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

Lilian Akwah; Fokunang Ntungwen Charles; Elias Nukenine Nchinwan; Emmanuel Kagning Tsinda; Armel Herve Nwabo Kamdje

doi:doi:10.11648/j.jdmp.20150104.11

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

Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje

Published in Journal of Diseases and Medicinal Plants (Volume 1, Issue 4)

Received: 18 August 2015 Accepted: 28 August 2015 Published: 2 September 2015

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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 Yaoundé 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.

Published in	Journal of Diseases and Medicinal Plants (Volume 1, Issue 4)
DOI	10.11648/j.jdmp.20150104.11
Page(s)	53-58
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Diabetic Foot Ulcer, Bacterial Profile, Antibiotic Sensitivity

References

[1]	AK Pappu, A Sinha, A Johnson. Microbiological profile of diabetic foot ulcer. Calicut Med Journal. 2011;9(3):e1–4.
[2]	S Shakil, AU Khan. Infected foot ulcers in male and female diabetic patients: A clinico-bioinformative study. Ann Clin Microbiol Antimicrob. 2010;9:1–10
[3]	U Sivaraman, S Kumar, NM Joseph, JM Easow, G Kandhakumari. Microbiological study of diabetic foot infections. Indian J Med Specialities. 2011;2(1):12–17.
[4]	DM Citron, EJC Goldstein, VC Merriam, BA Lipsky. Bacteriology of moderate to severe diabetic foot infections and invitro activity of antimicrobial agents. J Clin Microbiol. 2007;45(9):2819–28.
[5]	M Zubair, A Malik, J Ahmad. Clinico-bacteriology and risk factors for the diabetic foot infection with multidrug resistant microorganisms in North India. Biol Med. 2010;2(4):22–34.
[6]	SE Dowd, DW Randall, Yan Sun, T McKeehan, E Smith. Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP) PLoS ONE. 2008;3(10):e3326–32.
[7]	N Ahmed. (2005). Advanced glycation end products--role in pathology of diabetic
[8]	VK Sharma, PB Khadka, A Joshi, R Sharma. Common pathogens isolated in diabetic foot infection in Bir Hospital. Kathmandu Univ Med J (KUMJ). 2006 Jul-Sep;4(3):295-301.
[9]	J. Vimalin Hena, Lali Growther, Studies On Bacterial Infections Of Diabetic Foot Ulcer. 2010. Afr. J. cln. Exper. Microbiol 11(3): 146-149
[10]	AS Ayat, A H Khan., N Masood, N Shaikh, 2011. Study for microbiological pattern and in vitro antibiotic susceptibility in patients having diabetic foot infections at Tertiary Care Hospital in Abbottabad. World Appl. Sci. J., 12: 123 131
[11]	V Viswanathan, JJ Jasmine, C Snehalatha, A Ramachandran. Prevalence of pathogens in diabetic foot infection in South Indian type 2 diabetic patients. J Assoc Physicians India. 2002 Aug;50:1013-6.
[12]	Gadepalli R, Dhawan B, Sreenivas V, Kapil A, Ammini AC. A clinicomicrobiological study of diabetic foot ulcers in an Indian tertiary care hospital. DiabetesCare. 2006;29(8):1727–32.
[13]	AK Ako-Nai, IC Ikem, OO Akinloye, AO Aboderin, RT Ikem, OO Kassim, 2006. Characterization of bacterial isolates from diabetic foot infections in IleIfe, Southwestern Nigeria. The Foot, 16 (3): 158-164.
[14]	Shanker EM, Mohan V, Premalatha G, Srinivasan RS, Usha AR. Bacterial etiology of diabetic foot infection in south India. Eur J Int Med. 2005; 16:567–70]
[15]	MA Seyed, D Azar S Abdulah, A Dashtebozorg, EA Montazeri, Pak J Med Sci October - December 2007 (Part-I) Vol. 23 No. 5 681-684
[16]	K V Kavitha, S Tiwari, V Bharat Purandare, S Khedkar, S SBhosale, and A G Unnikrishnan. Choice of wound care in diabetic foot ulcer: A practical approach. World J Diabetes. 2014 Aug 15; 5(4): 546–556.Published online 2014 Aug 15. doi: 10.4239/wjd.v5.i4.546
[17]	E Bansal, A Garg, S Bhatia, AK Attri, J Chander. Spectrum of microbial flora in diabetic foot ulcers. Indian J Pathol Microbiol. 2008 Apr-Jun;51(2):204-8.
[18]	C Anandi, D Alaguraja, V Natarajan, M Ramanathan, CS Subramaniam, M Thulasiram, S Sumithra, Bacteriology of diabetic foot lesions. Indian J Med Microbiol 2004;22:175-8
[19]	P Ramakant, AK Verma, R Misra, KN Prasad. Changing Microbiological profile of pathogenic bacteria in diabetic foot infections: time to rethink on which empirical therapy to choose? Diabetologica. 2011;54(1):58–64
[20]	AK Pappu, A Sinha, A Johnson. Microbiological profile of diabetic foot ulcer. Calicut Med Journal. 2011;9(3):e1–4.
[21]	DM Citron, EJC Goldstein, VC Merriam, BA Lipsky. Bacteriology of moderate to severe diabetic foot infections and invitro activity of antimicrobial agents. J Clin Microbiol. 2007;45(9):2819–28
[22]	NS Raja. Microbiology of diabetic foot infections in a teaching hospital in Malaysia: A retrospective study of 194 cases. J Microbiol immunol infect. 2007;40(1):39–44.
[23]	F A Orji, N C Nwachukwu, and E C Udora, Bacteriological evaluation of diabetic ulcers in Nigeria, African Journal of Diabetes Medicine. 2009 DI-416 Orji.indd.

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Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje. (2015). Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). Journal of Diseases and Medicinal Plants, 1(4), 53-58. https://doi.org/10.11648/j.jdmp.20150104.11

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Lilian Akwah; Fokunang Ntungwen Charles; Elias Nukenine Nchinwan; Emmanuel Kagning Tsinda; Armel Herve Nwabo Kamdje. Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). J. Dis. Med. Plants 2015, 1(4), 53-58. doi: 10.11648/j.jdmp.20150104.11

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Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje. Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). J Dis Med Plants. 2015;1(4):53-58. doi: 10.11648/j.jdmp.20150104.11

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@article{10.11648/j.jdmp.20150104.11,
  author = {Lilian Akwah and Fokunang Ntungwen Charles and Elias Nukenine Nchinwan and Emmanuel Kagning Tsinda and Armel Herve Nwabo Kamdje},
  title = {Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon)},
  journal = {Journal of Diseases and Medicinal Plants},
  volume = {1},
  number = {4},
  pages = {53-58},
  doi = {10.11648/j.jdmp.20150104.11},
  url = {https://doi.org/10.11648/j.jdmp.20150104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jdmp.20150104.11},
  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 Yaoundé 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.},
 year = {2015}
}

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TY - JOUR
T1 - Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon)
AU - Lilian Akwah
AU - Fokunang Ntungwen Charles
AU - Elias Nukenine Nchinwan
AU - Emmanuel Kagning Tsinda
AU - Armel Herve Nwabo Kamdje
Y1 - 2015/09/02
PY - 2015
N1 - https://doi.org/10.11648/j.jdmp.20150104.11
DO - 10.11648/j.jdmp.20150104.11
T2 - Journal of Diseases and Medicinal Plants
JF - Journal of Diseases and Medicinal Plants
JO - Journal of Diseases and Medicinal Plants
SP - 53
EP - 58
PB - Science Publishing Group
SN - 2469-8210
UR - https://doi.org/10.11648/j.jdmp.20150104.11
AB - 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 Yaoundé 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.
VL - 1
IS - 4
ER -

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Author Information

Lilian Akwah

Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon
Fokunang Ntungwen Charles

Department of Pharmacotoxicology and Pharmacokinetics, University of Yaounde I, Yaounde, Cameroon
Elias Nukenine Nchinwan

Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon
Emmanuel Kagning Tsinda

Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon
Armel Herve Nwabo Kamdje

Department of Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon

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APA Style

Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje. (2015). Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). Journal of Diseases and Medicinal Plants, 1(4), 53-58. https://doi.org/10.11648/j.jdmp.20150104.11

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ACS Style

Lilian Akwah; Fokunang Ntungwen Charles; Elias Nukenine Nchinwan; Emmanuel Kagning Tsinda; Armel Herve Nwabo Kamdje. Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). J. Dis. Med. Plants 2015, 1(4), 53-58. doi: 10.11648/j.jdmp.20150104.11

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AMA Style

Lilian Akwah, Fokunang Ntungwen Charles, Elias Nukenine Nchinwan, Emmanuel Kagning Tsinda, Armel Herve Nwabo Kamdje. Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon). J Dis Med Plants. 2015;1(4):53-58. doi: 10.11648/j.jdmp.20150104.11

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@article{10.11648/j.jdmp.20150104.11,
  author = {Lilian Akwah and Fokunang Ntungwen Charles and Elias Nukenine Nchinwan and Emmanuel Kagning Tsinda and Armel Herve Nwabo Kamdje},
  title = {Bacteriology of Diabetic Foot Ulcers with Reference to Multidrug Resistance Strains at the Yaounde Central Hospital (Cameroon)},
  journal = {Journal of Diseases and Medicinal Plants},
  volume = {1},
  number = {4},
  pages = {53-58},
  doi = {10.11648/j.jdmp.20150104.11},
  url = {https://doi.org/10.11648/j.jdmp.20150104.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jdmp.20150104.11},
  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 Yaoundé 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.},
 year = {2015}
}

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