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Microbial spectrum, antibiotic susceptibility profile, and biofilm formation of diabetic foot infections (2014–18): a retrospective multicenter analysis

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A Correction to this article was published on 30 August 2021

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Abstract

This study identifies the risk factors, microbiological properties, antimicrobial susceptibility patterns, mortality, and clinical complications associated with organisms causing diabetic foot infections (DFIs) with or without antibiotic treatment using data from a retrospective multicenter surveillance. Specimens collected from different hospitals were cultured and the extended-spectrum β-lactamase (ESBL) excretion was estimated. The antibacterial susceptibility pattern and biofilm formation were completed along with the recommended standard methods. Overall, 792 diabetic foot patients (DFPs) were enrolled and a total of 1803 causative organisms were isolated. Polymicrobial infection was identified in 48.5% of the patients. The isolated Gram-positive pathogens (46.7%) were higher than Gram-negative (38.6%) or anaerobes (7.9%). The predominant pathogens were S. aureus (22.2%), methicillin-resistant S. aureus (7.7%), Enterococcus spp. (12.8%), Pseudomonas aeruginosa (9.4%), E. coli (7.9%), Klebsiella spp. (7.5%), Proteus mirabilis (8.9%), coagulase negative staphylococci (CoNS) (6.6%), anaerobic organisms (5.9%), and fungi (2.3%). Vancomycin and clindamycin exhibited no activity against Gram-positive bacteria. However, meropenem and imipenem displayed high activity against the Gram-negative isolates. Out of the 765 tested strains, 251 showed moderate (15.8%) to high (34%) level biofilm-producing phenotype. DFIs were widespread among the diabetic patients with different microbial etiology and the major organisms were aerobic organisms. Our findings may provide an insight into the development of appropriate therapeutic strategies for the management of DFIs.

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Acknowledgements

The authors thank the Deanship of Scientific Research and RSSU at King Saud University for their technical support.

Funding

The authors would like to extend their sincere appreciation to the Deanship of Scientific Research at King Saud University for funding the work through the research group Project No. RGP-202.

Author information

Authors and Affiliations

  1. Department of Pharmacology, Al-Jouf University, Sakaka, Saudi Arabia

    Fakhria A. Al-Joufi

  2. College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia

    Khalid M. Aljarallah

  3. College of Applied Sciences, Almaarefa University, Riyadh, Saudi Arabia

    Khalid M. Aljarallah

  4. Inaya Medical Colleges, Riyadh, Saudi Arabia

    Soheir A. Hagras

  5. NCRRT, EAEA, Cairo, Egypt

    Soheir A. Hagras

  6. Microbiology and Immunology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

    Ibrahim M. Al Hosiny

  7. Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia

    Mounir M. Salem-Bekhit, Abdullah M. E. Youssof & Faiyaz Shakeel

Authors
  1. Fakhria A. Al-Joufi
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  2. Khalid M. Aljarallah
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  3. Soheir A. Hagras
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  4. Ibrahim M. Al Hosiny
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  5. Mounir M. Salem-Bekhit
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  6. Abdullah M. E. Youssof
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  7. Faiyaz Shakeel
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Contributions

FAAJ: conceived and designed the experiments; IMAH: performed the experiments; KMA: Analyzed and interpreted the data; SAH: contributed reagents, materials, analysis tools or data; MMSB: wrote the paper and funding acquisition; AMEY: methodology; FS: formal analysis and project administrator.

Corresponding author

Correspondence to Faiyaz Shakeel.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethical Committee of Egyptian Hospitals. Written informed consent was attained in each case prior to enrollment in this study.

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Al-Joufi, F.A., Aljarallah, K.M., Hagras, S.A. et al. Microbial spectrum, antibiotic susceptibility profile, and biofilm formation of diabetic foot infections (2014–18): a retrospective multicenter analysis. 3 Biotech 10, 325 (2020). https://doi.org/10.1007/s13205-020-02318-x

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