Changing antibiogram profile of Acinetobacter baumannii in diabetic and non-diabetic foot ulcer infections: A comparative observational study.

Dr.Srinivas. Karri; Dr.K. Meenakshi; Dr.J. Balakrishna; Dr. Bindu  Madhavi.K

doi:10.51168/sjhrafrica.v6i12.2465

Authors

Dr. Srinivas Karri Associate Professor, Department of Microbiology, Nimra Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India
Dr. K. Meenakshi Assistant Professor, Department of Microbiology, Nimra Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India
Dr. J. Balakrishna Associate Professor, Department of Microbiology, Malla Reddy Medical College for Women, Hyderabad, Telangana, India.
Dr. Bindu Madhavi. K Assistant Professor, Department of Physiology, Nimra Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2465

Keywords:

Acinetobacter baumannii, diabetic foot infection, foot ulcer, antibiogram, multidrug resistance, colistin, tigecycline

Abstract

Background:

Diabetic foot infections represent a major cause of hospitalization, limb loss, and antimicrobial exposure worldwide. Their microbiological landscape is increasingly dominated by multidrug-resistant gram-negative organisms. Acinetobacter baumannii has emerged as a clinically significant pathogen in chronic wounds and healthcare-associated infections, frequently exhibiting extensive resistance and narrowing therapeutic choices.

Objectives:

To compare the antimicrobial susceptibility profile and multidrug-resistant (MDR) burden of Acinetobacter baumannii isolated from infected foot ulcers in diabetic and non-diabetic patients.

Methods:

This comparative observational study was conducted in the Department of Microbiology, NIMRA Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India, from May to October 2025. A total of 100 patients with clinically infected foot ulcers were enrolled, including 60 diabetics and 40 non-diabetics. Wound specimens were processed using standard culture techniques, and isolates were identified by conventional microbiological methods. Antimicrobial susceptibility testing was performed according to standard guidelines. MDR was defined as non-susceptibility to at least one agent in three or more antimicrobial classes.

Results:

The mean age of participants was 56.2 ± 10.8 years, and 68% were male. Diabetic patients had longer ulcer duration (median 18 vs 9 days). Resistance to ceftazidime and ceftriaxone was higher in diabetic than non-diabetic isolates (88.3% vs 70.0% and 83.3% vs 65.0%, respectively). Carbapenem resistance was 41.7% vs 25.0%, and amikacin resistance was 55.0% vs 37.5%. Colistin and tigecycline retained susceptibility above 90% in both groups. MDR prevalence was higher in diabetics (29/60, 48.3%) than in non-diabetics (11/40, 27.5%; Fisher’s exact p = 0.041).

Conclusion:

Acinetobacter baumannii from diabetic foot ulcers exhibited a substantially higher resistance burden and MDR frequency. Colistin and tigecycline remained the most effective therapeutic options.

Recommendations:

Strengthen antimicrobial stewardship, implement routine local antibiogram surveillance, optimize wound care, and enforce strict infection control practices.

Author Biographies

Dr. Srinivas Karri, Associate Professor, Department of Microbiology, Nimra Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India

is an Associate Professor in the Department of Microbiology at Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh. He has extensive experience in clinical microbiology, antimicrobial resistance surveillance, and hospital infection control. His academic interests focus on multidrug-resistant Gram-negative pathogens, antibiogram monitoring, and evidence-based antimicrobial stewardship. He is actively involved in undergraduate and postgraduate teaching and has contributed to several research publications in infectious diseases and laboratory medicine.ORCID iD: https://orcid.org/0009-0000-9039-0003

Dr. K. Meenakshi, Assistant Professor, Department of Microbiology, Nimra Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India

serves as an Assistant Professor in the Department of Microbiology at Nimra Institute of Medical Sciences, Vijayawada. Her areas of expertise include diagnostic bacteriology, antimicrobial susceptibility testing, and clinical laboratory quality assurance. She has a strong interest in wound microbiology, emerging resistance mechanisms, and translational research aimed at improving patient-centered infection management. She participates actively in academic training and institutional research initiatives.

Dr. J. Balakrishna, Associate Professor, Department of Microbiology, Malla Reddy Medical College for Women, Hyderabad, Telangana, India.

is an Associate Professor in the Department of Microbiology at Viswabharathi Medical College and General Hospital, Kurnool, Andhra Pradesh. His professional focus includes healthcare-associated infections, molecular epidemiology of resistant organisms, and clinical correlation of microbiological findings. He has contributed to institutional infection control programmes and is engaged in mentoring postgraduate trainees in microbiological research and diagnostics.

Dr. Bindu Madhavi. K, Assistant Professor, Department of Physiology, Nimra Institute of Medical Sciences, Jupudi, Vijayawada, Andhra Pradesh, India

is an Assistant Professor in the Department of Physiology at Nimra Institute of Medical Sciences, Vijayawada. Her academic interests encompass pathophysiological mechanisms underlying chronic diseases, metabolic regulation, and integrative biomedical research. She contributes to interdisciplinary studies linking physiological alterations with infectious and inflammatory conditions, and is actively involved in medical education and curriculum development.

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