A study on the relation of the severity of diabetic foot ulcers with the type of bacterial flora isolated from the wounds (original) (raw)
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Clinico-microbiological profile and outcome of diabetic foot ulcers
International Surgery Journal, 2020
Background: Diabetic foot ulcers (DFU) are debilitating to the patients and significantly impair their quality of life. DFU associated with infection have the worst outcomes and may lead to amputations if timely intervention is not done. In the present study, aim was to identify the association between the type of organism isolated and the rates of amputations in diabetic foot ulcers.Methods: We retrospectively studied 50 diabetic foot ulcers from January 2017 to June 2017, who were in-patients in a single unit of surgery department in King George Hospital, Visakhapatnam. Baseline clinical examination was done. Parameters such as age, sex, duration, diabetic status and its treatment, organisms isolated, various treatment options for ulcers and the outcomes were studies.Results: Males were the predominant study subjects (M: F=32:18). The age of presentation was 18-65 years with an average of 46 years. Gram negative organisms were the frequent microbial isolates, all being mono-microb...
International Surgery Journal, 2020
Background: Diabetes is one of the commonest diseases worldwide and diabetic foot ulcer and its complications are associated with significant morbidity and even amputation. Early detection of colonizing agent of these ulcers help in reduced morbidity and hospital stay. We targeted this subgroup of patients to study Wagner’s grade, identify the bacterial agent and its antibiotic sensitivity and ankle-brachial pressure index (ABPI) assessment to detect PAD, for the best treatment outcome of diabetic foot ulcers.Methods: The present study was conducted in the Department of Surgery of SGMCRF, Venjaramoodu on 210 patients with diabetic foot ulcers between November 2017 and May 2019. Wagner’s grading of ulcer, culture and antibiotic sensitivity of microbe were done as well as ABPI was measured. Outcome of ulcers was compared to ABPI and ABPI was compared to time of healing.Results: Out of 210 patients 122 were males and 88 females, 62.9% had neuropathy and 66.7% had vasculopathy. Most pat...
International Journal of Advances in Medicine, 2021
India is the diabetic capital of the world, the diabetic population in the country is close to hitting the alarming mark of 69.9 million by 2025 and 80 million by 2030. 1 In diabetic population, the lifetime risk of a diabetic foot ulcer (DFU) is 15% and around 28% of them may require some form of amputation. 2 Chronic diabetes causes macro and microangiopathy and peripheral sensory and motor neuropathy. These neuropathies lead to foot deformities, in turn escalates to ischemia, and foot infection. 3 DFUs are responsible for considerable morbidity and a significant cost of health-care worldwide. 4 Foot infections account for 20% of hospitalization of diabetic patients yearly. 5 Presence of superimposed infection in an already existing DFU, not only delays healing but also poses risk of systemic infection, ABSTRACT Background: Diabetes associated neuropathy and vasculopathy leads to development of diabetic foot ulcers (DFU). They are responsible for considerable morbidity and a significant cost of health-care worldwide. The magnitude of the problem becomes worse in regions where foot care is inadequate like in our country. The aim of the study to determine the microbiological profile and antimicrobial susceptibility pattern of organisms isolated from patients with diabetic foot ulcers. Methods: The study was a cross sectional study done at King George's Medical College, Lucknow from 2012-2014 in Lucknow, Uttar Pradesh. Based on the inclusion criteria sample were collected from 112 patients. The standard protocol for the identification of microorganisms was followed. A descriptive analysis of the data was done. Results: Out of the 112 ulcers total 180 isolates were found. Of the 112 cases, 78 were monomicrobial, 32 were polymicrobial, and 2 cases were sterile on culture. The most common bacteria found was Staphylococcus aureus. Most of the staphylococcus isolated were sensitive to vancomycin, teicoplanin, cephalosporins, linezolid levofloxacin and pipercillin-tazobactum. Nearly 65% of S. aureus were methicillin-resistant S. aureus. Conclusions: This study compiled clinical and microbiological profile of diabetic foot ulcers along with their antibiotic susceptibility patterns. Our study illuminates light on a high figure of neglected and poorly treated NHUs which could have been managed well and early treatment will prevent devastating consequences such as sepsis and amputation.
Pakistan Journal of Medical and Health Sciences, 2021
Background: Most of the diabetic patients present as diabetic foot in surgical outdoor and emergency department. Diabetic Foot infections are common and take long duration to be treated. Both Gram positive and Gram negative aerobic bacteria are involved in diabetic foot infection. Aim: To determine the frequency of most prevalent bacteria in wound of diabetic foot ulcers and to determine the antimicrobial susceptibility of isolated bacteria from diabetic foot ulcers so that an empirical antibiotics can be started before the report of culture and sensitivity. Methods: This cross sectional study was conducted in surgical unit 1 of Bahawal Victoria Hospital (BVH) Bahawalpur from 01-08-2020 to 31-07-2021. This study was conducted on 145 patients with diabetic foot ulcer from outdoor and emergency department of BVH. Data about patient’s demography, duration of diabetes, duration of DFUs, type of pathogen and its antibiotic susceptibility was entered on a proforma. Pus sample was obtained...
Aerobic bacteria associated with diabetic foot ulcers and their susceptibility pattern
Biomedical Dermatology, 2019
Background: Foot ulcers in diabetes mellitus subjects cause morbidity and mortality and lead to non-traumatic amputations worldwide. Knowledge of the microbial burden in the ulcers may improve patients' care and management. Objectives: This prospective study was designed to isolate, identify and carry out antibiotic susceptibility testing on bacterial isolates associated with diabetic foot ulcers among subjects in University of Calabar Teaching Hospital. Methods: Subjects with diabetic foot ulcer were recruited after obtaining ethical clearance from the Research Committee and informed consent from the subjects. Samples were obtained from subjects using sterile swabs and subjected to microscopy and culture. Isolates were identified using standard bacteriological techniques. Kirby-Bauer method was used for susceptibility testing. Results: Out of the 50 subjects recruited, 19 (38.1%) were males and 31 (62.0%) were females with mean age of 55.4 ± 10.1 and a minimum age of 40.0 years. All the subjects had grade 4 wounds. The study recorded 100% infection rates among subjects with 70.0% polymicrobial infections. A total of 97 isolates were obtained from the 50 subjects accounting for the average of 1.94 isolates per subject. The most prevalent isolate was Staphylococcus aureus (32 (32.9%)), while the least isolated pathogen was Klebsiella pneumonia (10 (20.4%)). Females harboured more isolates (61 (62.9%)) than males (36 (37.1%)), but infection rates were not significantly associated with gender (χ² = 15.0, p ≥ 0.05). Erythromycin was the most effective antibiotic agent (65.6%) against S. aureus while gram-negative bacteria were more susceptible to augmentin (87.5%) and ciprofloxacin (75.0%). Conclusion: The multiple antibiotic resistance of the bacterial isolates calls for the need to monitor resistance. The best practice is to perform antibiotic susceptibility testing before treatment. Wounds should be evaluated for bacterial agents before treatment is instituted. Information on the mi.uction of morbidity and amputation rates on the patients.
Journal of Medical Research and Surgery, 2022
Objectives: To determine the common pathogens isolated from DFI to administer appropriate antibiotic treatment, followed by surgical interventions. Methods: A retrospective study was performed on 260 patients who presented with diabetic foot at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2014 to September 2020. All patients underwent swabs and tissue culture for microbiological evaluation. Patient medical records were reviewed to collect demographic and clinical data, including Glycated Hemoglobin (HgA1C), Diabetes Mellitus (DM) type, duration of diabetes, swab, tissue culture, type of surgery, and type of isolated organism. Results: Escherichia coli was the most common organism isolated from the feet of diabetic patients, followed by Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus agalactiae, and Pseudomonas aeruginosa. Amputations were significantly higher in patients who did not have Staphylococcus aureus or Pseudomonas aeruginosa infection, with no significant relationship between amputation and any other isolated organisms. A significant negative correlation between patient age and HgA1C level was discovered, as well as a significant positive correlation between HgA1C and the number of minor amputations. Patients with major and minor amputations had a significantly higher percentage of non-Multidrug Resistance (MDR), whereas patients with MDR had a significantly higher rate of infection with Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, or Staphylococcus aureus. Conclusion: DM is a metabolic syndrome that affects all the body systems and impacts both morbidity and mortality. The most common organism isolated from the feet of diabetic patients was Escherichia coli, followed by Staphylococcus aureus. Ulcer specimens should be collected for culture and identification of causative organisms. Preventive measures such as good glycemic control, appropriate foot care, targeted antibiotic therapy, and patient education can reduce the incidence of amputation.
International Journal of General Medicine & Surgery
Aim: To determine the microbiological profile and antibiotic susceptibility pattern of organisms in diabetic foot ulcers in our population. Settings and Design: A prospective observational study Material and Method: A prospective study was carried out on 62 patients of diabetic foot ulcers attending the endocrine OPD. The aerobic bacterial agents were isolated, and their antibiotic susceptibility pattern was studied. Results: Organisms were cultured from 90.32% cases of diabetic foot ulcers. Staphylococcus aureus (both MRSA and non-MRSA) was the commonest organism found in 36.77% cases followed by E. coli in 30.88%, Enterococci in 7.35%, Pseudomonas aerogenosa in 5.88% and Klebsiella in 5.88% of cases. Polymicrobial infection was seen in 9.68% cases. In 47.05% of the cases infections was due to gram negative organisms. Staphylococcus aureus was chiefly susceptible to levofloxacin, vancomycin, pipracillin tazobactum, linezolid while E. coli to levofloxacin, piperacillin tazobactum, and meropenem. Conclusion: Gram-negative organisms were most frequent type of isolate. Staphylococcus aureus was the most common type of bacteria. All bacterial isolate in our study have sensitivity for levofloxacin, pipracillin-tazobactum linezolid, and meropenem.
Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya
Around 25% of people with diabetes experience diabetic foot ulcers in their lives, accompanied by infections due to various types of bacteria. Infection due to Gram-negative and Gram-positive bacteria are reported to have different inflammation patterns, where the latter being reported to have a higher mortality rate. This study was an analytic observational study with a cross-sectional design to determine the relationship between bacterial characteristics and mortality in diabetic foot ulcers. Data were obtained from medical records of diabetic ulcer patients admitted to Dr. H. Abdul Moeloek General Hospital, Lampung, in 2017–2020. There were 131 diabetic foot ulcers patients identified, with the median age of the subjects was 53 years, 43.5% of the subject were male, and 56.5% were female. The mean hemoglobin was 9.3 g/dl, WBCs were 19.0 ×103/ml, and platelets were 422.1 ×103/ml. The mean length of stay in the hospital was 10.7 days. Eighteen subjects died during the hospital stay...