Microbial detection and antibiotic resistance in diabetic foot infections: A comparative study between diabetic patients and healthy individuals

Abstract:

Foot ulcers associated with diabetes are one of the most serious and limiting complications of the disease. They are often complicated by multiple and complex microbial infections, and the number of these infections is increasing due to the rise of antibiotic resistance. Skin microbiome disorders are now recognized as significant contributors to disease pathogenesis and disruption of wound healing.

This study aims to thoroughly identify the microbial composition of the skin in individuals who have diabetic foot ulcers in comparison to both individuals with type 2 diabetes and healthy subjects. It also seeks to assess the susceptibility of the bacteria isolated from the skin of people with diabetic foot ulcers to various antibiotics.

Three groups were studied, including diabetic foot ulcer patients, people with Type 2 Diabetes, and those without any issues, for this research project. Sample collection involved using sterile swabs and placing the samples in selective media for bacterial growth.

Traditional microbiological lab techniques were utilized to identify the bacterial isolates. The identity was subsequently confirmed using the Vitek Compact 2 automated identifications system. Antibiotic susceptibility testing was conducted according to CLSI standards and statistical analysis using ANOVA.

Results indicate that Staphylococcus aureus was found in 100% of samples from each of the groups with count results reflecting higher counts in persons with diabetic foot ulcers (4.328 log CFU/cm²) compared to those who were healthy (2.028 log CFU/cm²). Healthy individuals did not show any detection of intestinal bacteria; however, there was an increase of 1.367 log CFU/cm² of intestinal bacteria in individuals with diabetic foot ulcers. Furthermore, diabetic foot infections contained a greater variety of Gram-negative species such as Klebsiella pneumoniae and Acinetobacter spp than seen in healthy individuals.

Antibiotic susceptibility testing showed that Ampicillin and Ciprofloxacin had higher levels of resistance than either Amikacin or Imipenem, which had greater effectiveness against all tested bacteria. Multidrug resistant (MDR) isolates were more prevalent in the gram-negative group compared to gram-positive.

The current research has shown significant differences in the skin microbiome of patients who have developed diabetic foot ulcers and there is also an increase in the number of antibiotic-resistant bacterial strains found in the skin of these individuals. The findings highlight the importance of having a regular microbiological assessment and antibiotic susceptibility testing performed on a routine basis in order to help to make evidence-based decisions regarding the use of antibiotics for treatment, thereby reducing the likelihood of complications.