A Comparative Study on Treatment of Diabetic Foot Infection by Acetic Acid, Rifampicin and Probiotics

number: 
3096
English
Degree: 
Author: 
NOORHAN SABIH RESN
Supervisor: 
Dr. Abdulwahid B. Al-Shaibani
Dr. Sadeq A. Al- Mukhtar
year: 
2013

This study was aimed to treat diabetic foot infection patients by different methods and ways in order to select the best treatment. For such purpose, a total of 67 foot swab samples were collected from patients of both sexes who referred to three hospitals in Baghdad during  the period of 4/11/2012 – 30/1/2013. Results showed that 105 bacterial isolates were obtained, and found after identification by cultural, microscopic, biochemical characterizations and Api-20E kit, to be belonging to the following 12 bacterial species: (Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Proteus mirabilis, Citrobacter freundii, Acinetobacter baumannii, Enterobacter cloacae, Morganella morganii, Pseudomonas fluorescence, Aeromonas hydrophila and Serratia marcescens). Antibiotic susceptibility of bacterial isolates against 16 of  the commonly  used  antibiotics  was  investigated through disc-diffusion method. Results declared that, generally, all isolates were resistant to penicillin and cephalosporin groups.  Some of the isolates were sensitive to the amikacin and others to ciprofloxacin. On the other hand, all isolates were sensitive to imipenem except Acinetobacter baumannii which resisted all antibiotics used. Local and systemic ways of treatment were applied on the diabetic foot  infection to determine which of them gives better recovery. Two antibiotics were selected for using in the systemic treatment depending on their inhibitory activity in the antibiotic susceptibility test. While the local treatment was performed by using three agents (vinegar of 5% acetic acid, rifampicin and probiotics represented by Lactobacillus fermentum and L. delbrueckii). The two methods were compared by culturing wound swabs of the diabetic foot infection patients before and after treatment to detect whether all original pathogens of the initial wound culture were eradicated, still present or if organism(s) other than the original pathogens appeared in the last culture. Results showed that using of the chosen antibiotics by the systemic treatment had no effect on diabetic foot infections except on one patient who was cured. While local treatment with Rifampicin antibiotic was efficient by recording high inhibitory effect against the causative bacterial isolates. Acetic acid on the other hand, gave a slight inhibitory effect on bacterial isolates. While  treatment by probiotics had almost no effect against the diabetic foot infection pathogens.