Abstract

MRSA, MRCONS AND ANTIBIOTIC RESISTANT PATTERNS OF BACTERIA RECOVERED FROM INFECTED DIABETIC FOOT AS CORRELATED TO RISK FACTORS

Mohammed Shakir Ali and Hadeel AL-Hadithi*

ABSTRACT

Aim of the study: To identify bacteria infecting diabetic foot (DFI); principally methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative Staphylococci (MRCoNS); correlate their frequencies with risk factors, and study their antibiotics resistance patterns. Patients and Methods: Samples from DFI lesions of outpatients attending National Centre for Diabetes Endocrinology and Genetics / The University of Jordan were cultured onto a number of bacteriological media. MRSA and MRCoNS were detected on Mannitol salt agar supplemented with 6μg/ml Oxacillin. Assortment of antibiotics against recovered Gram positive and Gram negative were examined to explore antibiotic resistance patterns. Results: DFI was more prevalent in elderly patients aged > 50years (88.6%), HbAIC was uncontrolled in 70.0% patients and 47.1% have a duration of diabetes for more than 30 years. A significant correlation was found between HbAlC values with gender and diet (p<0.05). Duration of foot infection ranges from < month to > 1 yr. S.aureus was the predominating bacteria (51.4%) followed by CoNs (47.1%), Enterococcus (12.9%) and Group B streptococci (11.4%). Incidence of MRSA and MRCoNs was 40 % and 30% respectively. The highest percentage recovery of MRSA (75%) and MRCoNs (50%) was amongst DFI duration of 6 months - 1year. Incidence of major Gram negative bacteria as following: Proteus mirabilis 18.6%, Pseudomonas aeruginosa14.3%, and Acinetobacter spp.7.1%. Multiple drug resistant organisms (MDROs) were prevalent at alarming levels. Conclusions: Results reflect the importance of throwing light on MRCoNs (Reported for the first time from DFI lesions in Arabic Region) alongside with MRSA. Besides, it is crucially important to investigate the extent of MDROS prevalence on individual basis for accurate treatment.

Keywords: DFI, MRSA MRCoNS, MDROS, Antibiotic Resistant Patterns.