title: Bacteriological and resistance profile in isolates from diabetic patients.
abstract: BACKGROUND
  Diabetes mellitus has become a global epidemic illness and poses a threat for development of resistant bacterial infections.
  
  
  OBJECTIVE
  This study was aimed to know the bacteriological and resistance profile of isolates obtained from diabetic patients.
  
  
  METHODS
  The bacterial isolates obtained from various samples of diabetic patients admitted in medicine department in 6-month period were identified and tested for antibiotic susceptibility. The extended spectrum beta-lactamases (ESβL), AmpC, and metallo-beta-lactamases (MβL) enzymes were detected in gram-negative bacilli. Methicillin, macrolide-lincosamide-streptogramin (MLS), and linezolid resistance in Staphylococcus spp. were detected. High-level aminoglycoside resistance (HLAR) in Enterococcus spp. was also tested.
  
  
  RESULTS
  In all, 38 of 125 diabetic patients (30.4%) had bacterial infection, 18 patients had wound infections, 18 had urinary tract infections (UTIs), and 2 had respiratory tract infections. Escherichia coli among gram-negative bacteria and Staphylococcus aureus among gram-positive bacteria were the predominant pathogens. 32.5% gram-negative bacilli were AmpC producers, 37.5% were MβL producers, and 40% were ESβL producers. Methicillin and MLS resistance was found in 50% and 33.3% isolates of Staphylococcus spp., respectively. HLAR resistance was alarming in Enterococcus spp. Polymyxin among gram-negative bacteria and vancomycin for gram-positive bacteria were the last resort with highest susceptibility rates to treat infections among diabetic patients.
  
  
  CONCLUSIONS
  Resistant bacterial infections in diabetic patients are common. The presence of various resistance mechanisms in isolates of our study shows that therapeutic failure can occur if empirical prescription is unsubstantiated.
authors.affiliation: Department of Microbiology, Government Medical College, Haldwani, Uttarakhand, India.
authors.forename: Vinita
authors.initials: V
authors.lastname: Rawat
authors.forename: Monil
authors.initials: M
authors.lastname: Singhai
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.forename: Pawan Kumar
authors.initials: PK
authors.lastname: Jha
authors.forename: Rajeev
authors.initials: R
authors.lastname: Goyal