ABSTRACT
AIMS: The aim of this study was to isolate and characterize staphylococcal isolates from diabetic foot ulcers (DFU) in Jordanian patients. METHODS AND RESULTS: Selected aerobic pathogens recovered from DFU specimens and patients' nares with a focus on staphylococci were investigated. Antimicrobial susceptibilities and the prevalence of methicillin-resistant staphylococci (MRS) were determined. SCCmec types and toxigenic characteristics were analysed and spa typing was performed for methicillin-resistant Staphylococcus aureus (MRSA) isolates. The relationship between toxigenic characteristics of MRSA and the Wagner ulcer grading system was statistically analysed. A total number of 87 DFU patients were recruited for the study. The DFU cultures were polymicrobial. Members of the genus Staphylococcus were the most common among DFU-associated isolates found in 48·3% (n = 42) of all patients enrolled. Coagulase-negative staphylococci (CoNS) comprised 63·3% of staphylococci isolated from DFUs predominated by Staphylococcus epidermidis in both DFU (7·6%) and nares (39·2%). Staphylococcus aureus was isolated from DFUs and nares in 14·2 and 9·8%, respectively, while 93 and 70% of these isolates were MRSA. Most of MRSA carried SCCmec type IV (76·2%) while SCCmec elements were non-typeable in most methicillin resistant coagulase negative staphylococci (MR-CoNS) (61·9%). The most frequent MRSA spa type was t386 (23·8%). Most MRSA and MR-CoNS exhibited resistance towards aminoglycosides, fluoroquinolones and macrolides and susceptibility towards vancomycin, mupirocin and linezolid. No association was found between the possession of pvl, tst, sea and hlg toxins and Wagner ulcer grading system (P value >0·05). CONCLUSIONS: This analysis of Jordanian DFU culture demonstrated its polymicrobial nature with predominance of Staphylococcus sp. SIGNIFICANCE AND IMPACT OF THE STUDY: This study is the first of its type to assess the microbiology of DFU among Jordanian patients. The results will help in the appropriate application of antimicrobial chemotherapy in the management of DFU.
Subject(s)
Diabetes Mellitus , Diabetic Foot , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections , Anti-Bacterial Agents/pharmacology , Diabetic Foot/epidemiology , Humans , Methicillin Resistance , Methicillin-Resistant Staphylococcus aureus/genetics , Microbial Sensitivity Tests , Staphylococcal Infections/epidemiology , Staphylococcus/geneticsABSTRACT
To evaluate knowledge, attitude and practices (KAP) of physicians regarding the management of medications in Ramadan we used a self-administered questionnaire on a target sample of 381 physicians at Jordan University Hospital, King Abdulla University Hospital and a number of private clinics in Amman, during September and October of 2008. A total of 297 questionnaires were returned. Physicians' KAP about management of medications in Ramadan was generally insufficient. The main factors that affected KAP were age, nationality, specialty, and country and year of last qualification (P < 0.05). Female physicians scored better than males, and fellows scored better than other groups for knowledge. Most physicians' attitudes and practices were in line with religious opinion in regard to which routes of drug administration can nullify fasting, indicating that physicians have adequate knowledge in this area.
Subject(s)
Drug Therapy , Health Knowledge, Attitudes, Practice , Islam , Practice Patterns, Physicians'/statistics & numerical data , Adult , Aged , Fasting , Female , Humans , Jordan , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
To evaluate knowledge, attitude and practices [KAP] of physicians regarding the management of medications in Ramadan we used a self-administered questionnaire on a target sample of 381 physicians at Jordan University Hospital, King Abdulla University Hospital and a number of private clinics in Amman, during September and October of 2008. A total of 297 questionnaires were returned. Physicians' KAP about management of medications in Ramadan was generally insufficient. The main factors that affected KAP were age, nationality, specialty, and country and year of last qualification [P < 0.05]. Female physicians scored better than males, and fellows scored better than other groups for knowledge. Most physicians' attitudes and practices were in line with religious opinion in regard to which routes of drug administration can nullify fasting, indicating that physicians have adequate knowledge in this area