Bacterial Profile And Antimicrobial Susceptibility Pattern Of Isolates From Diabetic Foot Infections At Selected Public Hospitals Of Addis Ababa Ethiopia.

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Background: Globally, diabetic foot infections continue to be a major public health problem,rnbringing socio economic burdens to the affected people. Clinically infected foot ulcers requirerntreatment guided by appropriate cultures and antimicrobial susceptibility testing. Updatedrninformation is scarce in Ethiopian context in general and in the study sites in particular, hence werntried to fill this gap. rnObjective: To determine the Bacterial profile and Antimicrobial susceptibility pattern of isolatesrnfrom Diabetic foot infections at selected public Hospitals of Addis Ababa, Ethiopia. rnMethod: A cross sectional design was used to recruit 135 diabetic adult patients with diabeticrnfoot infections attending selected public hospitals in Addis Ababa, Ethiopia. Convenientrnsampling was employed in recruiting participants for one year from May, 2018 to April, 2019.rnWound Aspirates (deep wound swabs) from the foot ulcers were collected aseptically andrninoculated into Blood, MacConkey, Chocolate and Manitol salt Agar. The antimicrobialrnsusceptibility patterns were conducted according to the criteria of the National Committee forrnClinical Laboratory Standards (NCCLS) by disk diffusion method. A structured questionnairernwas used to collect information regarding the socio-demographic status, clinical history and riskrnfactors of the study participants. Data obtained was analyzed using the statistical package forrnsocial sciences software version 20. Statistical significance was set at 95% confidence levelrnand p values ≤0.05 was considered significant. The associated factors of DFI were determinedrnusing multiple ordinal regressions with the test of parallel line assumption being fulfilled forrneach risk category separately. rnResults: Of the 135 patients investigated majority105 (77.8%) of them were males. The Meanrnage (SD) of the patients was 57.64 (± 13.20 SD) Years. According to the International WorkingrnGroup on the Diabetic Foot (IWGDF) classifications, mild, moderate and severe Diabetic footrninfections in our study were 36 (26.7%), 75 (55.5%) and 24(17.8%), respectively. One hundredrnninty bacterial isolates were identified among 135 patients. Among them, 85 (62.96%) had monornbacterial infection while 50 (37.04%) had mixed bacterial infections. Gram negative aerobicrnbacterial infections were more accounting 121 cases (63.7%) than gram positive aerobicrnbacteria 69, (36.3%). The most commonly isolated bacteria was S. aureus (26.3%), followed by Klebsiella spp (22.1%) and Proteus spp (11.1%). In general, 140(73.68%) of the isolates inrnour study developed multidrug resistance to at least one drug in three different classes ofrnantibiotics. Meropinem and Amikacin appeared to be the best antibiotics for therapy against rnGram negative and Cefoxitin and Vancomycin against gram positive organisms. Moreover,rnHealth education on proper foot care (AOR=3.743, 95% CI 1.615-8.674), Peripheral VascularrnDisease (AOR=0.298,95% CI 0.116-0.765), Nephropathy (AOR=0.354, 95% CI 0.135-0.927)rn,BMI normal (AOR=0.052,95% CI 0.004-0.663) and overweight (AOR=0.072, 95% CI 0.0060.935)rnwerernfoundrntornbernassociatedrnwithrnSeverityrnof Diabeticrnfoot infection.rnrnConclusion: High level of multidrug resistance in this study implies, definitive therapy should bernbased upon culture and susceptibility analysis to promote the rational use of the Antibiotics andrnreduce emergence of bacterial resistance to antimicrobials.

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Bacterial Profile And Antimicrobial Susceptibility Pattern Of Isolates From Diabetic Foot Infections  At Selected Public Hospitals Of Addis Ababa Ethiopia.

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