scholarly journals Epidemiology of Bacterial Contamination of Inert Hospital Surfaces and Equipment in Critical and Non-critical Care Units: A Brazilian Study

2020 ◽  
pp. 31-43
Author(s):  
Dayane Otero Rodrigues ◽  
Laís da Paixao Peixoto ◽  
Erica Tatiane Mourao Barros ◽  
Julianne Rodrigues Guimaraes ◽  
Bruna Clemente Gontijo ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Bacterial Contamination ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Hospital Environment ◽  
Cross Sectional ◽  
Adult Intensive Care Unit ◽  
Inert Surfaces

Aims: The hospital environment is an important reservoir of microorganisms, including multidrug-resistant pathogens, which can cause in-patient contamination and healthcare-related infections.  The objective of this study was to describe the epidemiology of bacterial contamination (contaminated sites, pathogen species and their antimicrobial susceptibility, and identifying of multidrug-resistant microorganisms - MDR) of inert hospital surfaces and medical equipment in two public hospitals in Northern Brazil. Methods: This was a cross-sectional study with 243 samples (n = 208, from Hospital A; and n = 35, from Hospital B) collected by friction with humidified swabs from inert surfaces and equipment. Sequentially the samples were cultivated and bacterial species were identified by culture-based methods and tested for their susceptibility through agar diffusion assay according to the Clinical and Laboratory Standards Institute (CLSI). Results: Most inert surfaces and equipment analyzed presented bacterial contamination (95.5%). Staphylococcus aureus was the main pathogen of clinical significance detected both in Hospital A (61.8%) and B (68.6%). Hospital A showed higher rates of isolated MDR bacteria than Hospital B, especially in the Adult Intensive Care Unit, which included methicillin-resistant Staphylococcus aureus (MRSA) (52.7%), Enterobacteria resistant to 4th generation cephalosporins (19.4%), and multidrug-resistant Pseudomonas aeruginosa (2.8%). Conclusion: The failures in the control of bacterial contamination of inert surfaces and equipment in the two hospitals analyzed reinforce the need for a revised protocol for cleaning and disinfection of the inert surfaces and equipment, and for regulation of antibiotic dispensing, mainly in the AICU of Hospital A, which was found to be a reservoir of MDR pathogens.

scholarly journals Epidemiology of bacterial contamination of inert hospital surfaces and equipment in critical and non-critical care units: a Brazilian multicenter study

2019 ◽  
Author(s):  
Dayane Otero Rodrigues ◽  
Laís da Paixão Peixoto ◽  
Erica Tatiane Mourão Barros ◽  
Julianne Rodrigues Guimarães ◽  
Bruna Clemente Gontijo ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Equipment ◽  
Bacterial Contamination ◽  
Bacterial Species ◽  
Brain Heart Infusion ◽  
Multidrug Resistant ◽  
Public Hospitals ◽  
Hospital Environment ◽  
Cross Sectional ◽  
Inert Surfaces

AbstractThe hospital environment is an important reservoir of microorganisms, including multidrug-resistant pathogens, which can cause in-patient contamination and healthcare-related infections. The objective of this study was to analyze the epidemiology of bacterial contamination (contaminated sites, pathogen species and their antimicrobial susceptibility, and tracking of multidrug-resistant microorganisms - MDR) of inert hospital surfaces and medical equipment in two public hospitals in Northern Brazil. This was a cross-sectional study with 243 samples (n = 208, from Hospital A; and n = 35, from Hospital B) collected by friction with swabs moistened in Brain Heart Infusion from inert surfaces and equipment. The samples were cultivated and bacterial species were identified by the classical approach and tested for their susceptibility through agar diffusion assay according to the Clinical and Laboratory Standards Institute (CLSI). Most inert surfaces and equipment analyzed presented bacterial contamination (95.5%). Staphylococcus aureus was the main pathogen of clinical significance detected both in Hospital A (61.8%) and B (68.6%). Hospital A showed higher rates of isolated MDR bacteria than Hospital B, especially in the Adult Intensive Care Unit, which included methicillin-resistant Staphylococcus aureus (MRSA) (52.7%), Enterobacteria resistant to 4th generation cephalosporins (19.4%), and multidrug-resistant Pseudomonas aeruginosa (2.78%). The failures in the prevention and control of infections in the two hospitals analyzed reinforce the need for a revised protocol for cleaning and disinfection of inert surfaces and medical equipment, and for regulation of antibiotic dispensing, mainly in the AICU of Hospital A, which was found to be a reservoir of MDR pathogens. This study is innovative because it is the pioneer in Western Bahia that describes the epidemiology of contamination of hospital surfaces, opportuning futures studies in this field.

scholarly journals Contamination of the Surfaces of a Health Care Environment by Multidrug-Resistant (MDR) Bacteria

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Laila Chaoui ◽  
RajaaAit Mhand ◽  
Fouad Mellouki ◽  
Naima Rhallabi
Keyword(s):  
Staphylococcus Aureus ◽  
Pathogenic Bacteria ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Health Care Environment ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Gram Negative

Nosocomial infections (NIs) are known worldwide and remain a major problem despite scientific and technical advances in the field of health. The severity of the infection depends on the characteristics of the microorganisms involved and the high frequency of resistant pathogens in the hospital environment. The aim of this study is to determine the distribution of pathogenic bacteria (and their resistance to antibiotics) that spread on hospital surfaces, more specifically, on those of various departments in the Provincial Hospital Center (PHC) of Mohammedia, Morocco. A cross-sectional study was conducted from March 2017 to April 2018. Samples were collected by swabbing the hospital surfaces, and the isolated bacteria were checked for their susceptibility to antibiotics by the Kirby–Bauer disk diffusion method following the standards of the Clinical and Laboratory Standards Institute (CLSI). Among 200 swab samples, 176 (88%) showed bacterial growth. Gram-negative isolates were predominant at 51.5% (101/196), while the Gram-positives were at 48.5% (95/196). The main isolates are Enterobacteria weighted at 31.6% (62/196), Staphylococcus aureus reaching 24% (47/196), Pseudomonas aeruginosa at 9.2% (18/196), and Acinetobacter spp. with 3.3% (6/196). Moreover, the antimicrobial susceptibility profile of the isolates showed that about 31.7% (32/101) of the Gram-negative isolates were found to be MDR. This resistance is also high among isolates of S. aureus of which 44.7% (20/47) were methicillin-resistant Staphylococcus aureus (MRSA). Contamination of hospital surfaces by MDR bacteria is a real danger to public health. The concept of environmental bacterial reservoir is a reality that requires strict compliance with current guidelines and recommendations for hand hygiene, cleaning, and disinfection of surfaces in hospitals.

scholarly journals Nasopharyngeal Carriage and Antimicrobial Susceptibility Profile of Staphylococcus aureus among Children under Five Years in Accra

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 136
Author(s):  
Nicholas T. K. D. Dayie ◽  
Mary-Magdalene Osei ◽  
Japheth A. Opintan ◽  
Patience B. Tetteh-Quarcoo ◽  
Fleischer C. N. Kotey ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Penicillin G ◽  
Nasopharyngeal Carriage ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance ◽  
Under Five

This cross-sectional study investigated the Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage epidemiology in Accra approximately five years post-pneumococcal conjugate vaccines introduction in the country. Archived nasopharyngeal swabs collected from 410 children aged under five years old were bacteriologically cultured. The resultant S. aureus isolates were subjected to antimicrobial susceptibility testing and screening for carriage of the mecA and LukF-PV (pvl) genes, following standard procedures. The data obtained were analyzed with Statistical Products and Services Solutions (SPSS) using descriptive statistics and Chi square tests of associations. The isolated bacteria decreased across coagulase-negative Staphylococci (47.3%, n = 194), S. aureus (23.2%, n = 95), Diphtheroids (5.4%, n = 22), Micrococcus species (3.7%, n = 15), Klebsiella pneumoniae (3.2%, n = 13), Moraxella species and Citrobacter species (1.5% each, n = 6), Escherichia coli, Enterobacter species, and Pseudomonas species (0.9% each, n = 2). The MRSA carriage prevalence was 0.49% (n = 2). Individuals aged 37–48 months recorded the highest proportion of S. aureus carriage (32.6%, 31/95). Resistance of S. aureus to the antibiotics tested were penicillin G (97.9%, n = 93), amoxiclav (20%, n = 19), tetracycline (18.9%, n = 18), erythromycin (5.3%, n = 5), ciprofloxacin (2.1%, n = 2), gentamicin (1.1%, n = 1), cotrimoxazole, clindamycin, linezolid, and teicoplanin (0% each). No inducible clindamycin resistance was observed for the erythromycin-resistant isolates. Three (3.2%) of the isolates were multidrug resistant, of which 66.7% (2/3) were MRSA. The pvl gene was associated with 59.14% (55/93) of the methicillin-sensitive S. aureus (MSSA) isolates, but was not detected among any of the MRSA isolates.

scholarly journals Genotypic and Phenotypic Markers of Livestock-Associated Methicillin-Resistant Staphylococcus aureus CC9 in Humans

2016 ◽  
Vol 82 (13) ◽  
pp. 3892-3899 ◽  
Author(s):  
Xiaohua Ye ◽  
Xiaolin Wang ◽  
Yanping Fan ◽  
Yang Peng ◽  
Ling Li ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Phenotypic Markers ◽  
Methicillin Resistant ◽  
Content Type ◽  
Gene Environment ◽  
Increased Risk ◽  
Study Participants

ABSTRACTUse of antimicrobials in industrial food animal production is associated with the presence of multidrug-resistantStaphylococcus aureusamong animals and humans. The livestock-associated (LA) methicillin-resistantS. aureus(MRSA) clonal complex 9 (CC9) is associated with animals and related workers in Asia. This study aimed to explore the genotypic and phenotypic markers of LA-MRSA CC9 in humans. We conducted a cross-sectional study of livestock workers and controls in Guangdong, China. The study participants responded to a questionnaire and provided a nasal swab forS. aureusanalysis. The resulting isolates were assessed for antibiotic susceptibility, multilocus sequence type, and immune evasion cluster (IEC) genes. Livestock workers had significantly higher rates ofS. aureusCC9 (odds ratio [OR] = 30.98; 95% confidence interval [CI], 4.06 to 236.39) and tetracycline-resistantS. aureus(OR = 3.26; 95% CI, 2.12 to 5.00) carriage than controls. All 19S. aureusCC9 isolates from livestock workers were MRSA isolates and also exhibited the characteristics of resistance to several classes of antibiotics and absence of the IEC genes. Notably, the interaction analyses indicated phenotype-phenotype (OR = 525.7; 95% CI, 60.0 to 4,602.1) and gene-environment (OR = 232.3; 95% CI, 28.7 to 1,876.7) interactions associated with increased risk for livestock-associatedS. aureusCC9 carriage. These findings suggest that livestock-associatedS. aureusand MRSA (CC9, IEC negative, and tetracycline resistant) in humans are associated with occupational livestock contact, raising questions about the potential for occupational exposure to opportunisticS. aureus.IMPORTANCEThis study adds to existing knowledge by giving insight into the genotypic and phenotypic markers of LA-MRSA. Our findings suggest that livestock-associatedS. aureusand MRSA (CC9, IEC negative, and tetracycline resistant) in humans are associated with occupational livestock contact. Future studies should direct more attention to exploring the exact transmission routes and establishing measures to prevent the spread of LA-MRSA.

scholarly journals Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

2020 ◽  
Author(s):  
Yingying Wang ◽  
Jialing Lin ◽  
Junli Zhou ◽  
Zhigang Han ◽  
Zhenjiang Yao
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Users ◽  
Nasal Carriage ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Molecular Characteristics ◽  
Community Based ◽  
Cross Sectional ◽  
Nasal Swabs

Abstract Background: Staphylococcus aureus ( S. aureus ), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. This cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users. Methods: All eligible drug users, with both injection and non-injection route of drug administration , were asked to complete questionnaires and collect nasal swabs by trained personal during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus . Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage. Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower while the prevalence of MRSA carriage was moderate compared to previous studies. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed high proportions of antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization and antibiotic stewardship might be implemented for drug users with MRSA carriage.

scholarly journals The bacterial profile and sensitivity patterns of isolates from medical equipment and surfaces in the Children’s emergency room of a Nigerian hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 192-197
Author(s):  
Ikenna Kingsley Ndu ◽  
Isaac Nwabueze Asinobi ◽  
Uchenna Ekwochi ◽  
Obinna Chukwuebuka Nduagubam ◽  
Ogechukwu Francesca Amadi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Emergency Room ◽  
Nosocomial Infections ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Coagulase Negative Staphylococcus ◽  
Cross Sectional

Objective:  Nosocomial infections are those acquired in hospitals or healthcare service units that first appear 48 hours or more after admission or within 30 days after discharge following in-patient care. Knowledge of the bacterial profile and sensitivity patterns of any hospital environment is a key factor in infection control and good antibiotic stewardship. Material and Methods: This hospital-based cross-sectional study was conducted in the Children’s Emergency Room (CHER) of Enugu State University Teaching Hospital, Enugu, Nigeria.  Samples for culture were collected from equipment and hospital surfaces. Antimicrobial susceptibility testing was determined for each isolate by the Agar diffusion method using Standard Nutrient Agar 1 discs. Results: Bacterial growth was observed in 83 (70.3%) specimens. Staphylococcus aureus (53.4%) was the most common isolate cultured followed by Coagulase-negative Staphylococcus (18.8%), then Escherichia coli (13.9%). Among Staphylococcus aureus isolates, 25.9% were MRSA. Ampicillin resistance of the gram negatives was high. All the Gram-negative isolates were susceptible to Ciprofloxacin and Ceftriaxone. Conclusion: Staphylococcus aureus, Coagulase-negative Staphylococcus, and Escherichia coli were the commonest isolates. More efforts are needed to ensure improved hygiene standards in order to reduce the burden of nosocomial infections.

scholarly journals Bugs on Cuffs and Pockets: A Cross-sectional Study of the Contamination of Healthcare Personnel Attire at Salmanyia Medical Complex

10.3823/828 ◽  
2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jameela M. AlSalman ◽  
Yusuf N AlAlwan ◽  
Mohamed Redha Rajab ◽  
Nermin K Saeed
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Epidermidis ◽  
Data Entry ◽  
Cross Sectional Study ◽  
Hospital Environment ◽  
Healthcare Personnel ◽  
Categorical Variables ◽  
Sectional Study ◽  
Cross Sectional ◽  
Skin Flora

Background: Hospital acquired infections increase the morbidity and mortality of the inpatient population. Pathogens like Staphylococcus aureus and Enterococci are transmitted by direct contact or transmitted by fomites such as healthcare personnel’s attires. This is a cross-sectional study aimed to explore the prevalence ofcontamination of the attires of healthcare personnel working atSalmanyia Medical Complex. Method: We randomly selected 100 doctors and nurses working in different departmentsand swabbed their attire's sleeves and pockets. We then stored both swabs in their accompanying syringe that contains a bacterial transportation media, and sent them to the lab for culturing. SPSS 23 was used for data entry and analysis. After that, percentages and frequencies were computed for different categorical variables, and a cross-tabulation was computed between each two categorical variables. Chi-Squared test was used to determine whether there were significant relationships between each two categorical variables. Results:Of the total samples, 44 pocket and 45 cuff samples were contaminated with staphylococcus epidermidis (skin flora). Thirty eight participants were found to have contamination of both the cuff and pocket. Nurseshad slightly higher prevalence of cuff contamination than doctors (P=0.032). Amongst doctors, surgeons had the highest prevalence (P=0.006). Discussion:Compared to the data available in the literature, our data did not reveal contamination with significant pathogens such as staphylococcus aureus or MRSA.Nevertheless, contamination with staphylococcus epidermidis could be whether from autoinoculation or contamination from the hospital environment and could correlate to level of hygiene. Frequent washing of attire doesn’t reduce the level of contamination.

scholarly journals Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

2019 ◽  
Author(s):  
Yingying Wang ◽  
Jialing Lin ◽  
Junli Zhou ◽  
Zhigang Han ◽  
Zhenjiang Yao
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Users ◽  
Nasal Carriage ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Oral Drug ◽  
Molecular Characteristics ◽  
Community Based ◽  
Cross Sectional

Abstract Background: Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. The cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users.Methods: All eligible drug users, both intravenous and oral drug users, were asked to complete questionnaires and collect nasal swabs during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage.Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower when the prevalence of MRSA carriage was moderate. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed serious antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization might be considered for drug users with MRSA carriage.

scholarly journals Surfaces and Air Bacteriology of Selected Wards at a Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hailu Getachew ◽  
Awoke Derbie ◽  
Daniel Mekonnen
Keyword(s):  
Antimicrobial Agents ◽  
Bacterial Load ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Referral Hospital ◽  
Hospital Environment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Air Samples

Background. The hospital environment is a source of medically important pathogens that are mostly multidrug resistant (MDR) and posing a major therapeutic challenge. The aim of this study was to assess the surface and air bacteriology of selected wards at Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. Methods. A cross-sectional study was carried out from 15th February to 30th April 2017. A total of 356 surface and air samples were collected from selected wards using 5% sheep blood agar (Oxoid, UK) and processed at FHRH microbiology laboratory following the standard bacteriological procedures. Pure isolates were tested against the recommended antibiotics using Kirby–Bauer disc diffusion methods, and the susceptibility profile was determined based on Clinical Laboratory Standards Institute (CLSI). Data were entered and analyzed using SPSS version 23 for Windows. Results. Of the total 356 samples processed, 274 were from surfaces and 82 were from air. Among these, 141 (39.6%) showed bacterial growth, yielding a total of 190 isolates. Gram-positive isolates were predominant at 81.6% (n=155), while the gram negatives were at 18.4% (n=35). The main isolates were coagulase negative staphylococci (CoNs), 44%, followed by S. aureus, 37.4%, and Klebsiella species at 11.6%. The bacterial load on surfaces and air was found beyond the standard limits. Besides, the antimicrobial susceptibility profile of the isolates showed that about 75% of the identified isolates were found resistant for two and more antimicrobial agents tested. Conclusions. This study showed high degree of bacterial load that is beyond the standard limits on both surfaces and air samples of the hospital. Furthermore, some 75% of the isolates were found multidrug resistant. Therefore, it is important to evaluate and strengthen the infection prevention practice of the hospital. Moreover, stakeholders should also reinforce actions to decrease the pressure of antimicrobial resistance in the studied area.

scholarly journals Study on Microbiome of Chronic Non Healing Diabetic Ulcers with Special Reference to Biofilm and Multidrug Resistant Strains

2021 ◽  
Author(s):  
P Ramaprabha ◽  
CP Ramani ◽  
R Kesavan
Keyword(s):  
Staphylococcus Aureus ◽  
Biofilm Formation ◽  
High Sensitivity ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Molecular Characterisation ◽  
Cross Sectional ◽  
Diabetic Ulcers ◽  
Resistant Strains

Introduction: Diabetic Foot Ulcers (DFU) represent a silent epidemic and are the leading cause of 80% of non traumatic lower-limb amputations. Anaemia in diabetes may have adverse effects on systemic diseases and predict the progression of diabetes complications. Biofilms act as a mechanical barrier to antimicrobials and immune system cells and contribute to Multidrug Resistance (MDR). Aim: To determine the bacteriome and mycobiome of diabetic ulcers and the associated biofilm formation and anti-microbial resistance profile of the pathogens. Also, to determine the molecular characterisation of biofilm-forming resistant isolates by Polymerase Chain Reaction (PCR). Materials and Methods: This cross-sectional study was done on 150 diabetic patients with non healing ulcers and was chosen and studied from January-December 2019. Pus and tissue bit samples were processed as per standard microbiological procedures. Antimicrobial susceptibility test was performed as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Biofilm formation was detected by the tissue culture plate method. Molecular characterisation of resistant pathogens was done by PCR. Variables were expressed as proportions or percentages. Results: Out of 150 diabetic patients, 17.3% of patients underwent amputation. A 90% of patients were associated with anaemia. Most ulcers were polymicrobial in nature. Predominantly isolated pathogens were Pseudomonas aeruginosa 37 (17.1%) and Staphylococcus aureus 33 (15.2%) among aerobic bacteria, Peptostreptococcus 10 (4.6%) among the anaerobes and Candida albicans 20 (9.2%) in fungus. Gram negative bacteria showed high sensitivity to piperacillin-tazobactam, meropenem, and gram positive cocci to vancomycin and linezolid. A 82% of bacterial isolates and 50% of fungal isolates were biofilm producers. Staphylococcus aureus was a strong biofilm producer. On molecular characterisation, blaCTX-M, blaTEM, blaNDM-1, blaOXA-23, mecA genes were present in resistant biofilm-forming isolates. Conclusion: Polymicrobial wound infection and biofilm formation in DFU confers antibiotic resistance and contributes to Multidrug Resistant Organisms (MDRO’s). However, proper antibiotic surveillance and antibiotic policy, and preventive strategies can curtail the spread of resistant strains.

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