Prevalence of Quinolone susceptible Pseudomonas aeruginosa and Staphylococcus aureus in Delayed healing DFU's in Ekpoma, Nigeria

Abstract

Aim. To investigate the prevalence and antibiogram of Pseudomonas aeruginosa and Staphylococcus aureus from delayed-healing foot ulcers among patients with diabetes in Ekpoma. Methods. Using standard aseptic microbiological methods, 220 delayed-healing diabetic foot ulcer samples were analyzed for bacteria isolation, identification, and susceptibility before and 12 weeks after antibiotic administration. Chi-squared (α = 0.01) was used to test for statistical significance. Results. Out of the 220 samples analyzed, 181 (82.3%) were infected (P aeruginosa [41.8%]; S aureus [30%]; co-infection of P aeruginosa and S aureus [10.5%]). Wound healing was significantly (P < 0.01) dependent on the presence of P aeruginosa and S aureus in the study population. S aureus and P aeruginosa showed the highest (74.2% and 71.3%, respectively) and lowest (38.2% and 34.8%) susceptibilities to levofloxacin and sparfloxacin, respectively. P aeruginosa was 68.7% susceptible to rifampicin; 53% to erythromycin, 52.2% to vancomycin; 38.3% to ceftriazone; 36.5% to cefuroxin; and 32.2% to oxacillin. S aureus was 51.7% susceptible to rifampicin, 37.1% to cefuroxin; 33.7% to ceftriazone; 28.1% to vancomycin; and 25.8% to oxacillin. Twelve weeks after antibiotic administration, 54% of samples had no growth and showed accelerated wound healing; 26.7% yielded P aeruginosa, while 19.3% yielded S aureus. Conclusion. Delayed-healing diabetic foot ulcers in Ekpoma are colonized by levofloxacin- and sparfloxacin-susceptible P aeruginosa and S aureus. Microbial load reduction due to appropriate antibiotic administration contributed to the acceleration of the wound healing process for 54% of patients who participated in the follow-up procedures. Surveillance with improved diagnostic facilities is recommended. Address correspondence to: Ezera Agwu, PhD Medical Microbiology & Parasitology, School of Health Sciences Kampala International University, Western Campus, Ishaka Box 71, Bushenyi