{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:08:41Z","timestamp":1793038121151,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"Introduction<\/jats:title>Infected diabetic foot ulcer (IDFU) is a worldwide problem associated with diabetes mellitus. It could lead from soft tissue infection to bone infection and is a leading cause of lower limb amputation. Gram-negative and Gram-positive bacteria, including anaerobic bacteria and fungi, are considered potential causes of infection. The early diagnosis of DFU infection and appropriate treatment based on the identification of the pathogens and their antimicrobial susceptibility pattern is important for good prognosis. Therefore, the purpose of this study was to isolate the bacteria that infect foot ulcers in selected Hospitals and determine their antimicrobial resistance profile.<\/jats:p><\/jats:sec>Method<\/jats:title>An institutional-based multicenter, cross-sectional study was conducted in selected Hospitals in Addis Ababa, Ethiopia, from November 2020 to May 2021.\u00a0A sterile swab was used to collect samples from the foot ulcer and a sterile needle to collect pus. Isolates were identified by culture, Gram-staining, and a series of biochemical tests. For each bacterial species identified, the antibiotic profiling was determined by the Kirby-Bauer disk diffusion method.<\/jats:p><\/jats:sec>Results<\/jats:title>one hundred and twenty-seven pathogenic bacteria were isolated from samples taken from 130 patients with a diabetic foot ulcer. Sixty-eight percent had growth of multiple microorganisms. Two-thirds (66.7%) of the isolates were gram-negative bacteria. The predominant bacterial species were S. aureus<\/jats:italic> 25.19% (32\/127), Pseudomonas species<\/jats:italic> 18.89% (24\/127), and Escherichia coli<\/jats:italic> 16.53% (21\/127). Overall, 92.9% (118\/127) of the isolates were identified as multi-drug resistant. Gram-positive isolates were susceptible to chloramphenicol, clindamycin, and amikacin. Gram-negative isolates were also sensitive to chloramphenicol, aztreonam, and amikacin.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The majority of bacteria isolated from patients presenting with Diabetic foot ulcer infections were found to be multi-drug resistant in the study sites of the current study. The results demonstrate the importance of timely identification of infection of diabetic foot ulcers, proper sample collection for identification of the pathogens and for determining their antibiotic susceptibility pattern before initiating antimicrobial treatment<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.987487","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T09:22:53Z","timestamp":1661937773000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":58,"title":["Bacterial isolates from diabetic foot ulcers and their antimicrobial resistance profile from selected hospitals in Addis Ababa, Ethiopia"],"prefix":"10.3389","volume":"13","author":[{"given":"Asegdew","family":"Atlaw","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habtamu Biazin","family":"Kebede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdurezak Ahmed","family":"Abdela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimtubezinash","family":"Woldeamanuel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong","year":"2017","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2879809","article-title":"Increased mortality in diabetic foot ulcer patients: The significance of ulcer type","volume":"7","author":"Chammas","year":"2016","journal-title":"J Diabetes Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054","article-title":"Association of diabetic foot ulcer and death in a population-based cohort from the united kingdom","volume":"33","author":"Walsh","year":"2016","journal-title":"Diabetes Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2016.1231932","article-title":"Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis \u2020","volume":"49","author":"Zhang","year":"2017","journal-title":"Ann Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.21315\/mjms2019.26.1.10","article-title":"The significant association between polymicrobial diabetic foot infection and its severity and outcomes","volume":"26","author":"Hitam","year":"2019","journal-title":"Malays J Med Sci"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis346","article-title":"Infectious diseases society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections","volume":"54","author":"Lipsky","year":"2012","journal-title":"Clin Infect Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2015.04.007","article-title":"Diabetic foot ulcer\u2013a review on pathophysiology, classification and microbial aetiology","volume":"9","author":"Noor","year":"2015","journal-title":"Diabetes Metab Syndr"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.11.025","article-title":"The burden of infected diabetic foot ulcers on hospital admissions and costs","volume":"33","author":"Hicks","year":"2016","journal-title":"Ann Vasc Surg"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-015-2544-1","article-title":"The microbiome of diabetic foot osteomyelitis","volume":"35","author":"van Asten","year":"2016","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v10.i3.200","article-title":"Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicenter evaluation of diabetic foot ulcer in Nigeria","volume":"10","author":"Ugwu","year":"2019","journal-title":"World J Diabetes"},{"key":"B11","doi-asserted-by":"publisher","first-page":"19003061","DOI":"10.1101\/19003061","article-title":"Prevalence of diabetic foot ulcer and its association with duration of illness and residence in Ethiopia: a systematic review and meta-analysis","author":"Mulugeta","year":"2019","journal-title":"medRxiv"},{"key":"B12","first-page":"1","article-title":"Incidence of diabetic foot ulcer among diabetes mellitus patients admitted to nekemte referral hospital, Western Ethiopia: a prospective observational study","volume":"8","author":"Bekele","year":"2019","journal-title":"Endocrinol Metab Syndr"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2879249","DOI":"10.1155\/2017\/2879249","article-title":"Prevalence of diabetic foot ulcer and associated factors among adult diabetic patients who attend the diabetic follow-up clinic at the university of gondar referral hospital, north West Ethiopia, 2016: Institutional-based cross-sectional study","author":"Mariam","year":"2017","journal-title":"J Diabetes Res"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4172\/2155-6156.1000322","article-title":"Prevalence and factors influencing diabetic foot ulcer among diabetic patients attending arbaminch hospital, south Ethiopia","volume":"5","author":"Deribe","year":"2014","journal-title":"J Diabetes Metab"},{"key":"B15","doi-asserted-by":"publisher","first-page":"17","DOI":"10.4314\/ejhd.v25i1.69841","article-title":"Diabetic foot disease in Ethiopian patients: a hospital-based study","volume":"25","author":"Amogne","year":"2011","journal-title":"Ethiopian J Health Dev"},{"key":"B16","first-page":":17\u201321","article-title":"Assessment of prevalence of diabetic foot ulcer and associated factors among diabetic patient attending tikur anbesa specialized hospital diabetic clinic, Addis Ababa, Ethiopia","volume":"25","author":"Yimam","year":"2017"},{"key":"B17","volume-title":"Performance standards for antimicrobial susceptibility testing. 29th ed. CLSI supplement M100","year":"2020"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/s0074-7742(02)50082-9","article-title":"Polyol pathway and diabetic peripheral neuropathy","volume":"50","author":"Oates","year":"2002","journal-title":"Int Rev Neurobiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3947\/ic.2018.50.1.11","article-title":"Microbiology and antimicrobial therapy for diabetic foot infections","volume":"50","author":"Kwon","year":"2018","journal-title":"Infect Chemother"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3329\/jss.v24i1.52213","article-title":"Bacteriological profile of diabetic foot infection and its effect on limb salvation","volume":"24","author":"Murshed","year":"2020","journal-title":"J Surg Sci"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.18203\/2349-2902.isj20210389","article-title":"Bacteriological profile of diabetic foot","volume":"8","author":"Shah","year":"2021","journal-title":"Int Surg J"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3268","article-title":"Definitions and criteria for diabetic foot disease","volume":"36","author":"Van Netten","year":"2020","journal-title":"Diabetes\/metabolism Res Rev"},{"key":"B23","doi-asserted-by":"publisher","first-page":"39","DOI":"10.18683\/germs.2021.1239","article-title":"Microbial profile, antimicrobial resistance, and molecular characterization of diabetic foot infections in a university hospital","volume":"11","author":"Ismail","year":"2021","journal-title":"Germs"},{"key":"B24","doi-asserted-by":"publisher","first-page":"95","DOI":"10.12816\/0024935","article-title":"Diabetic foot infection: Microbiological causes with special reference to their antibiotic resistance pattern","volume":"24","author":"Dwedar","year":"2015","journal-title":"Egyptian J Med Microbiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"8694903","DOI":"10.1155\/2017\/8694903","article-title":"Bacterial profile and antibiotic resistance in patients with diabetic foot ulcer in guangzhou, southern China: Focus on the differences among different wagner\u2019s grades, IDSA\/IWGDF grades, and ulcer types","author":"Xie","year":"2017","journal-title":"Int J Endocrinol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/1534734619884430","article-title":"A study on isolation, characterization, and exploration of multiantibiotic-resistant bacteria in the wound site of diabetic foot ulcer patients","volume":"20","author":"Thanganadar Appapalam","year":"2021","journal-title":"Int J Low Extrem Wounds"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1177\/1534734618793557","article-title":"Common pathogens and antibiotic sensitivity profiles of infected diabetic foot ulcers in Saudi Arabia","volume":"17","author":"Al Ayed","year":"2018","journal-title":"Int J Low Extrem Wounds"},{"key":"B28","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1186\/s12879-020-04973-0","article-title":"Pseudomonas infections among hospitalized adults in Latin America: a systematic review and meta-analysis","volume":"20","author":"Ponce de Leon","year":"2020","journal-title":"BMC Infect Dis"},{"key":"B29","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1186\/s13104-019-4278-0","article-title":"Bacterial isolation and antibiotic susceptibility from diabetic foot ulcers in Kenya using microbiological tests and comparison with RT-PCR in the detection of s. aureus and MRSA","volume":"12","author":"Mutonga","year":"2019","journal-title":"BMC Res Notes"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1186\/s41702-019-0039-x","article-title":"Aerobic bacteria associated with diabetic foot ulcers and their susceptibility pattern","volume":"3","author":"Ogba","year":"2019","journal-title":"BioMed Dermatol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3126\/ajms.v12i5.34415","article-title":"Bacteriological profile and antimicrobial sensitivity pattern of isolates from the diabetic foot of patients attending a teaching hospital in northern India","volume":"12","author":"Aleem","year":"2021","journal-title":"Asian J Med Sci"},{"key":"B32","doi-asserted-by":"publisher","first-page":"Doc02","DOI":"10.3205\/dgkh000245","article-title":"Bacterial aetiology and antibiotic susceptibility pattern of diabetic foot infections in tabriz, Iran","volume":"10","author":"Akhi","year":"2015","journal-title":"GMS hygiene infection control"},{"key":"B33","article-title":"Antimicrobial sensitivity patterns of pseudomonas aeruginosa isolates obtained from foot ulcer diabetes patients in Tripoli, Libya","volume":"12","author":"Elbaz","year":"","journal-title":"2018, Libyan Journal of Medical Research (LJMR)"},{"key":"B34","article-title":"Microbiological pattern of diabetic foot infections at a tertiary care centre in a developing country","volume":"67","author":"Miyan","year":"2017","journal-title":"J Pak Med Assoc"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.4102\/ajlm.v10i1.1261","article-title":"Multicentre study of the burden of multidrug-resistant bacteria in the aetiology of infected diabetic foot ulcers","volume":"10","author":"Adeyemo","year":"2021","journal-title":"Afr J Lab Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.4103\/ijem.IJEM_546_16","article-title":"Bacteriological profile of diabetic foot ulcer with special reference to drug-resistant strains in a tertiary care center in north-East India","volume":"21","author":"Jain","year":"2017","journal-title":"Indian J Endocrinol Metab"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.987487\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T09:23:04Z","timestamp":1661937784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.987487\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,31]]},"references-count":36,"alternative-id":["10.3389\/fendo.2022.987487"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.987487","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,31]]},"article-number":"987487"}}