Prevalence and antibiotic susceptibility pattern of bacterial infection in diabetic foot ulcer in different regions of khyber pakhtunkhwa

Background: Diabetic foot infections (DFIs) represent a significant public health challenge, and understanding the pathogens responsible is essential for effective antibiotic therapy. The microorganisms causing these infections, along with their antibiotic resistance patterns, vary by geographic region, necessitating localized empirical treatment. Objective: This study aims to investigate the incidence of antibiotic sensitivity and resistance patterns of bacterial infections in diabetic foot ulcers in Khyber Pakhtunkhwa. Material and method: A cross-sectional study was conducted at the Diabetes Center, Hayatabad Medical Complex, Peshawar, over four months, involving 500 randomly selected diabetic patients with foot ulcers. Samples were collected aseptically using wound swabs and cultured on various media, including Mueller-Hinton agar, MacConkey agar, and CLED. Bacterial identification was carried out using biochemical assays (catalase, coagulase, TSI), Gram staining, and the use of specific media. Antibiotic susceptibility was evaluated using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar. Data were analyzed using SPSS version 25. Result: Out of 500 samples, 200 (40%) showed positive bacterial growth, with the highest sample contribution from Peshawar (35%), followed by Bannu (25%). Female participants accounted for 58%, with the majority (68%) aged between 41 and 60 years. Staphylococcus aureus and Klebsiella pneumoniae were the principal isolates, confirmed through Gram staining and biochemical assays. Antibiotic susceptibility testing showed high sensitivity to Amikacin (91%) and Gentamicin (89%), while resistance rates for Cotrimoxazole and Imipenem exceeded 90%. Conclusion: This study highlights the significant prevalence of Staphylococcus aureus and Klebsiella pneumoniae in diabetic foot ulcers across Khyber Pakhtunkhwa and the high rates of antibiotic resistance. The results underscore the critical need for localized antibiotic management strategies to reduce resistance and improve patient outcomes.