ABSTRACT
Background: Diabetic foot lesions are a major medical, social and economic problem and are the leading cause of hospitalization for patients with diabetes worldwide. Infection sometimes leads to amputation of the infected foot if not treated promptly. The present study was conducted to isolate and identify the bacterial pathogens associated with diabetic foot ulcer and to find out its antibiotic susceptibility pattern to reduce the risk of complications. Methods: Total 100 pus samples were collected from patients having diabetic foot ulcer, during July to October 2012. Samples were processed as per standard guidelines. Results: Out of 100 pus samples, 73 (73%) yielded growth of organisms making total of 92 isolates. Out of 92 bacterial isolates, 72 were gram negative and 20 were gram positive. Pseudomonas aeruginosa 25 (27%) was most common isolate causing diabetic foot infections followed by 20 (22%) Klebsiella sp., 17 (19%) E. coli, 15 (17%) S. aureus, 6 (7%) Proteus sp. and 4(3%) Enterococci, 2 (2%) Acinetobacter sp. and 2(2%) CONS and 1(1%) Providencia. Out of 72 GNB, 50 (69.4%) were extended spectrum β lactamase (ESBL) producer. Most gram negative isolates were resistant to levofloxacin, gentamicin, ampicillin-sulbactam and gatifloxacin. All GNB were sensitive to imipenem. Out of 15 S. aureus, 9 (60%) were Methicillin Resistant Staphylococcus aureus (MRSA) and were sensitive to vancomycin and linezolid. Conclusions: Pseudomonas sp. was the most common cause of infections. Most isolates were multi drug resistance.
ABSTRACT
Background: Cefadroxil has good tissue penetration & exerts more sustained action at the site of infection after oral absorption. Our aim of the study was to check topical cefadroxil has any efficacy over staphylococcal superficial skin infection or not. Methods: Pre-treatment nasal swabs were obtained from 25 healthy human volunteers and bacterial load was recorded. After single application of topical cefadroxil 3% in left anterior nare and placebo (vehicle) in right anterior nare nasal swabs were obtained and results were compared. 150 patients with staphylococcal superficial skin infections were distributed in 4 groups: Group A - oral cefadroxil 500 mg twice daily for 5 days, Group B - topical cefadroxil (0.5 % to 5%) twice daily, Group C - cefadroxil 500 mg orally plus placebo (vehicle) topically twice daily and Group D -cefadroxil 500 mg orally plus cefadroxil preparation topically twice daily. Bacterial load was measured before treatment, on follow up &after clinical cure and results were compared. Results: Topical cefadroxil significantly reduced bacterial load after single application in anterior nare. Topical cefadroxil cured and significantly reduced bacterial load in staphylococcal superficial skin infections within 3 days of treatment. Oral plus topical cefadroxil combination therapy significantly reduced bacterial load and cured infection within 3 days of treatment in patients with moderate to heavy bacterial growth. No any adverse effect was observed during entire study period in any of groups. Conclusions: Topical preparation of cefadroxil is safe and effective in treating staphylococcal superficial skin infections. Combination of oral plus topical cefadroxil showed synergistic effect in infections with moderate to heavy growth. This study is registered at CTRI [REG ID: CTRI/2013/02/003433 REF: REF/2013/02/004576].
ABSTRACT
Background: Metallo-β-lactamase (MBL) mediated resistance to carbapenem is an emerging threat in Pseudomonas isolates. The aim of this study is to detect metallo-β-lactamase producing isolates of Pseudomonas spp. from various clinical samples from indoor patients in a teaching hospital. Materials and Methods: Total 900 bacterial strains were isolated from different clinical samples from indoor patients. The bacterial strains were isolated and identified as per the standard guidelines. Amongst them 100 isolates of Pseudomonas were taken for the present study. All pseudomonas isolates were subjected to antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method (CLSIs). In all imipenem resistant isolates of Pseudomonas spp., MBL detection was carried out by Imipenem-EDTA combined-disc synergy test (CDST). Results: Out of 100 isolates of Pseudomonas, 44 (44%) were imipenem resistant. Of these 44 isolates, 30 were producing MBL enzyme. 30 MBL positive isolate included 12 (40%) from surgical wards, 10 (33.33%) from tuberculosis ward, 4 (13%) from medicine ward, 2 (7%) from paediatric ward, 1 (3%) from urology ward and 1 (3%) from neonatal ICU. All MBL positive strains were resistant to β-lactams, aminoglycosides and fluoroquinolones. Conclusion: Prevalence of MBL producing Pseudomonas spp. is 30%. The MBL producing Pseudomonas spp. isolates were multidrug resistant. It is important to identify MBL producing pseudomonas isolates in laboratory as may cause serious infections and may cause a nosocomial outbreak.