Antibiotics Susceptibility Pattern in Diabetic Ulcer Patients

Mita Rahma Yani, Dewi Indah Noviana Pratiwi, Rahmiati Rahmiati, Noor Muthmainah, Alfi Yasmina


Diabetic ulcers are a chronic complication of diabetes mellitus and have a high risk of infection. Severe ulcer infections
are a significant cause of lower-extremity amputations in addition to trauma. Therefore, therapy for diabetic ulcer infections
must be performed immediately. This study aimed to determine the bacterial susceptibility pattern to the antibiotic in
diabetic ulcer patients. This study was retrospective observational descriptive by taking the results of swab culture and
antibiotic susceptibility patterns data in diabetic ulcer patients at Ulin General Hospital, Banjarmasin, in 2016-2018. The
results showed 41 (62.1%) monomicrobial infections and 25 (37.9%) polymicrobial infections. The number of Gram-negative
bacilli (57.4%) was higher than Gram-positive cocci (42.6%). The most common bacterial isolates on pus culture were
Staphylococcus aureus (26.6%), Klebsiella pneumonia (19.1%), and Escherichia coli (12.8%). Antibiotic susceptibility test
results showed that Gram-positive bacteria were sensitive to Tigecycline (100%), Nitrofurantoin (96.9%), and Linezolid
(96.8%). Gram-negative bacteria were susceptible to Ertapenem (92.7%), Meropenem, and Amikacin (90.6%). S.aureus
isolates were sensitive 100% to Meropenem and Tigecycline. K.peneumoniae and E.coli isolates were susceptible 100% to
Meropenem and Amikacin. It was concluded in this study that the prevalence of Gram-negative bacteria in diabetic ulcer
infection was higher than Gram-positive bacteria. The most common isolated Gram-negative bacteria were K.pneumoniae
and E.coli, while the most common Gram-positive bacteria were S.aureus. The most sensitive antibiotics for K.pneumoniae
and E.coli were Meropenem and Amikacin, while the most sensitive antibiotics for S.aureus were Linezolid and Tigecycline.


Diabetic ulcer, bacterial pattern, antibiotic susceptibility

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Karuranga S, Fernandes JR, Huang Y, Malanda B. IDF

th diabetes atlas. 8 Ed., United States, International

Diabetes Federation, 2017; 130.

World Health Organization. Global report on diabetes.

Prancis, World Health Organization. 2016. Available

f r o m U R L : h t t p s : / / w w w . w h o . i n t / d i a b e t e s /

global-report/en/ (accessed 9 December, 2018).

Kementerian Kesehatan RI. Hasil utama Riskesdas

0 1 8 . A v a i l a b l e f r o m U R L : h t t p : / / w w w .

hasil-riskesdas-2018.pdf (accessed 9 December,


Kementerian Kesehatan RI. Situasi dan analisis

diabetes. 2014. Available from URL:http://www.

infodatin-diabetes.pdf (accessed 9 December, 2018).

Sari YO, Almasdy D, Fatimah A. Evaluasi penggunaan

antibiotik pada pasien ulkus diabetikum di Instalasi

Rawat Inap (IRNA) penyakit dalam RSUP Dr. M. Djamil

Padang. Jurnal Sains Farmasi & Klinis, 2018; 5(2):


Ibrahim AM. Diabetic foot ulcer: Synopsis of the

epidemiology and pathophysiology. International

Journal of Diabetes and Endocrinology, 2018; 3(2):


Nurhanifah D. Faktor-faktor yang berhubungan

dengan ulkus kaki diabetik di poliklinik kaki diabetik.

Healthy-Mu Journal, 2017; 1(1):32-41.

Perim MC, Borges JC, Celeste RSC, Orsolin EF, Mendes

RR, et al. Aerobic bacterial profile and antibiotic

resistance in patients with diabetic foot infections Revista da Sociedade Brasileira de Medicina Tropical,

; 48(5): 546-54.

Smith K, Collier A, Townsend EM, O'Donnell LE, Bal Am,

et al. One step closer to understanding the role of

bacteria in diabetic foot ulcers: Characterising the

microbiome of ulcers. BMC Microbiology, 2016;

(54): 1-12.

Riddle MC. Standards of medical care in diabetes-2019.

Diabetes Care, 2019; 42(1): S1-S193.

Patil P, Khadse R, Chavan S, Raut S. Bacteriological

profile of diabetic foot infections. European Journal of

Pharmaceutical and Medical Research, 2018; 5(6):


Jain SK, Barman R. Bacteriological profile of diabetic

foot ulcer with special reference to drug-resistant

strains in a tertiary care center in North-East India.

Indian Journal of Endocrinology and Metabolism,

; 21(5): 688-94.

Yi KR, Leng LC, Kumar RJ, Zakaria ZAM, Khan ES.

Microbiology of diabetic foot infection in three district

hospitals in Malaysia and comparison with southeast

Asian countries. Med J Malaysia, 2019; 74(5): 394-9.

Nur A, Nelly M. Gambaran bakteri ulkus diabetikum di

Rumah Sakit Zainal Abidin dan Meuraxa tahun 2015.

Buletin Penelitian Kesehatan, 2016; 44(3): 187–96.

Saraswathy KM, Pramodhini S, Babu CPG, Umadevi S,

Seetha KS. Bacteriological profile and their antibiotic

susceptibility pattern in diabetic foot ulcer in a tertiary

care hospital, Puducherry, India. Int.J.Curr.Microbiol.

App.Sci, 2017; 6(3): 1560-6.

Spichler A, Hurwitz BL, Armstrong DG, Lipsky BA.

Microbiology of diabetic foot infections: From Louis

Pasteur to 'crime scene investigation'. BioMed Central

Medicine, 2015; 13(2): 1-13.

Brooks GF, Carrol KC, Butel JS, Morse SA, Mietzner TA.

Jawetz, Melnick & Adelbergs medical microbiology.

th 28 Ed., United States, McGraw-Hill, 2019; 202-3.

Noor AP, Puntodewo. Microbiology and antibiotic

sensitivity pattern of diabetic foot ulcer patients.

American Scientific Research Journal, 2019; 54(1):


Katzung BG. Basic & clinical pharmacology. 14 Ed.,

New York, McGraw-Hill, 2018; 833-34.



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