ANTIBIOTIC SUSCEPTIBILITY AND PREVALENCE OF Staphylococcus aureus IN DIABETIC WOUNDS AMONG PATIENTS AT MOI TEACHING AND REFFERAL HOSPITAL, KENYA

Abstract

The frequent source of deferred healing processes in wounds is Staphylococcus aureus worldwide. Diabetic wounds in diabetic patients contribute to delayed healing due to antibacterial resistance, which has caused a lot of suffering and a low quality of life for patients. This study investigated the prevalence, possible risk factors, and antimicrobial susceptibility profile of S. aureus isolated from diabetic wounds of patients attending Moi Teaching and Referral Hospital (MTRH). It involved purposive sampling; patients with diabetic wound infections who were willing to participate in the study were selected. The study included Type 2 Diabetes patients aged 13 years and above, who presented at the MTRH diabetic clinic during the study, and had not used antibiotics for any reason. The study targeted 156 diabetic patients attending MTRH. A questionnaire was administered to collect socio-demographic data. Wound swabs were aseptically collected and cultured on blood agar, then sub-cultured on Mannitol Salt Agar to isolate S. aureus. It was further identified by catalase and coagulase tests. Determination of antimicrobial susceptibility was by the Agar disk diffusion method. The occurrence of S. aureus in diabetic wounds was significantly (p=0.025) influenced by the sex of patients attending the diabetic clinic at MTRH. However, age (p=0.6503), underlying conditions (p=0.8437), previous hospitalization (p=0.808), previous antibiotic use (p=0.6874), marital status (p=0.118), and the level of education (p=0.192) do not significantly predispose the wounds of diabetic patients attending an outpatient diabetic clinic at MTRH to S. aureus. 31 samples were positive for S. aureus. An instance of intermediate sensitivity 26 (10.48%) was shown by S. aureus isolated in this study, with 72 (29.03%) resistance to antibiotics. However, most of the isolates were vulnerable to the test antibiotics. A higher number of S. aureus isolates were susceptible to Cefoxitin (96.77%) and Clindamycin (80.65%), with lesser susceptibility to Ampicillin (25.81%). A prevalence of 19.87%, Cefoxitin being effective against most of the S. aureus isolates, and a significant relation between sex and occurrence of S. aureus in diabetic wounds were established. Early surveillance and screening to detect any presence of MRSA in diabetic wounds and the susceptibility profile of S. aureus

in diabetic wounds of patients attending the diabetic clinic at MTRH is recommended. Re- evaluation of the use of Ampicillin should also be taken into consideration to prevent

widespread antibiotic resistance. Female diabetic patients should take more precautions to prevent any traumatic injury, which could lead to diabetic wound infections.