Occurrence and Antimicrobial Resistance of Extended- Access Spectrum Beta-Lactamase Producing Bacteria in Diabetic Foot Infections at Korle-Bu Teaching Hospital:

Sarkodie Kodom; Jeanette Bentum; Steven Simpeh; Noah Obeng Nkrumah; Patrick  Feglo; Beverly  Egyir

doi:10.46829/hsijournal.2025.6.7.1.1161-1166

Sarkodie Kodom University of Ghana Hospital, Legon, Accra, Ghana; Department of Pathology, East Kent University Hospital Foundation Trust, Ashford, UK
Jeanette Bentum Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
Steven Simpeh Department of surgery, Korle Bu Teaching Hospital, Accra, Ghana
Noah Obeng Nkrumah Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health, University of Ghana
Patrick Feglo Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Beverly Egyir Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana

DOI: https://doi.org/10.46829/hsijournal.2025.6.7.1.1161-1166

Keywords: diabetic foot infection, ESBL, polymerase chain reaction

Abstract

Background: Common complications of diabetes mellitus include foot infections, leading to increased healthcare costs and delayed wound healing. Diabetic foot infections (DFIs) can be caused by Gram-negative, Extended-Spectrum Beta-Lactamase (ESBL)-producing bacteria, which are resistant to a wide range of antibiotics used in clinical medicine. This poses a significant challenge to treating DFIs. Availability of data on such bacterial species is therefore crucial in the management of these infections.
Objective: This study investigated the antimicrobial resistance and molecular characteristics of ESBL-producing bacteria from diabetic foot ulcers at Korle Bu Teaching Hospital (KBTH) using disk diffusion and PCR.
Methods: Tissue samples, aspirates or pus were collected from diabetic patients in the ulcer room at the Department of Surgery, KBTH, from January to September 2018. Patients’ demographics were gathered using a data collection tool. Bacterial culture, antimicrobial susceptibility testing and PCR detection of ESBL genes were performed.
Results: 138 Gram-negative isolates were recovered from the 50 study participants. Among the isolates, 41 (28.9%) were phenotypically positive for ESBL production using CHROMagar ESBL. The antimicrobial resistance profile of ESBL-positive isolates revealed high resistance to cefuroxime in Escherichia coli (84.2%, n = 16/19) and Klebsiella pneumoniae (75.0%, n = 3/4). CTX-M was predominantly identified in E. coli (50.0%, n = 9/18) when PCR detection was done.
Conclusion: ESBL-producing Gram-negative bacteria remain a significant challenge in Ghana, with the CTX-M gene being the most prevalent among the ESBL-positive isolates. However, a higher percentage of isolates were susceptible to meropenem, indicating that it may be an effective therapeutic option.

Occurrence and Antimicrobial Resistance of Extended- Access Spectrum Beta-Lactamase Producing Bacteria in Diabetic Foot Infections at Korle-Bu Teaching Hospital

Extended spectrum beta-lactamase producers in diabetic foot infections

Abstract