High prevalence of multidrug-resistant bacteria in diabetic foot infections: a series of 59 cases at a district hospital in Cameroon

Abstract

Introduction: Diabetic foot infections (DFI) represent a common and significant healthcare challenge, particularly in low-resource settings like Sub-Saharan Africa. This study aimed to outline the epidemiological, clinical, and microbiological aspects along with the patterns of anti-biotic susceptibility relevant to DFI in Yaoundé.

Materials and Methods: A cross-sectional study was conducted at Cité Verte District Hospital from October 15, 2022, to July 21, 2023. We enrolled diabetic patients with infected foot ulcers. Bacteriological samples were taken to identify the causative pathogens and determine their anti-biotic susceptibility profile.

Results: The study sample comprised 59 patients, mostly male, with a mean age of 52 (± 11.8) years. A significant proportion of patients had type 2 diabetes (88%) which lasted for less than a decade. Foot ulcers were chronic and severe (66% Wagner grade 3), and only 39% had received some form of education on foot care. The predominant pathogens identified were gram-negative bacilli, including Klebsiella pneumoniae (20%), Proteus mirabilis (10%), Escherichia coli (8%), followed by gram-positive cocci Staphylococcus saprophyticus (36%). There was polymicrobial infection in 17% of cases. Other notable findings included high level resistance to amoxicillin-clavulanic acid, cephalosporins, and vancomycin. These findings suggest the presence of com-mon multidrug resistant and strains resistant to methicillin.

Conclusion: The study highlights the prevalence of multidrug-resistant bacteria in DFI in Ya-oundé, limiting therapeutic options. Strengthening preventive education, improving microbiolog-ical diagnostic capacity, and adapting antibiotic stewardship are critical in such resource-limited settings.