Antimicrobial susceptibility of bacteria that infect diabetic foot ulcers at Kenyatta National Hospital, Kenya

Background: Diabetic foot ulcers are prone to bacterial infection and this forms the major cause of hospital admission among patients with diabetes. Local bacterial sensitivity patterns to antimicrobials used to treat the infections is necessary in guiding drug selection for prompt management of the diabetic foot infections. Objective: To determine the etiology and antimicrobial sensitivity patterns of bacteria that infects diabetic foot ulcers at Kenyatta National Hospital. Methodology: A cross- sectional study was carried out on 75 adult diabetic patients attending Kenyatta National Hospital.  The patients were selected by convenient sampling and data obtained via a questionnaire and antimicrobial susceptibility determination of bacteria from the diabetic foot ulcers using disk diffusion method. Results: A total of 85 bacterial isolates were identified with Staphylococcus aureus (37.3%), Proteus spp (21.3%) and Klebsiella spp (14.7%) as the most prevalent organisms.  Among the Staphylococcus aureus, 39.3% were methicillin resistant. All the bacteria were sensitive to imipenem.   Gram positive and negative bacteria were sensitive to ciprofloxacin and piperacillin-tazobactam, respectively. Varied sensitivities to commonly used antibiotics: amoxicillin-clavulanate, meropenem, clindamycin, ceftriaxone, piperacillin-tazobactam and ciprofloxacin to different isolates are reported. Conclusion: In Kenyatta National Hospital, diabetic foot ulcers are infected with both gram negative and positive bacteria that are highly sensitive to imipenem. This study recommends the initiation of empirical antibiotic therapy with imipenem for moderate to severe diabetic foot infections as culture and sensitivity tests to determine more specific antimicrobials are awaited. Key words: Antimicrobial, Antimicrobial susceptibility, Diabetic foot ulcers