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Abstract
Diabetes mellitus (DM) is rapidly becoming a major global public health problem that affects a large segment of the population. It has become the fourth leading cause of death in most developed countries and will be one of the most challenging health problems worldwide in the 21st century. (1) It is by far the most common metabolic disorder, and its prevalence is varying widely worldwide and ranging from 1% to more than 50%.(1, 2)
A diabetes epidemic is underway. Its incidence is increasing rapidly, and it is estimated that by the year 2025 the number of diabetic patients is expected to rise to at least 300 million by 2025. Although DM, especially type 2 occurs worldwide, it is more common in developed countries. (3)
The greatest increase in prevalence rate is, however, expected to occur in Asia and Africa. Between 1995 and 2025 the number of the adult population affected by DM in developing countries is projected to grow by 170%, from 84 to 228 million people. The increase in incidence of diabetes in the developing countries follows the trend of urbanization and life style changes. The number of people with diabetes is increasing due to population growth, aging, urbanization, and increasing prevalence of obesity and physical inactivity. (4)
In Egypt, DM is a major emerging clinical and public health problem. It has been estimated that the total number of persons with diagnosed and undiagnosed DM in Egypt has increased from 3.24 million in 1995 to 3.8 million in 2000, and that by the year 2025, 8.8 million Egyptians will suffer from DM. (5)
Individuals with diabetes can have any infection that affects the general population. However, diabetics appear to be at greater risk for a number of different kinds of infections and a variety of specific infectious complications including complicated urinary tract infections (UTI), soft tissue infections including diabetic foot infections (DFI’s) and pneumonia. (6)
These infections can be caused by a variety of bacterial and fungal species, both singly and in combination. Etiologic agents in published reports vary largely because of differences in the types of culture methods used, the populations studied, and the definitions of infection. (7)
As a result of the significant increase in the number of antimicrobial-resistant microorganisms causing clinical infections; it is therefore mandatory that the microbiology laboratory provides reliable, accurate susceptibility data in a time frame that is useful for clinicians requesting information in order to achieve a good clinical outcome. (7)
A wide variety of antimicrobial susceptibility testing (AST) methodologies are being used by microbiology laboratories around the world. The selection of an AST methodology may be based on numerous factors, such as the ease of performance, flexibility, adaptability to automated or semi-automated systems, cost, reproducibility, reliability.