Diabetic foot ulcer in Southern Jordan: A cross-sectional Study of Clinical and Microbiological Aspects

Diabetes mellitus (DM) is a common metabolic disorder that significantly affects public health. Diabetic foot ulcer (DFU) is one of the serious complications of diabetes. DFU has a wide spectrum of bacterial isolates comprising Gram-positive, Gram-negative, aerobic bacteria and anaerobes. In the las...

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Bibliographic Details
Published in:	Annals of medicine and surgery Vol. 76; p. 103552
Main Authors:	Aborajooh, Emad, Alqaisi, Talal M., Yassin, Mohammad, Alqpelat, Eyad, Abofaraj, Alaa, Alrawajih, Tariq, Alzoubi, Hamed, Abu lubad, Mohammad
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-04-2022 Elsevier
Subjects:	Cross-sectional Study Diabetes Diabetic foot ulcer Jordan Multidrug resistance Wagner's grade DFU Multidrug resistance MDR Diabetes Jordan Diabetic foot ulcer Wagner's grade DFU, Diabetic Foot Ulcer MDR, multidrug-resistant isolates
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Summary:	Diabetes mellitus (DM) is a common metabolic disorder that significantly affects public health. Diabetic foot ulcer (DFU) is one of the serious complications of diabetes. DFU has a wide spectrum of bacterial isolates comprising Gram-positive, Gram-negative, aerobic bacteria and anaerobes. In the last two decades there has been an increase in the multidrug-resistant isolates (MDR). This cross-sectional prospective observational study was conducted in southern Jordan among patients with DFU. The included variables are sociodemographic and clinical information. Isolates from swab culture of ulcers and antimicrobial susceptibility pattern are also recorded. A total of 64 diabetic patients with DFU were included in this study. Most patients included in the study were males with male-to-female ratio of (2.2:1). The mean age was 54 years (SD ± 10.7). The mean duration of DM was 16.4 years (SD ± 7.5) and the mean HbA1c was 9.9% (SD ± 2.1). Neuropathy and anemia were noted in 72% and 44% of patients, respectively. The most frequent bacterial isolates were gram negative bacteria accounts for 29 isolates (45.3%). About 37.5% (24) of bacterial isolates showed MDR pattern. Previous antibiotic use in the last 30 days showed significant association with MDR bacteria (p-value <0.05). Previous history of amputations, presence of neuropathy, renal impairment, retinopathy, presence of anemia, limited joint mobility and presence of foot deformity were significantly associated with Wagner's grade ≥ three. Many factors affect and increase the risk of having high grade diabetic foot ulcer. The most frequent bacterial isolates from diabetic foot ulcers were gram negative bacteria. High rates of MDR in this study reflect the loose implementation of regulations in Jordan regarding antibiotics dispensing. •Diabetic foot ulcer is a common complication of diabetes.•This study is first of its kind in southern Jordan that combined clinical and microbiological aspects of diabetic foot ulcer.•The most frequent bacterial isolates from diabetic foot ulcers are gram negative bacteria.•Inappropriate previous use of antibiotics is the main determinant of multi-drug resistant isolates.•High rates of multi-drug resistant isolates in this study reflect the loose implementation of antibiotics dispensing regulations in Jordan.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2049-0801 2049-0801
DOI:	10.1016/j.amsu.2022.103552