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

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 Yaounde 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.