تاريخ مجلس الدراسات العليا

2020-09-10

اسم الطالب

محمد شاكر علي الشويخي

ملخص الرسالة

Background: Incidence of diabetes is rising worldwide, and the prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. Contaminating bacteria among diabetic foot can couse foot ulceration and this can develop to gangarin then ampotation. Aim of the study: Collecte Samples from diabetic foot infection (DFI) lesions at National Centre for diabetes endocrinology and genetics (NCDEG) diabetic foot clinic / University of Jordan, to isolate and identify contaminating bacteria, correlate their frequencies with risk factors, and study their antibiotics resistance patterns. Patient and Methods: Seventy diabetic outpatients (Type II) aged above 30 years, with diabetic foot infection (DFI) attending NCDEG during the period from October 2019- Mid March 2020 were included in the study. A structural questionnaire (Appendix A) was designed to collect data through interviewing patients in addition to medical records. Swabs from DFI lesions were cultured onto a number of bacteriological media. methicillin resistant Staphelococcus aureus (MRSA) and Methicillin-resistant staphylococcus aureus (MRCONS) were detected by growing isolates on Mannitol salt agar (MSA) and Mueller-Hinton agar supplemented with 6ug/ml Oxacillin. An assortment of antibiotics against Gram negatev and Gram positive were examined to explore antibiotic resistance patterns. Results:DFI are more prevalent in elderly patients aged > 50years (88.6%), male are more affected than females. HbAIC was uncontrolled in 70.0% of patients and 47.1% of them have a duration of diabetes for more than 30 years. Number of patients not committed to diet is 60% and 74.3% are non-smokers. A significant correlation was found between HbAlC values with gender and diet (p<0.05). A Similar incidence of DFI was reported by patients on either oral or insulin medication (17: 24.3% each). 36 patients (51.4%) were on both oral and insulin medication. The duration of foot complication (28.6 %) of patients has lasted for more than 6 months. Gram positive was the predominating bacteria isolated from DFI lesions. S.aureus was the largest group (51.4%) followed by CONs (47.1%) and Enterococcus (12.9%). MRSA and MRCONs were recovered from 40 % and 30% of study participants respectively. The highest percentage recovery of MRSA and MRCONs were recorded among patients with duration of foot infection of 6 months - 1year (75% and 50% respectively). Percentage frequencies of major Gram negative bacteria as following: Proteus mirabilis 18.6%, Pseudomonas aeruginosa 14.3%, and Acinetobacter spp.7.1%. High frequencies of S. aureus (55.6%), P. aeruginosa (50%) and Kleb. penumoniae (40%) were recovered among patients having surgical amputation. Conculution: MDROs were prevalent amongst Gm+ve and Gm-ve isolates at alarming levels. S. aureus and Groub B streptococci (GBS) were resistant to seven and six antibiotics respectively. Vancomycin, Linezolid, Teicoplanin and Tigecycline were the most effective against Gram positive organisms. Gm-ve bacteria showed resistance to varied numbers (8-11)of antibiotics Only Prot. mirabilis was resistant to Tigecycline (100%).