الفهرس 
ContentsOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
Diabetic foot infection is a major concern between diabetic communities as it is
increasing rapidly with more virulent organisms. These virulent organisms include the
flesh and bone eating bacteria which produce proteolytic enzymes in order to hydrolyse the
skin, flesh and bone. When infection spreads, physicians lean to amputation followed by
long term of broad spectrum antibiotics. Even after complete eradication of bacteria, their
proteolytic enzymes remain in the blood circulation which leads to prior amputation.
Isolation of 33 bacterial samples was done from 10 diabetic foot ulcers patients. It was
found that they were 24 Gram-negative and only 9 Gram-positive. The most distributed
were Proteus mirabilis and Pseudomonas aeruginosa. These bacterial samples were
inoculated onto different protein sources to evaluate which is the highest proteolytic
activity. It was set on using 6 bacterial samples which showed an ability of collagen
hydrolysis (the most abundant compound in human’s connective tissue). They were MRSA
1, S. pyogenes 1, N. meningitides 1, P. mirabilis 3, P. aeruginosa 4 and P. aeruginosa 5.
They were the confirmed flesh and bone eating bacteria.
Only six natural methanolic extracts showed anti-proteolytic activity from 24 different
extracts and they were cinnamon, colocynth, goldenseal, Saint John wort and ulva.
Cinnamon methanolic extract was the most effective anti-proteolytic agent and also it
showed an ability of being anti-protease producing agent against all the pathogens. More
investigation needed to be done on the anti-protease producing part to determine whether it
is because of enzyme inhibition or gene disorder.
When the biochemical evaluation of the anti-proteolytic activity was done, it showed
the complete enzyme inhibition by the methanolic extract of cinnamon. Antibacterial
activity was done for cinnamon methanolic extract, it has no antibacterial activity.
15 different antibiotics were used referring to 8 antibiotic groups of the most widely
used antibiotics. Imipenem was the most effective antibiotic against all the pathogens
whether they were Gram-positive or Gram-negative. In the other hand, ceftazidime,
methicillin, linezolid and doxycyclin have no antibacterial activity against the pathogens. It
must be referred that Klebsiella pneumoniae 1 was the most resistant organism, while
Staphylococcus aureus*2 (MRSA 2) was the most sensitive organism.
Imipenem was used as anti-proteolytic agent in different experiments including
biochemical tests. Surprisingly, it was found that imipenem has anti-proteolytic activity
and enzyme inhibition by 60%.
It was found that; imipenem caused severe changes in the degree of dissimilarity
between organisms as it caused S. pyogenes 1 to be separated in different group. The tested
antibiotics didn’t have any proteolytic activity which is an indicator of their safety.
Imipenem has high antibacterial activity against the chosen proteolytic bacteria but the
bacteria managed to form resistant colonies. Prepared chitosan has high antibacterial
activity and this is an advantage due to it can be used to eradicate the formed resistant
Summary
colonies. Imipenem and cinnamon methanolic extract were antagonistic to each other in
the antibacterial activity.
So this thesis reaches to a Final Formula of (Imipenem alone followed by
Cinnamon methanolic extract loaded on chitosan gel for superficial infection or loaded on
liposome for deep infection) for complete and safe enzyme inhibition.
from this thesis one can conclude:
1. Gram negative bacteria especially Proteus mirabilis and Pseudomonas
aeruginosa have the highest proteolytic activity.
2. Casein was the easiest to hydrolyse by isolated bacteria as 15 bacteria.