ABSTRACT

The incidence of diabetes mellitus is increasing globally and there is a concomitant increase in the prevalence of infections associated with it. Diabetic ulcers have become a major escalating public health issue that has its morbidities, impairments and debilitating consequences. The present study was undertaken to evaluate the bacteriological and multidrug resistant profile of chronic diabetic foot ulcers in patients in Mbano metropolis. One hundred and fifty samples were collected. Samples were processed by standard microbiological methods such as microscopy, culture and biochemical tests. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion technique for the aerobic isolates. The total number of isolates obtained in this study was 210. One hundred and thirty seven (65.5%) were Gram negative, fifty three (25.5%) were Gram positive and twenty (9.5%) were anaerobes. The most frequently isolated organism in this study was Escherichia coli (32.1%), and the least was Enterobacter spp (1.57%) for the aerobes. For the anaerobes, Peptococcus spp (15%), Peptostreptococcus spp (40%), Bacteroides spp (30%) and Fusobacterium spp (15%). The percentage of isolates producing Extended Spectrum Beta-lactamse (ESBL) among E.coli isolates was 44%, with Proteus vulgaris 4% as the least. Percentage of biofilm forming organisms were E.coli (36.8%), S.aureus (23.1%), and Proteus vulgaris 4.2%. E.coli was sensitive to Ciprofloxacin at 57.3% while S. aureus was sensitive to Ofloxacin (63%). Enterococcus faecalis was 100% sensitive to Streptomycin while Enterobacter spp was 100% sensitive to Ofloxacin. No methicillin resistant S. aureus was encountered. The AmpC producers encountered were Klebsiella pneumonia 10% and E.coli 8.1%. The plasmid profile of 15 resistant isolates were studied using the Alkaline lysis method and Gel Electrophoresis. Subsequently, the plasmid analysis and curing using ethidium bromide at various concerntrations were performed.  The isolates were exposed to the antibiotics for which they demonstrated resistance initially and the findings revealed nine isolates had plasmids thus suggesting that the mode of antibiotic resistance may be plasmid-mediated. Proper management of diabetic wound infection with appropriate antibiotic therapy should be encouraged.