients (97.33%) had type 2 diabetes, with a significant proportion of them having been diagnosed for 1-5 years (29.33%). Notably, a substantial number of these individuals were on insulin usage (78.66%). Among the patients under examination, 49.33% reported having no use of tobacco products, alcohol, or betel leaf. The ulcers analyzed in this study were classified into grades 1-5 according to the Wagner scale. Wagner grade 2 diabetic foot ulcers had the highest number of culture-positive patients, at 33.33%. Pus samples collected from patients were cultured on selective media, and bacterial identity was confirmed by biochemical tests and polymerase chain reaction. A total of 141 isolates were isolated. Among the isolates, 82.97% gram-negative bacteria and 17.02% gram-positive bacteria were detected. Klebsiella pneumoniae was the most common isolate. Proteus spp., Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were also detected. Approximately 61.33% of the ulcers exhibited were polybacterial. In this study, it was observed that all bacterial isolates, except for Proteus spp., were primarily detected in patients classified under Wagner's grade 2. Moreover, antibiotic susceptibility was also tested on these 141 isolates. Among them, Escherichia coli showed the highest multidrug resistance, 81.81%. Most of the gram-negative bacteria were resistant to ampicillin. All of the gram-negative isolates exhibited high levels of susceptibility to piperacillin-tazobactam, and these levels were Klebsiella pneumoniae (97.56%), Pseudomonas aeruginosa (95.24%), Escherichia coli (81.82%), and Proteus spp. (80%). On the other hand, gram-positive Staphylococcus aureus mostly showed sensitivity towards vancomycin and norfloxacin (79.17%).
本研究的主要目的是从糖尿病足溃疡中分离细菌，并随后评估其抗生素耐药能力。对 75 名被诊断为糖尿病足溃疡的患者进行了调查。其中许多患者（97.33%）患有 2 型糖尿病，其中相当一部分患者的患病时间为 1-5 年（29.33%）。值得注意的是，这些患者中有相当一部分人正在使用胰岛素（78.66%）。在接受检查的患者中，有 49.33%的人没有使用烟草制品、酒精或槟榔叶。本研究中分析的溃疡根据 Wagner 量表分为 1-5 级。Wagner 2 级糖尿病足溃疡的培养阳性患者最多，为 33.33%。从患者身上采集的脓液样本在选择性培养基上进行培养，通过生化试验和聚合酶链反应确认细菌身份。共分离出 141 株。在分离株中，检测到 82.97%的革兰氏阴性菌和 17.02%的革兰氏阳性菌。肺炎克雷伯菌是最常见的分离株。还检测到变形杆菌属、大肠杆菌、铜绿假单胞菌和金黄色葡萄球菌。大约 61.33%的溃疡呈多细菌感染。在本研究中，观察到所有细菌分离株，除变形杆菌属外，主要存在于 Wagner 2 级分类的患者中。此外，还对这 141 株分离株进行了抗生素敏感性测试。其中，大肠杆菌的多药耐药率最高，为 81.81%。大多数革兰氏阴性菌对氨苄西林耐药。所有革兰氏阴性菌对哌拉西林-他唑巴坦均高度敏感，其中肺炎克雷伯菌（97.56%）、铜绿假单胞菌（95.24%）、大肠杆菌（81.82%）和变形杆菌属（80%）的敏感性最高。另一方面，革兰氏阳性金黄色葡萄球菌对万古霉素和诺氟沙星（79.17%）的敏感性最高。
