ABSTRACT

Diabetic foot ulcer is a major complication of diabetes mellitus. The present study was undertaken to evaluate the microbial profile of diabetic foot ulcer in patients in Aba metropolis. Swap samples were collected from twenty patients with diabetic foot ulcers and all yielded growth of bacteria organism. Samples were processed by standard microbiological methods such as microscopy, culture and biochemical test. Antibiotic susceptibility testing was done by disc diffusion technique. The total number of isolates obtained in this study was 42.While 30(71.3%) were gram negative and 12(28.5%) were gram positive. The most frequently isolated organism in this study was Escherichia coli (40.4%) followed by S. aureus and Proteus (19.0%) each, Pseudomonas aeruginosa (7.1%), Strept. spp, klebsiella and COANS (4.7%). The percentage of extended spectrum beta lactamases (ESBL) among E.coli isolates was 35.2% and its percentage among all the gram negative organism was 20%. Almost all the isolates showed resistance against most of the narrow spectrum antibiotics tested like Cotrimoxazole, Chloramphenicol and Amoxillin. No methicillin resistance S. aureus was encountered. Proper management of diabetic wound infection with appropriate antibiotic is very important.

TABLE OF CONTENT

Cover page

Title page i

Certification ii

Dedication iii

Acknowledgment iv

Table of content v-vi

List of tables vii

Abstract viii

CHAPTER ONE

1.0 Introduction 1

1.1 Aim of the study 3

1.2 Objectives of the study 3

CHAPTER TWO

2.0 Literature review 4

2.1 Risk factors associated with diabetic ulcer 5

2.2 Pathophysiology 5

2.3 Altered metabolism 7

2.4 Impaired no synthesis 8

2.5 Structural and functional changes in fibroblasts 8

2.6 Increased matrix metalloproteinase (MMP) activity 9

2.7 Footwear 10

CHAPTER THTREE

3.0 Materials and methods 11

3.1 Collection of samples 11

3.2 Sterilization of materials 11

3.3 Preparation of media 11

3.4 Cultivation of isolates 11

3.5 Subculturing of the isolates 12

3.6.0 Identification and characterization of isolates 12

3.6.1 Gram staining 12

3.6.2 Motility test 13

3.6.3 Biochemical test 13

3.6.3.1 Catalase test 13

3.6.3.2 Urease test 13

3.6.3.3 Indole test 14

3.6.3.5 Methy red-Voges Proskauer test 14

3.6.3.6 Citrate utilization test 14

3.6.3.7 Tripple sugar iron agar 15

3.6.4 Sensitivity 15

3.6.5 Procedure for extended beta lactamases 16

3.6.6 Phenotypic confirmation test 16

CHAPTER FOUR

4.0 Result 17

4.1 Table 1 1 7                                                                                                                                    4.2 Table 2 18

4.3 Table 3 19

4.4 Table 4 21

4.5 Table 5 22

CHAPTER FIVE

5.0 Discussion 23

5.1 Conclusion 24

5.2 Recommendation 24

References