The Incidence of Methicillin Resistance Staphylococcus aureus in Diabetic Septic Foot

Abstract

Background: Foot infection is the most common problem in a person with diabetes. Infection in these patients is difficult to treat because these individuals have impaired microvascular supply, Which limits the access of phagocytic cell in the infected area and result in poor concentration of antibody in the infected tissue. Staphylococcus aureus is a major cause of potentially life-threatening infection which was acquired in the health care and community setting. These microorganisms have developed resistance against most classes of antibacterial agent as indicated by a dramatic increase in the number of healthcare-associated infection due to methicillin resistance S. aureus, which become endemic in hospitals worldwide. Methods: All collected samples were cultured directly on the blood and chocolate agar to primary isolation, then purified by several subcultures from a single well-isolated colony. Identification of isolated bacteria depends on gram reactions, organism morphology, colonial morphology in different media and biochemical tests-catalase test, coagulase test, DNase test, mannitol fermentation test, and VP test. The antimicrobial test was carried by disc diffusion method Kirby-Bauer method on Muller and Hinton media to several single antibiotic discs-Vancomycin, cloxacillin, Tobracillin, Ciprofloxacin, and Ceftriaxone. The inhibition zone was measured by ruler in millimeter the compared with incorporated chart. Results: A total of 50 diabetic patients with wound infection were including S. aureus n:20, 40% and other pathogens n:30,60%. Frequency of male was 43,86% while 7,14% were female. All patient were classified into two groups of age, one (35-55) with moderate frequency n:20, 40% and another age group (56-90) with the highest frequency n:30,60%. All isolated S. aureus were resisted cloxacillin while sensitive to vancomycin, 60% of them resist tobracillin 40% were sensitive and 10% resist ciprofloxacin 90% were sensitive, 25% were resisted ceftriaxone 75% were sensitive. Conclusion: MRSA is highly 40% prevalent among populations of S. aureus isolated from surgical site infection in Khartoum state. This study discusses the link between MRSA acquisition factors like age, sex, occupation, ethnicity, geographical location, hospitalization, antibiotic use, surgery and distinction community-acquired MRSA and hospital-acquired MRSA.