Characterization of bacterial pathogens in Diabetic skin and soft tissue infections: A hospital-based study in Sohar, Oman

• Author Details:   
• Sendhil Coumary Arumugam
• Rokia Abdullah Sulaiman Al Zakwani
• Reem Aamir Hadoob Aamir Al Malki
• Noor Badar Abdullah Al Nadabi
• Al Hanuf Ali Saif Ali Al Abri

Introduction: Diabetes mellitus (DM) is a commonly prevalent, long-term metabolic condition that contributes to damage in multiple organs, resulting in significant health issues and financial burdens. In Oman, the prevalence of diabetes stands at 15.7%. Over the past 20 years, the emergence of multidrug-resistant (MDR) organisms has become a major global concern, complicating the management of diabetic foot infections (DFIs) and often leading to treatment failure, morbidity, and mortality.

Materials and Methods: This retrospective study reviewed medical records of diabetic patients with skin and soft tissue infections (SSTIs) who were hospitalized at New Sohar Hospital from January 2020 to December 2022. Data collected included patient demographics, diabetes-related details, microbiology samples, and lab findings. Pathogens were identified through Gram staining and culture.

Results: A total of 200 samples were collected from 71 patients, with 197 showing positive bacterial cultures. The average age of the patients was 60.06 ± 17.25 years. Diabetic foot ulcers were the most frequently observed type of infection. Gram-negative bacteria (73.6%) were more prevalent than Gram-positive bacteria (26.4%). The most commonly isolated Gram-negative bacterium was Proteus mirabilis (17.3%), while Staphylococcus aureus (10.1%) was the leading Gram-positive isolate. Older age was associated with a higher incidence of MDR organisms. Poor glycaemic control was significantly linked to MDR infections, with a p-value of 0.048.

Conclusion: The findings highlight that diabetic foot ulcers are the most prevalent SSTIs among diabetic patients. Gram-negative bacteria were the dominant pathogens, showing good susceptibility to beta-lactam antibiotics but resistance to third-generation cephalosporins. In contrast, trimethoprim-sulfamethoxazole and gentamicin were more effective against Gram-positive organisms. These insights are valuable for guiding empirical antibiotic choices in diabetic patients with SSTIs, particularly foot ulcers. Ongoing surveillance of bacterial strains and their resistance profiles is crucial for improving treatment strategies, reducing healthcare costs, and preventing the development of resistant bacteria.