scholarly journals Bacterial ecology and antibiotic resistance mechanisms of isolated resistant strains from diabetic foot infections in the north west of Algeria

Author(s):  
Bakhta Bouharkat ◽  
Aicha Tir Touil ◽  
Catherine Mullié ◽  
Nadia Chelli ◽  
Boumediene Meddah
2015 ◽  
Vol 59 (3) ◽  
pp. 1751-1754 ◽  
Author(s):  
Robert K. Flamm ◽  
Paul R. Rhomberg ◽  
Katie M. Simpson ◽  
David J. Farrell ◽  
Helio S. Sader ◽  
...  

ABSTRACTPexiganan, a 22-amino-acid synthetic cationic peptide, is currently in phase 3 clinical trials as a topical antimicrobial agent for the treatment of mild infections associated with diabetic foot ulcers. Bacterial isolates from the 2013 SENTRY Antimicrobial Surveillance Program designated as pathogens from diabetic foot infections (DFI) and Gram-negative and -positive pathogens from various infection types that harbored selected resistance mechanisms/phenotypes were tested against pexiganan in reference cation-adjusted Mueller-Hinton broth. The MIC50and MIC90against all organisms tested from DFI were 16 and 32 μg/ml, respectively.Escherichia coli,Klebsiella pneumoniae,Citrobacter koseri,Enterobacter cloacae,Acinetobacterspecies, andPseudomonas aeruginosaMIC values ranged from 8 to 16 μg/ml. Pexiganan MIC values amongStaphylococcus aureus(methicillin-resistantS. aureus[MRSA] and methicillin-susceptibleS. aureus[MSSA]), beta-hemolytic streptococci, andEnterococcus faeciumranged from 8 to 32 μg/ml. Pexiganan activity was not adversely affected for members of the familyEnterobacteriaceaeorP. aeruginosathat produced β-lactamases or resistance mechanisms to other commonly used antimicrobial agents. Decreased susceptibility to vancomycin did not affect pexiganan activity againstS. aureusorE. faecium.Enterococcus faecalisappears to be intrinsically less susceptible to pexiganan (MIC, 32 to 256 μg/ml). The “all organism” MIC90of 32 μg/ml for pexiganan in this study was >250-fold below the pexiganan concentration in the cream/delivery vehicle being developed for topical use.


2021 ◽  
Vol 24 (3) ◽  
pp. 192
Author(s):  
Casadidio, I.

The diabetic foot can be treated only if you know how to work as a team and the diabetologist, the natural referent of the clinical case, has to create a multiprofessional/multidisciplinary team that can manage the patient to prevent injuries and treat them if they show up. The creation of structured diagnostic-therapeutic paths guarantees a better coordination of the professional figures involved, optimizes the management of the direct and indirect resources required to manage such a clinically challenging complication. After many years of activity we have built a solid integration between diabetologist and orthopedic, between hospital and territory and we have simplified a complex path. The fulcrum of this activity is the joint orthopaedic clinic that guarantees the correct care of the patient and allows the professional growth of the whole team. KEY WORDS diabetic foot; integrated management; PDTA; team.


2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Frank Eric Tatsing Foka ◽  
Collins Njie Ateba

The misuse/abuse of antibiotics in intensive animal rearing and communities led to the emergence of resistant isolates such as vancomycin-resistant enterococci (VREs) worldwide. This has become a major source of concern for the public health sector. The aim of this study was to report the antibiotic resistance profiles and to highlight the presence of virulence genes in VREs isolated from feedlots cattle of the North-West Province of South Africa. 384 faecal samples, 24 drinking troughs water, and 24 soil samples were collected aseptically from 6 registered feedlots. Biochemical and molecular methods were used to identify and categorise the enterococci isolates. Their antibiotic resistance profiles were assessed and genotypic methods were used to determine their antibiotic resistance and their virulence profiles. 527 presumptive isolates were recovered, out of which 289 isolates were confirmed asEnterococcussp. Specifically,E. faecalis(9%),E. faecium(10%),E. durans(69%),E. gallinarum(6%),E. casseliflavus(2%),E. mundtii(2%), andE. avium(2%) were screened after molecular assays.VanA(62%),vanB(17%), andvanC(21%) resistance genes were detected in 176Enterococcussp., respectively. Moreover,tetK(26),tetL(57),msrA/B(111), andmefA(9) efflux pump genes were detected in 138 VRE isolates.Multiple antibiotic resistances were confirmed in all the VRE isolates of this study; the most common antibiotic resistance phenotype wasTETR-AMPR-AMXR-VANR-PENR-LINR-ERYR.CylA,hyl,esp,gelE, andasa1virulence genes were detected in 86 VREs with the exception of vancomycin-resistantE. mundtiiisolates that did not display any virulence factor. Most VRE isolates had more than one virulence genes but the most encountered virulence profile wasgelE-hyl. Potentially pathogenic multidrug resistant VREs were detected in this study; this highlights the impact of extensive usage of antimicrobials in intensive animal rearing and its implications on public health cannot be undermined.


2018 ◽  
Vol 108 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Carla D. McArdle ◽  
Katie M. Lagan ◽  
David A. McDowell

Background: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs. Methods: Thirty bacterial isolates were recovered from DFU wound fluid, including Staphylococcus spp, Staphylococcus aureus, Escherichia coli, Streptococcus spp, Pseudomonas spp, and Pseudomonas aeruginosa. The resistances of these isolates to a panel of antibiotics currently used in the treatment of infected or potentially infected DFUs, ie, ciprofloxacin, amoxicillin-clavulanate, doxycycline, and piperacillin-tazobactam, at the previously mentioned pH values were determined by a modification of the Kirby-Bauer assay. Results: The resistance of DFU isolates to clinically relevant antibiotics was significantly affected by the pH levels in DFU wound fluid. Conclusions: These findings highlight the importance of a more comprehensive understanding of the conditions in DFUs to inform clinical decision making in the selection and application of antibiotics in treating these difficult-to-heal wounds. The scale of the differences in the efficacies of antibiotics at the different pH values examined is likely to be sufficient to suggest reconsideration of the antibiotics of choice in the treatment of DFU infection.


2016 ◽  
Vol 30 (5) ◽  
pp. 910-916 ◽  
Author(s):  
Mustafa Hatipoglu ◽  
Mesut Mutluoglu ◽  
Vedat Turhan ◽  
Gunalp Uzun ◽  
Benjamin A. Lipsky ◽  
...  

2015 ◽  
Vol 48 (5) ◽  
pp. 546-554 ◽  
Author(s):  
Michele Cezimbra Perim ◽  
Joelma da Costa Borges ◽  
Stela Regina Costa Celeste ◽  
Ederson de Freitas Orsolin ◽  
Rafael Rocha Mendes ◽  
...  

2017 ◽  
Vol 16 (4) ◽  
pp. 255-259 ◽  
Author(s):  
Maria Demetriou ◽  
Nikolaos Papanas ◽  
Periklis Panagopoulos ◽  
Maria Panopoulou ◽  
Efstratios Maltezos

Diabetic foot infections are a common and serious problem for all health systems worldwide. The aim of this study was to examine the resistance to antibiotics of microorganisms isolated from infected soft tissues of diabetic foot ulcers, using tissue cultures. We included 113 consecutive patients (70 men, 43 women) with a mean age of 66.4 ± 11.2 years and a mean diabetes duration of 14.4 ± 7.6 years presenting with diabetic foot soft tissue infections. Generally, no high antibiotic resistance was observed. Piperacillin-tazobactam exhibited the lowest resistance in Pseudomonas, as well as in the other Gram-negative pathogens. In methicillin-resistant Staphylococcus aureus isolates, there was no resistance to anti-Staphylococcus agents. Of note, clindamycin, erythromycin, and amoxycillin/clavulanic acid exhibited high resistance in Gram-positive cocci. These results suggest that antibiotic resistance in infected diabetic foot ulcers in our area is not high and they are anticipated to prove potentially useful in the initial choice of antibiotic regimen.


Author(s):  
DÊNISSON GUEDES PONTES ◽  
IVAN TRAMUJAS DA COSTA E SILVA ◽  
JESSICA JANSEN FERNANDES ◽  
AMANDA DE FÁTIMA GURGEL MONTEIRO ◽  
PEDRO HENRIQUE DA SILVA GOMES ◽  
...  

ABSTRACT Purpose: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. Methods: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. Results: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. Conclusions: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.


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