Abstract

Background: Vancomycin is effective against most Gram-positive bacteria, including MRSA, E. faecalis, E. epidermidis, and Clostridium difficile. However, overuse and misuse of this antibiotic have caused resistance mechanisms. The study aimed to evaluate the prevalence of vancomycin resistance bacteria in patients with diabetes and chronic stress. Method: A total of 160 participants (150 patients and 10 control) were enrolled in this study, which was classified into two groups. Samples from each participant were collected during the period between December 2025 and March2026. Different clinical samples were collected and cultured on different culture media. The disk diffusion method and VITEK compact system used for antibiotic susceptibility analysis. Random blood sugar, HbA1C, C-reactive protein (CRP) and Interleukien-6 (IL-6) were measured for all studied groups. Results: In this study, 127 precipitants (79.4%) were diabetic and 36 (22.5%) were stressed. From investigated samples, Staphylococcus aureus and Enterococcus faecalis were the most isolated, with 18 (11.3%) each, followed by Staphylococcus hemolyticus with 15 (9.4%). Pseudomonas aeruginosa (6.8%), Escherichia coli and Acinetobacter (5.1% each), and Staph epidermidis (4.5%). One isolate (0.6%) of Streptococcus agalactia was the lowest proportion. E. faecalis was resistant to Erythromycin and Nitrofloxacin (100%), Tetracycline (88.9%), and Vancomycin (88.9%), but sensitive to Lvofloxacin, Linezolid, and Tigecycline. E. faecium was 100% erythromycin-resistant. Streptococcus agalactia was 100% resistant to levofloxacin, Tetracycline, Clindamycin, and Moxifloxacin but 100% sensitive to vancomycin, tigecycline, Nitrofloxacin, and Linezolid. S. aureus was resistant to erythromycin (100%), Benzylpenicillin, and Oxacillin (94.4%), but sensitive to Linezolid and vancomycin (83.3%). S. epidermidis was 100% resistant to Benzylpenicillin, penicillin, cephalosporin, Oxacillin, erythromycin, and Fusidic acid. S. hemolyticus was 100% resistant to Benzylpenicillin, Oxacillin, and Fusidic acid. They were 100% sensitive to Linezolid, Tigecycline, and Nitrofurantoin. S. hominis was 100% resistant to erythromycin, clindamycin, and fusidic acid. E. coli was 100% resistant to Trimethoprim/Sulfamethoxazole and Amikacin, but 100% sensitive to Ampicillin/Sulbactam, Cefotaxime, Imipenem, Meropenem, and Gentamicin. P. aeruginosa and Acinetobacter bautmmani were 100% antibiotic-resistant, except for colistin, which was mild. P. mirabilis was susceptible to colistin and ceftazidime but resistant to all other antibiotics. K. pneumonia was susceptible to gentamicin and colistin but resistant to all other antibiotics.The results revealed high mean level of RBS, HbA1C , CRP and IL-6 in patients group (187.4±71.7mg/dl, 7.74±2.13, 11.21±5.8 mg/L 9.22±9.3 ng/ml) than control group (87.1±15.2 mg/dl, 4.45±0.67, 3.34±0.66 mg/L ,0.89±0.35 ng/ml), respectively with (P=0.002, 0.03,0.001, 0.008). Conclusion: The study showed a significant prevalence of multidrug resistant bacteria among diabetes patients. A significant increase in RBS, HbA1c, CRP and IL-6 in patients revealed a strong relationship of poor glycemic control, inflammation, and severity of infection.