Incidence of Multi-Drug-Resistant Bacterial Pathogens from Pus Samples of Diabetic Foot Ulcer Patients Collected at a Tertiary Care Hospital in North Kerala, India

Background: Diabetes mellitus is a prevalent metabolic disorder, particularly affecting individuals over 45, with 529 million people worldwide impacted.Uncontrolled diabetes can lead to complications, including diabetic foot ulcers (DFU), which are responsible for 20% of morbidity and 25% of mortality in diabetic patients, especially in developing countries.Pathogenic bacteria cause infections in DFUs, and recovery is influenced by bacterial resistance to antibiotics.This study aimed to determine drug resistance rates of pathogens in DFUs and their impact on morbidity in a tertiary care hospital in North Kerala, India.Materials and Methods: Pus samples from DFU patients were collected between 2018 and 2022, and pathogens were identified through biochemical tests.Antibiotic resistance was assessed using the Kirby-Bauer disc diffusion method.Results: Of 3008 samples, 2920 showed significant bacterial growth.The majority of samples were from patients aged 51-60 years.Among the positive samples, 85.9% were males, and 14.1% were females.The bacterial distribution was 66.8% Gram-negative and 33.2% Gram-positive.Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the most common pathogens.Of 621 Staphylococcus aureus isolates, 48.9% were methicillin-resistant.Among the 1949 Gram-negative isolates, 8.3% were extended-spectrum beta-lactamase (ESBL) resistant, and 5.6% were carbapenem-resistant. Conclusion:The study concludes that the increasing resistance of DFU pathogens complicates treatment.Culturing and identifying causative organisms and understanding their susceptibility are crucial for effective management of infections in diabetic patients.