Phenotypic Profiling of Selected Bacterial Microbes Isolated from Wounds of Diabetic Patients at Jaramogi Oginga Odinga Teaching & Referral Hospital, Kenya

Abstract

Aims: To phenotypically profile selected bacteria microbes, determine antimicrobial resistance patterns and genetic diversity of resistant genes encoding extended spectrum β-lactamases in bacteria isolated from wounds of diabetes mellitus patients at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), Kenya.
 Study Design: A hospital based cross sectional study design.
 Place and Duration of Study: Jaramogi Oginga Odinga Teaching and Referral Hospital, Kenya between September, 2019 and February, 2020.
 Methodology: Pus swabs were collected for isolation of bacteria using conventional techniques and serology involving 117 patients. Samples collected were inoculated onto MacConkey agar, pseudomonas agar media (cetrimide) and blood agar plates then incubated aerobically at 37∘C for 18hours to 24hours. Inoculated plates were examined for growth after 24-48 hours. After attaining pure colonies, Gram staining, colony morphology, and biochemical testing were done. Biochemical tests involving Catalase, Coagulase, Indole, Oxidase, Urease, Citrate utilization tests were done to identify specific bacterial species according to microbiological standard procedures.
 Results: The results of analysis showed that the prevalence of Gram positive cocci isolated from diabetic wounds was 34.2% while the prevalence for Gram negative rods was 65.8%. The biochemically profiled bacterial microbes were S. aureus, E. coli, P. aeruginosa, K. pneumoniae and Proteus species. S. aureus was the most commonly isolated bacteria with a prevalence of 34.2%. P. aeruginosa had a prevalence of 24(20.5%), K. pneumoniae 22(18.8%), Proteus species 18(15.4 %) and E. coli 13(11.1%). More importantly, the prevalence basing on chi-square results was significantly associated with education level, age, smoking habit, patient setting, drug uptake and hospital visit at 5% level of significance (). 
 Conclusion: Diabetic patients with wounds at JOOTRH, Kenya are more exposed to Gram negative rods infection. The most prevalent Gram negative rod was P. aeruginosa with Its prevalence associated with the patient’s education level, smoking habit, patient setting, irregular hospital visit and adherence to taking of prescribe antibiotics regularly. Therefore, JOOTRH, Kenya healthcare providers are urged to initiate wound infection preventive measures that may include awareness campaigns on the importance of wound management, regular hospital visits, stopping smoking and regular uptake of prescribed drugs.