Abstract

The current majors  for bacteria Acinetobacter  baumannii Gram-negative aerobes Which is one of the most common pathogens of contaminants DFU), Also, the sensitivity of bacterial isolates to the alcoholic extract of propolis (EEP) was highlighted as a natural antimicrobial substance compared to the used antibiotic, As well as knowing the rates of infection with this bacteria and the relationship of infection with age and sex

         The study included the collection of 50 samples of diabetic foot ulcers for patients after their diagnosis by the specialist doctor in Al-Kafeel Specialist Hospital in Karbala Governorate, for the period from September 2022 until February 2023, and the ages ranged between ( 35-69) years and for both sexes The samples taken from the air were cultured on the medium of  Blood Agar and MaCconkey Agar, Biochemical tests were then conducted Vitek compact system-2 for bacterial diagnosis

                The results of the current study showed that out of 76 isolates, 18 isolates were obtained, with a rate of 23.7% belonging to the group of Gram-positive bacteria two isolates of Candida SP with a percentage of 2 (2.6%), and 56 negative isolates for gram stain, with a percentage of 73.7%, is a bacterial isolate, which is the most isolated for infections of diabetic foot ulcers. It may be due to its resistance to many antibiotics and virulence factors such as Endotoxins, Biofilm.

           The current study focused on the most common pathogen. The most included 16 isolates of A. baumanni bacteria, with a percentage of 21.1%. It was isolated from males (38, or 76%), and was not isolated from females.

The inhibitory effect of the crude alcoholic extract of propolis on A. baumannii  was evaluated as follows for the five concentrations (25, 12.5, 50, 100, 150 mg/ml), respectively Diameters had inhibition (23.67, 19.33, 14, 10, 8.33) by two methods Well diffusion and disc diffusion and it was found that there is a direct relationship between the concentrations of propolis and the diameter of growth inhibition against Gram-negative bacteria A.baumannii compared with the Positive control Trimethoprim-sulfamethoxazole , As it was found that the largest diameter of growth inhibition was 23.67  mm, the concentration showed 150 mg / ml, while the concentration 12.5 mg / ml showed the least diameter of growth inhibition 8.33  mm, while the concentrations showed 100, 50, and 25 mg / ml in diameter. The 70% ethyl alcohol used as a diluent did not show any significant effect in this regard, while the antibiotic – Trimetheprim sulfamethoxazole at a concentration of (23.75µg/1.25) approved by the( CLSI) was recorded. 2022 The inhibition diameter is 14  mm.

As it was found from the statistical analysis, there is a significant difference at the level of probability 0.05 for the two concentrations of 100 mg / ml and 150 mg / ml on the antibiotic Trimetheprim sulfamethoxazole. While the synergistic effect of (EEP) with Dermacyn solution showed a clear inhibition of bacteria, and the results of the minimum inhibitory.

          concentration (MIC) showed the lowest Minimum inhibitory concentration for A. baumannii, the concentration was 25 mg / ml. While the lowest lethalMinimum Bacteri concentration (MBC) was 100 mg/ml. We conclude from the current study that the alcoholic extract of crude propolis had a positive effect on bacterial growth. The synergistic action of the extract with Dermacin solution was clear in inhibiting these bacteria

     It was also noted in this study the emergence or presence of the so-called double or concomitant infection in one of the isolates of Acinetobacter  baumannii, the content of the study, it was found that polymicrobial infection caused by two or more disease-causing microorganisms or what is called co-infection increases the bacterial resistance to multiple drugs, including bacteria of the genus Klebsiella associated with Acinetobacter baumannii, which increased From its resistance to antibiotics, resistance was evident for all five concentrations of the alcoholic extract and the antibiotic used, while all isolates were sensitive to this antibiotic and all of them were single infections, and this is worrisome because it limits treatment options. Although this dual resistance is rare so far, it has been documented increasingly.

           The incidence rates were also determined, as the results were distributed according to the age of patients between (35 and 65 years and over). The lowest incidence rate was among the age groups 55-64 (25%), while the highest incidence was among the age groups (35-44) and 65 and over (37.5%). The results showed that there is a clear significant difference in the percentage of infection in males higher  than in females, where the p value was 0.00024

           It was also shown that there is no relationship to age with the rates of infection with this bacteria A.baumannii, which the current study focused on. The results also showed that Which the current study focused on, and the results also showed that age has a relationship with the rate of infection rates for all species that were dealt with in this study, and it included the highest infection rate for the age groups ranging between (55-64), where the p value was 0.048* We conclude that the Gram-negative aerobic bacterial species isolated from diabetic foot ulcers have the highest percentage of other infections, and most of them are of the multidrug-resistant type and are characterized by an unpleasant odor, which indicates the importance of these species in the severity of diabetic foot infections, and that the infection rates in males are higher than in females, and this indicates However, males are more likely to develop diabetic foot ulcers, which may be due to the nature of their work, personal hygiene, male gender, and high diabetes. Therefore, many studies in this field of research are required.