Prevalence of Quinolone-susceptible Pseudomonas aeruginosa and Staphylococcus aureus in Delayed-healing Diabetic Foot Ulcers in Ekpoma, Nigeria 

Wounds. 2010 Apr;22(4):100-5.

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.