Prevalence and Antibiotic Susceptibility Pattern of Pseudomonas Aeruginosa from the Foot Ulcer of Diabetic Patients in Hayatabad Medical Complex Peshawar, Pakistan
DOI:
https://doi.org/10.61919/jhrr.v4i2.877Keywords:
Antibiotic resistance, Diabetic foot ulcers, Pseudomonas aeruginosa, Susceptibility testing, PeshawarAbstract
Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, affecting 15% of diabetic patients and often leading to severe outcomes like amputation. These ulcers frequently become infected with bacteria such as Pseudomonas aeruginosa, which is known for its robust antibiotic resistance.
Objective: To investigate the prevalence and antibiotic susceptibility patterns of Pseudomonas aeruginosa isolated from the foot ulcers of diabetic patients in Hayatabad Medical Complex, Peshawar.
Methods: A total of 103 clinical samples from diabetic foot ulcers were collected and analyzed for the presence of Pseudomonas aeruginosa using culture techniques and biochemical tests. The antibiotic susceptibility was assessed using the Kirby-Bauer disk diffusion method to identify effective treatments.
Results: Pseudomonas aeruginosa was identified in 48 (46.60%) of the samples. High resistance was noted against amoxicillin-clavulanic acid (100%), and notable sensitivity was observed to gentamicin (79.16%) and cefoperazone-sulbactam (87.5%). The susceptibility to other tested antibiotics varied, with moderate resistance seen in agents like cefotaxime (25%) and trimethoprim-sulfamethoxazole (33.33%).
Conclusion: The study highlights a significant presence of Pseudomonas aeruginosa in diabetic foot ulcers with substantial antibiotic resistance, emphasizing the need for precise susceptibility testing to guide effective treatment strategies.
Downloads
References
Radji M, Putri CS, Fauziyah S. Antibiotic therapy for diabetic foot infections in a tertiary care hospital in Jakarta, Indonesia. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2014;8(4):221-4.
Pendsey SP. Understanding diabetic foot. Int J Diabetes Dev Ctries. 2010;30(2):75.
Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al. Prevalence of diabetes among men and women in China. New England journal of medicine. 2010;362(12):1090-101.
Gangawane A, Bhatt B, Sunmeet M. Skin infections in diabetes: a review. Diabetes Metab. 2016;7(2).
Pappas P. Infectious Diseases Society of America. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:503-35.
Ahmad J, Ahmad S. Simultaneous Application Of Non-Antibiotics With Antibiotics For Enhanced Activity Against Multidrug Resistant Pseudomonas Aeruginosa.
Inzucchi S, Sherwin R. Type 2 diabetes mellitus Cecil Medicine. Philadelphia (PA): Saunders Elsevier; 2011.
Javed S, Ahmad J, Zareen Z, Iqbal Z, Hubab M, Rehman MU, et al. Study on awareness, knowledge, and practices towards antibiotic use among the educated and uneducated people of Khyber Pakhtunkhwa Province, Pakistan. ABCS Health Sciences. 2023;48:e023218-e.
Clayton Jr W, Elasy TA. A review of the pathophysiology, classification, and treatment of foot ulcers in diabetic patients. Clin Diabetes. 2009;27(2):52-8.
Sohail M. Antibacterial Activity of Aqueous Plant Extracts and Honey against UTI causing Superbugs. Tobacco Regulatory Science (TRS). 2022:2010-9.
Sahay B. Infections in Diabetes Mellitus. Diabetes Mellitus. 2010:1-3.
Stanley MM. Bacillus pyocyaneus infections: a review, report of cases and discussion of newer therapy including streptomycin. The American journal of medicine. 1947;2(3):253-77.
Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol. 1999;26(3-4):259-65.
Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes/metabolism research and reviews. 2007;23(1):3-13.
Khardori N. Antibiotics—past, present, and future. Medical Clinics. 2006;90(6):1049-76.
Aziz A, Zahoor M, Aziz A, Asghar M, Ahmad J, Islam G. Identification of Resistance Pattern in Different Strains of Bacteria causing Septicemia in Human at Lady Reading Hospital of Khyber Pakhtunkhwa. Pakistan Journal of Medical & Health Sciences. 2022;16(08):687-.
Abdullah M. Effect of Pure and Ethanol Extract of Aloe Vera and Moringa against Streptococcusagalactiae and Staphylococcusaureus Isolated from Mastitis Milk of Buffalo. Tobacco Regulatory Science (TRS). 2022:959-76.
Ninama GL, Mistry K, Parmar R, Patel K, Vegad M. Antibiotic resistance pattern in Pseudomonas aeruginosa species isolated at a tertiary care hospital, Ahmadabad. National journal of medical research. 2012;2(02):156-9.
Ratemo NK. Antimicrobial susceptibility pattern of bacterial isolates from pus samples at Kenyatta National Hospital, Kenya: University of Nairobi; 2014.
Sivanmaliappan TS, Sevanan M. Antimicrobial susceptibility patterns of Pseudomonas aeruginosa from diabetes patients with foot ulcers. Int J Microbiol. 2011;2011.
Toda M, Okubo S, Hiyoshi R, Shimamura T. The bactericidal activity of tea and coffee. Letters in applied microbiology. 1989;8(4):123-5.
Edmonds M, Foster A. The use of antibiotics in the diabetic foot. The American journal of surgery. 2004;187(5):S25-S8.
Aziz A. Isolation and Identification of MDR Solmonella Typhi from Different Food Products in District Peshawar, KPK, Pakistan. Tobacco Regulatory Science (TRS). 2022:555-72.
Ahamd J, Khan W, Khan MK, Shah K, Yasir M, Ullah I, et al. Antimicrobial resistant and sensitivity profile of bacteria isolated from raw milk in peshawar, KPK, Pakistan. Annals of the Romanian Society for Cell Biology. 2022;26(01):364-74.
Ullah I, Khurshid H, Ullah N, Aziz I, Khan MJ, Khan BA, et al. Prevalence and antibiotic susceptibility pattern of Campylobacter species isolated from broiler chicken meat samples in district Bannu, Pakistan. Journal of Food Safety and Hygiene. 2019;5(4):230-6.
Claus D. A standardized Gram staining procedure. World J Microbiol Biotechnol. 1992;8:451-2.
Kumala W. Evaluation of the motility indole urease (MIU) test to detect Helicobacter pylori infection. Southeast Asian journal of tropical medicine and public health. 2006;37(5):966.
Khan MK, Arif MR, Ahmad J, Azam S, Khan RM, Ali MQ. Microbial Load And Antibiotic Susceptibility Profile Of Bacterial Isolates From Drinking Water In Peshawar, Pakistan. NVEO-NATURAL VOLATILES & ESSENTIAL OILS Journal| NVEO. 2021:4759-65.
Karmaker M, Sanyal SK, Sultana M, Hossain M. Association of bacteria in diabetic and non-diabetic foot infection–An investigation in patients from Bangladesh. Journal of infection and public health. 2016;9(3):267-77.
Qin X, Emerson J, Stapp J, Stapp L, Abe P, Burns JL. Use of real-time PCR with multiple targets to identify Pseudomonas aeruginosa and other nonfermenting gram-negative bacilli from patients with cystic fibrosis. Journal of clinical microbiology. 2003;41(9):4312-7.
Gaby W, Hadley C. Practical laboratory test for the identification of Pseudomonas aeruginosa. Journal of Bacteriology. 1957;74(3):356-8.
Winn WC, Allen S, Janda W. Koneman's color atlas and textbook of diagnostic microbiology: Lippincott Williams & wilkins. Philadelphia, PA[Google Scholar]. 2006.
Alshueli YJO, Alshammari MMM, Alwan MG. Determination of Parameters Required to Enhance the Production of Prodigiosin by Serratia Marcescens with The Antimicrobial Activities Evaluation. HIV Nursing. 2022;22(2):450-7.
Navaneeth B, Sridaran D, Sahay D, Belwadi M. A preliminary study on metallo-[beta]-lactamase producing Pseudomonas aeruginosa in hospitalized patients. Indian journal of Medical research. 2002;116:264.
Jones RN, Barry AL, Thornsberry C, Gerlach EH, Fuchs PC, Gavan TL, et al. Ceftazidime, a pseudomonas-active cephalosporin: in-vitro antimicrobial activity evaluation including recommendations for disc diffusion susceptibility tests. J Antimicrob Chemother. 1981;8(suppl_B):187-211.
Munawar M. Antibiotic susceptibility profile of Staphylococcus aureus and Micrococcus luteus isolated from tap water of hayatabad medical complex and Cantonment General Hospital Peshawar. Annals of the Romanian society for cell biology. 2021;25(7):1724-32.
Apelqvist J, Ragnarson‐Tennvall G, Larsson J, Persson U. Diabetic foot ulcers in a multidisciplinary setting An economic analysis of primary healing and healing with amputation. J Intern Med. 1994;235(5):463-71.
Kavitha KV, Tiwari S, Purandare VB, Khedkar S, Bhosale SS, Unnikrishnan AG. Choice of wound care in diabetic foot ulcer: A practical approach. World J Diabetes. 2014;5(4):546.
Riaz M, Miyan Z, Zaidi SI, Alvi S, Fawwad A, Ahmadani MY, et al. Characteristics and outcomes of subjects with diabetic foot ulceration. Diabetes Care. 2012;35(9).
Shahbazian H, Yazdanpanah L, Latifi SM. Risk assessment of patients with diabetes for foot ulcers according to risk classification consensus of International Working Group on Diabetic Foot (IWGDF). Pakistan journal of medical sciences. 2013;29(3):730.
Pociot F, McDermott M. Genetics of type 1 diabetes mellitus. Genes Immun. 2002;3(5):235-49.
Jain AKC. The menace of the green monster on the postoperative diabetic foot wounds. Medicine. 2017;6(2):384-8.
Najjad M, Idrees Z, Zamir M, Zeeshan S, Shah S. Pseudomonas as trespassers in diabetic foot infections: More questions and fewer answers. JPMA. 2014;64(Supplement 2):S112-S5.
Ozer B, Kalaci A, Semerci E, Duran N, Davul S, Yanat A. Infections and aerobic bacterial pathogens in diabetic foot. African Journal of Microbiology Research. 2010;4(20):2153-60.
Pappu AK, Sinha A, Johnson A. Microbiological profile of diabetic foot ulcer. Calicut Med Journal. 2011;9(3):1-4.
Hena J, Growther L. Studies on bacterial infections of diabetic foot ulcer. African Journal of Clinical and Experimental Microbiology. 2010;11(3).
Breidenstein EB, de la Fuente-Núñez C, Hancock RE. Pseudomonas aeruginosa: all roads lead to resistance. Trends Microbiol. 2011;19(8):419-26.
Allen HK, Donato J, Wang HH, Cloud-Hansen KA, Davies J, Handelsman J. Call of the wild: antibiotic resistance genes in natural environments. Nature reviews microbiology. 2010;8(4):251-9.
Van Eldere J. Multicentre surveillance of Pseudomonas aeruginosa susceptibility patterns in nosocomial infections. J Antimicrob Chemother. 2003;51(2):347-52.
Mesaros N, Nordmann P, Plésiat P, Roussel-Delvallez M, Van Eldere J, Glupczynski Y, et al. Pseudomonas aeruginosa: resistance and therapeutic options at the turn of the new millennium. Clinical microbiology and infection. 2007;13(6):560-78.
Idrees M, Naveed S, Hussain H, Sardar S, Yaseen M, Ullah H, et al. Prevalence Of Diabetes Mellitus And Chronic Kidney Disease Among General Population Of Peshawar. NVEO-NATURAL VOLATILES & ESSENTIAL OILS Journal| NVEO. 2021:5193-200.
URREHMAN AB, NAILA IU, JUNAID AHMAD ZA. A Review of Global Epidemiology and Antibiotic Resistance of Staphylococcus Aureus.
Fass RJ, Barnishan J, Solomon MC, Ayers LW. In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli. Antimicrobial agents and chemotherapy. 1996;40(6):1412-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Qasim Azam, Arbab Haroon, Mehboob Ullah, Noora Amir, Huma Imtiaz, Tanveer Tara, Farah Shireen, Nabila Qayum, Muhammad Jawad Ullah, Inam Ullah
This work is licensed under a Creative Commons Attribution 4.0 International License.
