Antibiotic Resistance in Diabetic Foot Ulcers and The Antibacterial Potential of Compounds Isolated from Endophytic Fungi

Background: Diabetic foot ulcers (DFUs) are a serious complication affecting millions globally. Bacterial infections often complicate DFUs, and rising antibiotic resistance presents a significant treatment challenge. This study aimed to identify the bacterial roles in DFUs and their resistance profiles, while exploring the potential of endophytic fungi from mangrove plants as an alternative antibacterial source. Methods: A total of 233 participants with DFUs were included. Ulcer severity was graded using the Wagner system. Bacteria were isolated from swab samples and identified. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method. Endophytic fungi were isolated from mangrove leaves, but their antibacterial activity is not reported here. Results: The study identified a high prevalence of DFUs, with Grade II ulcers most common. Staphylococcus aureus and Escherichia coli were the predominant bacteria isolated, often in polymicrobial infections. Alarmingly, the isolated bacteria exhibited high resistance to commonly used antibiotics like Penicillin, Tetracycline, and Erythromycin. This study confirms the high prevalence of DFUs and highlights the growing concern of antibiotic resistance among DFU-causing bacteria. The findings emphasize the urgent need for alternative treatment strategies. Although antioxidant potential of endophytic fungi isolated from mangroves warrants further investigation, their efficacy against the identified DFU pathogens remains unexplored in this study. Conclusion: The increasing prevalence of DFUs and the alarming levels of antibiotic resistance among responsible bacteria pose a significant clinical challenge. Further research is crucial to explore promising alternative treatment options like endophytic fungi, alongside stricter antibiotic stewardship measures to combat this growing problem and ensure improved patient outcomes