Resistance profile of the isolated bacteria.

The primary objective of this study was to isolate bacteria from diabetic foot ulcers and subsequently assess their antibiotic resistance capabilities. Seventy-five patients diagnosed with diabetic foot ulcers were investigated. A number of these patients (97.33%) had type 2 diabetes, with a significant proportion of them having been diagnosed for 1–5 years (29.33%). Notably, a substantial number of these individuals were on insulin usage (78.66%). Among the patients under examination, 49.33% reported having no use of tobacco products, alcohol, or betel leaf. The ulcers analyzed in this study were classified into grades 1–5 according to the Wagner scale. Wagner grade 2 diabetic foot ulcers had the highest number of culture-positive patients, at 33.33%. Pus samples collected from patients were cultured on selective media, and bacterial identity was confirmed by biochemical tests and polymerase chain reaction. A total of 141 isolates were isolated. Among the isolates, 82.97% gram-negative bacteria and 17.02% gram-positive bacteria were detected. Klebsiella pneumoniae was the most common isolate. Proteus spp., Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were also detected. Approximately 61.33% of the ulcers exhibited were polybacterial. In this study, it was observed that all bacterial isolates, except for Proteus spp., were primarily detected in patients classified under Wagner’s grade 2. Moreover, antibiotic susceptibility was also tested on these 141 isolates. Among them, Escherichia coli showed the highest multidrug resistance, 81.81%. Most of the gram-negative bacteria were resistant to ampicillin. All of the gram-negative isolates exhibited high levels of susceptibility to piperacillin-tazobactam, and these levels were Klebsiella pneumoniae (97.56%), Pseudomonas aeruginosa (95.24%), Escherichia coli (81.82%), and Proteus spp. (80%). On the other hand, gram-positive Staphylococcus aureus mostly showed sensitivity towards vancomycin and norfloxacin (79.17%).

本研究的核心目标为从糖尿病足溃疡样本中分离细菌，并进一步评估其耐药性。本研究共纳入75例确诊糖尿病足溃疡的患者，其中97.33%的患者为2型糖尿病，且29.33%的患者确诊病程为1~5年，占比可观。值得注意的是，78.66%的患者接受胰岛素治疗。受试患者中，49.33%无烟草、酒精及槟榔接触史。本研究中所分析的溃疡依据瓦格纳（Wagner）分级标准划分为1~5级，其中瓦格纳2级糖尿病足溃疡的培养阳性患者占比最高，达33.33%。研究人员采集患者脓液样本，接种于选择性培养基进行培养，通过生化试验与聚合酶链式反应（polymerase chain reaction）确认细菌种属。本次研究共分离得到141株细菌，其中革兰氏阴性菌占比82.97%，革兰氏阳性菌占比17.02%。肺炎克雷伯菌（Klebsiella pneumoniae）为最常见的分离菌株，此外还检出变形杆菌属（Proteus spp.）、大肠埃希菌（Escherichia coli）、铜绿假单胞菌（Pseudomonas aeruginosa）与金黄色葡萄球菌（Staphylococcus aureus）。约61.33%的溃疡呈现多菌感染特征。本研究观察到，除变形杆菌属外，其余所有分离菌株均主要检出于瓦格纳2级患者群体中。研究人员对这141株分离菌开展药敏试验，其中大肠埃希菌的多重耐药率最高，达81.81%。多数革兰氏阴性菌对氨苄西林耐药，所有革兰氏阴性菌均对哌拉西林他唑巴坦表现出较高敏感性，具体敏感率分别为：肺炎克雷伯菌97.56%、铜绿假单胞菌95.24%、大肠埃希菌81.82%、变形杆菌属80%。另一方面，革兰氏阳性菌中的金黄色葡萄球菌大多对万古霉素与诺氟沙星敏感（敏感率79.17%）。