Detection of Staphylococcus aureus and Pseudomonas aeruginosa among Diabetic Foot Ulcer Patients in Wasit Province

Abstract

Diabetic foot ulcer infection is a severe clinical complication that is determined by neuropathy, vascular impairment, tissue injury and successful bacterial invasion. Diabetic foot infections are the most common complication affecting people with diabetes, and bacterial pathogens play a key role. In this study, 90 subjects including 35 patients with diabetic foot ulcer (DFU) as well as 35 diabetic patients without ulcers and 20 healthy controls were enrolled. Methods: Wound swabs from ulcer group were processed through conventional culture, selective media, VITEK 2 identification and PCR. Univariate analysis identified isolation of P. aeruginosa (17/35;48.6%) being the most frequent isolate followed by S.aureus (13/35;37.1%) while other bacteria represented only 14.3%. Molecular confirmation using 16S rRNA, nuc and oprL genes showed complete concordance with phenotypic identification. Identification probabilities of both species on the VITEK 2 were greater than 90%. P. aeruginosa and S. aureus are clinically significant in diabetic foot ulcers due to their persistence, biofilm-forming ability and antimicrobial resistance; study results highlight concurrent use of culture, automated identification  and PCR for accurate diagnosis/management