Characterization of antibiotic resistance of Staphylococcus aureus isolated from patients with diabetic foot ulcers in Wasit Province

Rana H Raheema 1, *, Hassan Khalil Melek 2 and Atheer Tayeb Jassim 1

1 Department of Medical Microbiology Faculty of Medicine / University of Wasit, Iraq.
2 Department of Surgery Faculty of Medicine / University of Wasit, Iraq.
 
Research Article
International Journal of Science and Research Archive, 2021, 03(02), 201–208.
Article DOI: 10.30574/ijsra.2021.3.2.0146
Publication history: 
Received on 22 September 2021; revised on 19 October 2021; accepted on 21 October 2021
 
Abstract: 
Diabetic foot ulcers are one of the most common public health issues worldwide, putting a social strain on those who suffer from them; chronic ulcers that lead to amputation are a severe disease that can reduce diabetic patients' quality of life. A total of seventy-five samples were collected from diabetic foot ulcer with age (30 - 89) years, during the period from 1st October 2020 to15th January 2021, admitted to Al-Karama teaching hospital and private clinics in Wasit province. The results revealed that the frequency among males 50 (67 %) more than female 25 (33 %).The sample distribution according to age it appears high (42.7 %) with group (50-59) years. The results shows that Gram negative bacteria reveals a high rate 57.4% (n=35) which includes K. pneumoniae that show a high percentage 24% (n=18), then E.coli 13.2% (n=10). followed, P.aeruginosa 4.0% (n=3) and P.mirabilis 2.7(n=2) and A.baumannii 2.7% (n=2). While Gram-positive bacteria recorded 42.6% (n=26) ,which include S. aureus was the most isolated bacteria in this study with percentage 33.3 % (n=25) followed by streptococcus group B 1.4% (n=1).
 Methicillin resistant Staphylococcus aureus was recorded with 92.3 % in all isolates and results of MRSA isolates antibiotic susceptibility for S. aureus as shown: the maximum resistance level to the Oxacillin (100 %), penicillin (100 %), cefoxitin (92.3 % ), vancomycin (61.5 % ), clindamycin (61.5 % ), followed by gentamicin (53.8 %), erythromycin (53.8 %), while the lowest resistance with ciprofloxacin (38.4 %). The maximal S. aureus sensitivity has been to Trimethoprim-Sulfamethoxazole (57.8 %) , vancomycin (38.5 %) , ciprofloxacin (30.7 %) and gentamicin (34.6 %). DNA of twenty-five isolates S. aureus were extracted, also purity and concentration were confirmed with Nanodrop, the purity of the nucleic acid in the samples ranged between 1.8-2, while its concentration ranged from (50-360 mg / μl).
 Resistance genes possessed by the S. aureus isolates were: mecA (96%), ermC (40%), msrA (8.0 %) and aac(6′)-aph(2″) (16 %). while ermA and vanA genes were absent among all isolates. In conclusion, the findings of the present study revealed that most studied isolates which had multiple antibiotic resistances.
 
Keywords: 
Diabetic foot ulcer; S. aureus; Characterization; Antibiotic resistance genes.
 
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