Plasmid-mediated extended-spectrum beta-lactamase-producing strains of Enterobacteriaceae isolated from diabetes foot infections in a Brazilian diabetic center

we bacteriologically analyzed 156 species of enterobacteriaceae, isolated from 138 patients with community-acquired diabetic foot ulcers, in a prospective study made at a diabetic center and at the federal university of ceará, brazil, from march, 2000, to november, 2001.the samples were cultured using selective media, and identification, susceptibility tests and detection of plasmid-mediated-extended-spectrum-b-lactamase (esbl) producing strains were made with conventional and automated methods. the most frequently occurring pathogens were k. pneumoniae (21.2%), morganella morganii (19.9%) and e. coli (15.4%). high resistance rates were noted for ampicillin, first generation cephalosporin, trimethoprim/sulfamethoxazole, tetracycline, amoxicillin-clavulanic acid and chloramphenicol. esbl-producing strains were detected in 6% of the patients. resistance among gram-negative bacteria has become increasingly common, even in community-acquired infections.