blaSHV Genes in Bacteria Among Diabetic Foot Ulcer Patients from Selected Referral Hospitals in Uganda
Summary: This cross-sectional study at 7 Ugandan hospitals analyzed 117 diabetic foot ulcer (DFU) patients, finding 105 (89.7%) positive for bacterial growth, predominantly Gram-negative (E. coli, Klebsiella). ESBL production was 37.1% (39/105), with blaSHV genes in 71.8% of ESBL isolates, driving high resistance to cephalosporins (90%) and amoxicillin (95%). Gram-positives like S. aureus showed MRSA at 20%. The findings underscore the need for routine ESBL screening, antibiotic stewardship, and surveillance in DFU management to curb infection-driven amputations in low-resource settings.
Key Highlights:
- Demographics: 117 patients (mean age 58 years, 58% male); 105 cultures positive, 70% Gram-negative.
- ESBL Prevalence: 37.1%; blaSHV (28/39), blaTEM (24/39); multi-drug resistance in 82% ESBL producers.
- Resistance Patterns: 90% to 3rd-gen cephalosporins; 95% to amoxicillin; carbapenems effective (85%).
- Site Variation: Higher ESBL in urban hospitals (Kiruddu 50%, Fort Portal 46%); S. aureus in 30%.
- Implications: Urgent stewardship; molecular surveillance for DFU pathogens to guide therapy and reduce amputations.
Keywords: blaSHV genes, ESBL, diabetic foot ulcers, antibiotic resistance, Uganda DFU