The Antimicrobial Resistance Patterns & Distribution of Antibiotic Resistance Genes among Carbapenem Resistant Escherichia Coli Isolated from Diabetic Foot Infection.

Background: Diabetic foot infection (DFI) is an infection in soft tissue or bone in patient with diabetes mellitus, treatment of DFIs requires appropriate antibiotic selection, continuous updates of the microorganisms that are responsible of infection and their resistance pattern, the aim of this study to determine the frequency of antimicrobial resistance patterns, ESBLs, and MBLs produced carbapenem resistant Escherichia coli isolated from patients with DFI. Methods: about 111 swabs specimen were collection from patient suspected with DFI during the period of study, determinethe antibiotic susceptibility of E coli isolatesby using Kirby-Bauer disk diffusion method to 23 antimicrobial agents. ESBL production was screened by two tests initial method by the disk diffusion method of ceftazidime, ceftriaxone, cefotaxime, and aztreonam (30µg/disk each), accordingto the CLSI (2021) and confirmatory method by Double disk diffusion test, MBL production by the diskdiffusion method of imipenem and meropenem. Molecular detection for ESBL genes by monoplex PCR and MBL genes by multiplex PCR. Results: from 111 swabs specimen E.coli isolates had represented in 19 (27.5%) among Gram-negative bacteria. Antibiotic susceptibility test revealed that10 carbapenem resistant E.coli isolates, and the highest resistant to ß-lactam class and cephalosporin, results indicated also 100% of isolates were MDR and 63.1 XDR. PCR assay to ESBL genes revealed that blaCTX-M was found in 3 (30%) and blaOXA was noticed in 4 (40%). The PCR data of MBL genes revealed that, the frequency of MBL genes among isolates as following blaVIM1 (50%), blaNDM2 (100%), and blaSIM 2 (100%). Conclusion: the study show high frequency of antibiotic resistant pattern and the presence of ESBL and MBL genes among carbapenem resistant E.coli isolated from DFI. [ABSTRACT FROM AUTHOR]