Bacterial Profile and Multiplex PCR Detection of SHV, CTX-M, and mecA Genes in Diabetic Ulcer Infections

Authors

  • Amellya Octifani Department of Medical Laboratory Technology, Faculty of Health Science, Universitas Anwar Medika, Indonesia
  • Siti Nur Azizah Binti Fandik Department of Medical Laboratory Technology, Faculty of Health Science, Universitas Anwar Medika, Indonesia
  • Yulianto Ade Prasetya Department of Medical Laboratory Technology, Faculty of Health Science, Universitas Anwar Medika, Indonesia

DOI:

https://doi.org/10.31964/mltj.v12i1.716

Keywords:

CTX-M, diabetic ulcers, mecA, Multiplex Polymerase Chain Reaction, SHV

Abstract

Diabetes mellitus is a chronic disease with complications such as diabetic ulcers, which can lead to amputation. High blood glucose facilitates a mix of aerobic and anaerobic bacterial growth in ulcers. Prolonged antibiotic use risks resistance. This study aims to identify bacterial species and the presence of resistance genes (SHV, CTX-M, and mecA) in isolates from diabetic ulcer patients at Wahidin Hospital, Mojokerto, using multiplex PCR. The study design was a descriptive, observational study to identify bacterial patterns and detect the presence of SHV, CTX-M, and mecA genes in bacterial samples from ulcers of diabetic patients using a multiplex molecular genetic method. Bacterial identification of 32 ulcer swab samples from DM patients revealed Staphylococcus aureus (63%), Escherichia coli (28%), and Klebsiella pneumoniae (9%). The results of the detection of multiplexed genes encoding resistance in the identified bacteria were SHV 3%, CTX-M 19%, mecA 22%, SHV & mecA 3%, and CTX-M & mecA 3%. The multiplex PCR method was successfully used to detect genes encoding antibiotic resistance in bacteria infecting ulcers of patients with DM.

References

Abe, Y., Nakamura, K., Kaji, D., Takahashi, H., Aoki, K., Kuse, H., Okada, H., Ohta, K., Ohashi, K., Takano, Y., Ishii, Y., & Kanemitsu, K. (2019). Analysis of Clinical Isolates of Extended-Spectrum β-Lactamase-Producing Bacteria with Primer and Probe Sets Developed to Detect blaCTX-M, blaTEM, and blaSHV Using a Fully Automated Gene Detection System. Japanese Journal of Infectious Diseases, 72(6), 381–386. https://doi.org/10.7883/yoken.JJID.2018.466

Akash, M. S. H., Rehman, K., Fiayyaz, F., Sabir, S., & Khurshid, M. (2020). Diabetes-associated infections: development of antimicrobial resistance and possible treatment strategies. Archives of Microbiology, 202(5), 953–965. https://doi.org/10.1007/s00203-020-01818-x

Anggraini, D., Yovi, I., Yefri, R., Christianto, E., & Syarputri, E. (2020). Pola Bakteri dan Antibiogram Penyebab Ulkus Diabetikum Di Rs X Riau Periode. Biomedika, 12(1), 27–35. https://doi.org/10.23917/biomedika.v12i1.9316

Donastin, A., & Aisyah. (2019). Microbial Pattern of Diabetic Foot Ulcer Patient in Jemursari Islamic Hospital Surabaya Period 2012–2016. Indonesian Journal of Medical Laboratory Science and Technology, 1(1), 22–32. https://doi.org/10.33086/ijmlst.v1i1.914

Fau, P., Tarihoran, D. M., Astuti, D., Manik, M., Evikea, C., Tobing, W. K., & Marbun, E. (2021). Perawatan Luka Ulkus Diabetikum pada ny K. TRIDARMA: Pengabdian Kepada Masyarakat (PkM), 4(2), 1.

Ghenea, A. E., Zlatian, O. M., Cristea, O. M., Ungureanu, A., Mititelu, R. R., Balasoiu, A. T., Vasile, C. M., Salan, A. I., Iliuta, D., Popescu, M., Udriștoiu, A. L., & Balasoiu, M. (2022). TEM,CTX-M,SHV Genes in ESBL-Producing Escherichia coli and Klebsiella pneumoniae Isolated from Clinical Samples in a County Clinical Emergency Hospital Romania-Predominance of CTX-M-15. Antibiotics, 11(4), 1–12. https://doi.org/10.3390/antibiotics11040503

Hussein, K. A., Mohammed, A. A., Dawood, S. B., & Issa, S. S. (2024). Genetic identification of methicillin resistant Staphylococcus aureus (MRSA) isolated from diabetic foot ulcers and evaluating the inhibition activity of reuterin against this bacteria. Journal of the Pakistan Medical Association, 74(10), S132–S136. https://doi.org/10.47391/JPMA-BAGH-16-29

Lienard, A., Hosny, M., Jneid, J., Schuldiner, S., Cellier, N., Sotto, A., Scola, B. La, Lavigne, J. P., & Pantel, A. (2021). Escherichia coli isolated from diabetic foot osteomyelitis: Clonal diversity, resistance profile, virulence potential, and genome adaptation. Microorganisms, 9(2), 1–17. https://doi.org/10.3390/microorganisms9020380

Matheson, E. M., Bragg, S. W., & Blackwelder, R. S. (2021). Diabetes-Related Foot Infections: Diagnosis and Treatment. American Family Physician, 104(4), 386–394.

Mita Zuliana, N., Suliati, S., & Endarini, L. H. (2023). Identifikasi Bakteri pada Luka Ulkus Pasien Diabetes Mellitus. JPP (Jurnal Kesehatan Poltekkes Palembang), 18(2), 205–211. https://doi.org/10.36086/jpp.v18i2.1835

Novelni, R. (2019). Identifikasi dan Uji Resistensi Bakteri pada Pasien Ulkus Diabetikum di Bangsal Interne RSUP Dr. M. Djamil Padang. Jurnal Penelitian Farmasi Indonesia, 8(2), 67–74. https://doi.org/10.51887/jpfi.v8i2.550

Pratama, A. S., Djide, M. N., & Massi, M. N. (2019). ıdentıfıkası genotıp ctx-m pada Escherichia coli penghasıl extended spectrum beta lactamase (ESBL) yang resısten pada cephalosporın generası ııı dı RSUP Wahıdın Sudırohusodo makassar. Majalah Farmasi Dan Farmakologi, 23(1), 5–9. https://doi.org/10.20956/mff.v23i1.6458

Pratama Putri, C. M., Mahatma, G., Oktora, M. Z., & Anggraini, D. (2025). Karakteristik Penderita Diabetes Melitus Tipe 2 Dengan Komplikasi Nefropati Diabetik di RSUP Dr. M. Djamil Padang. Scientific Journal, 4(3), 218–226. https://doi.org/10.56260/sciena.v4i3.231

Rafif Khairullah, A., Rehman, S., Agus Sudjarwo, S., Helmi Effendi, M., Chasyer Ramandinianto, S., Aega Gololodo, M., Widodo, A., Hendriana Priscilia Riwu, K., & Ayu Kurniawati, D. (2022). Detection of mecA gene and methicillin-resistant Staphylococcus aureus (MRSA) isolated from milk and risk factors from farms in Probolinggo, Indonesia. F1000Research, 11, 722. https://doi.org/10.12688/f1000research.122225.1

Rizky, V. A., Siregar, S., Krisdianilo, V., Rahayu, A., Syafrina Ginting, S., & . K. (2021). Identifikasi Bakteri Escherichia Coli O157:H7 Pada Feses Penderita Diare Dengan Metode Kultur Dan Pcr. Jurnal Farmasimed (Jfm), 3(2), 118–123. https://doi.org/10.35451/jfm.v3i2.615

Salim, S. E., Sukrama, I. D. M., Fatmawati, N. N. D., & Hendrayana, M. A. (2020). Pola bakteri pada pasien kaki diabetik dan resistensinya terhadap antibiotik di rumah sakit umum pusat sanglah periode 1 januari 2017 – 28 februari 2018. Jurnal Medika Udayana, 9(10), 98–104.

Sartika, D., Sari, T. M., & Hardiansyah, I. (2020). Pola kepekaan Bakteri Penyebab Ulkus Diabetikum Terhadap Antibiotika Di RSUP Dr. M. Djamil Padang Periode 2018 dan Periode 2019. Jurnal Akademi Farmasi Prayoga, 5(2), 21–33.

Selano, M. K., Tinggi, S., Kesehatan, I., Semarang, E., No, J. K., & Indonesia, S. (2021). hubungan lama menderita dengan kejadian neuropati diabetikum pada pasien diabetes melitus the relathions of long suffering with the event of diabetic neuropaty in diabetes mellitus patients pendahuluan Organisasi Internasional Diabetes Federation ( IDF. 8(2), 129–134.

Shibasaki, M., Komatsu, M., Sueyoshi, N., Maeda, M., Uchida, T., Yonezawa, H., Inagaki, K., Omi, A., Matsumoto, H., Murotani, M., Iwamoto, T., Kodaka, Y., Kieda, H., Tokiwa, M., Masuwa, B., Kinoshita, M., Saito, K., & Katou, M. (2016). Community spread of extended-spectrum β-lactamase-producing bacteria detected in social insurance hospitals throughout Japan. Journal of Infection and Chemotherapy, 22(6), 395–399. https://doi.org/10.1016/j.jiac.2016.03.001

Sugireng, & Rosdarni. (2021). Deteksi Gen nuc Isolat Bakteri Staphylococcus aureus dari Pasien Ulkus Diabetikum dengan Metode PCR. (November), 133–136.

Teixeira, N. B., Castelo Branco Fortaleza, C. M., de Souza, M. C., Monteiro Pereira, T. A., de Camargo Colenci, B. P., & Ribeiro de Souza da Cunha, M. de L. (2021). Molecular characterization of methicillin-resistant Staphylococcus aureus among insulin-dependent diabetic individuals in Brazil. Annals of Clinical Microbiology and Antimicrobials, 20(1), 1–12. https://doi.org/10.1186/s12941-020-00401-y.

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Published

2026-06-08

How to Cite

Octifani, A., Binti Fandik, S. N. A. ., & Prasetya, Y. A. (2026). Bacterial Profile and Multiplex PCR Detection of SHV, CTX-M, and mecA Genes in Diabetic Ulcer Infections. Medical Laboratory Technology Journal, 12(1), 63–71. https://doi.org/10.31964/mltj.v12i1.716

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