Kavitha E

Abstract

Background: Diabetes mellitus is a metabolic disorder which impedes the normal steps of the process of wound healing. It has higher risks of foot infection and postoperative wound infection that is polymicrobial with increased antibiotic resistance. Objectives: A comparative study of bacteriological profile from the wound samples of diabetic and nondiabetic patients and to understand the relationship between bacterial load and high glycemic index among diabetic patients. Materials and Methods: A cross sectional study involving 50 diabetic and 50 non- diabetic patients wound swab or pus samples collected under aseptic precautions. Results: Polymicrobial infection is mostly observed. Among the isolates, gram negative bacilli were about 55% and gram positive cocci were about 45%. The most common organism isolated was Staphylococcus aureus in diabetic and nondiabetic wound. In diabetic wound the predominant organism isolated was Staphylococcus aureus and Proteus mirabilis followed by Pseudomonas species. In non- diabetic wound, the predominant organism isolated was Staphylococcus aureus followed by Pseudomonas species. The Total Extended spectrum beta lactamase producer was about 76% whereas total Methicillin Resistant Staphylococcus aureus was 23%. In diabetic wound, glycemic index was poorly controlled in which fasting blood glucose level was > 150mg and post prandial blood glucose level was > 210mg among majority of cases. Conclusion: Antibiotic susceptibility test screening showed gram positive cocci isolates to more sensitive towards Erythromycin, Vancomycin, Amikacin and gram negative bacilli isolates to be more sensitive for Amikacin, Gentamycin and Imipenem. Thus, early diagnosis of diabetic wound infection is required for the antimicrobial therapy. Keywords: Bacteriological profile, Diabetic wound, Glycemic index, Non diabetic wound.

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Abstract

Introduction: The aim is to isolate and to identify Staphylococcus aureus from the nasal swabs of the health care workers and screen for the mupirocin resistance among the isolated Staphylococcus strains. Materials and Methods: Present study is a prospective type of study. A total of 100 nasal swabs were collected from health care workers. All the nasal swabs were cultured on MacConkey and Blood agar. Isolated organisms were subjected for antibiotic susceptibility testing by Kirby-Bauer disk diffusion method. Results: Among the 100 nasal swabs, Staphylococcus spp. was isolated in 100 (100%) samples which comprised of 13 (13%) Staphylococcus aureus isolates and 87(87%) were Coagulase negative Staphylococcus. Of 13 Staphylococcus aureus isolates, 7 (53.84%) and 6 (46.15%) were detected as Methicillin Resistant Staphylococcus aureus and Methicillin Sensitive Staphylococcus aureus respectively. None of S.aureus isolates was resistant to mupirocin. Low level mupirocin resistant (MupL) was seen in 10 (30%) of Methicillin Resistant Coagulase negative Staphylococcus and 5 (14.7%) in Methicillin Sensitive Coagulase negative Staphylococcus isolates, respectively. High level mupirocin resistant (MupH) was seen in 4 (12%) of Methicillin Resistant Coagulase negative Staphylococcus and 4 (12%) of MRCoNS and MSCoNS isolates, respectively. Conclusion: Mupirocin is a potent antibiotic to treat the nasal carriage of S. aureus. As resistance to mupirocin both low and high level is on rise, it is a matter of great concern. Policies and guidelines should be framed to create awareness among the health care workers regarding the screening methods for the detection and treatment of nasal carriage. Keywords: MRSA- Methicillin resistant Staphylococcus aureus, MSSA- Methicillin sensitive Staphylococcus aureus, Mupirocin resistance

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