Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Asegdew Atlaw Woldeteklie; Habtamu Biazin Kebede; Abdurezak Ahmed Abdela; Yimtubezinash Woldeamanuel

doi:10.2147/IDR.S371431

Prevalence of Extended-Spectrum β-Lactamase and Carbapenemase Producers of Gram-Negative Bacteria, and Methicillin-Resistant Staphylococcus aureus in Isolates from Diabetic Foot Ulcer Patients in Ethiopia

Infect Drug Resist. 2022 Aug 11:15:4435-4441. doi: 10.2147/IDR.S371431. eCollection 2022.

Authors

Asegdew Atlaw Woldeteklie^{1

2}, Habtamu Biazin Kebede¹, Abdurezak Ahmed Abdela³, Yimtubezinash Woldeamanuel¹

Affiliations

¹ Department of Microbiology, Immunology, and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia.
² Department of Medical Laboratory Science, Debre Berhan College of Health Sciences, Debre Berhan, Ethiopia.
³ Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia.

Abstract

Background: Infectious diabetic foot ulcers (IDFU) are a widespread health issue that affects people all over the world. IDFU, like other medical disorders, can have negative implications if drug resistance develops. Clinicians will be able to choose the optimal antibiotics to treat impacted patients based on the antibiotic susceptibility pattern of bacterial strains. In this project, we attempted to evaluate the levels of extended-spectrum beta-lactamase (ESBL), carbapenemase, and MRSA in patients with diabetic foot ulcers.

Methods: A sterile swab was used to collect a sample from the leg ulcer, while a sterile needle was used to collect the aspirated pus. Bacteria identification and antibiotic susceptibility tests are carried out based on conventional bacterial culture. The double-disc inactivation method and modified carbapenem (meropenem) were used to screen the production of ESBL and carbapenemase.

Results: Of the 76 isolates tested, 53.9% (41/76) were phenotypically ESBL producers. K. pneumoniae 75% (6/8), Acinetobacter species 75% (9/12), Serratia species 75% (3/4), Pseudomonas species 64.3% (14/9), E. coli 57.8% (11/19), Citrobacter species 50% (2/4) and Proteus mirabilis 25% (1/4) had the highest frequency of ESBL production. Of the 68 GNB isolates tested, 27.9% (19/68) were carbapenemase-producing organisms. K. pneumoniae 62.5% (5/8), Serratia 50% (3/6), Acinetobacter species 40% (4/10), Pseudomonas species 23.5% (4/17) and E. coli 15.8% (3/19) are the top five major carbapenemase producers. In this study, 32 isolates of Staphylococcus aureus were tested for methicillin resistance. Among them, 81.3% (26/32) were methicillin-resistant Staphylococcus aureus (MRSA), and 18.7% (6/32) of the remaining isolates were methicillin-sensitive Staphylococcus aureus (MSSA).

Conclusion: The result draws attention to the management of diabetic foot ulcer infections based on the results of microbiological analysis and drug susceptibility testing.

Keywords: DFU; DM; ESBL; MRSA; carbapenemase; prevalence.

Grants and funding

The study work was funded by Addis Ababa University, College of Health Science. Data collection, study design, data analysis, and interpretation were all done without the involvement of the funder.