CLINICO-BACTERIOLOGICAL PROFILE IN DIABETICS ADMITTED FOR FOOT ULCERS: RETROSPECTIVE OBSERVATIONS FROM A TERTIARY CARE HOSPITAL (original) (raw)
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Cureus, 2022
Background This study aimed to assess the bacterial profile of diabetes patients with an infected foot and their antimicrobial susceptibility pattern in a tertiary care hospital. Methodology We conducted a six-month prospective study at a hospital in Peshawar, Pakistan. Demographics and clinical characteristics such as age, sex, type and duration of diabetes, glycemic control, presence of retinopathy, nephropathy, neuropathy, peripheral vascular disease, ulcer size, outcomes, and the number of admitted days at the facility were collected. Pus or discharges from the ulcer base and debrided necrotic tissue were obtained. Gram staining was performed on the samples which were isolated on chocolate agar and MacConkey agar. Incubation was done for 24 hours at a temperature of 37°C, and isolates were identified using standard bacteriological methods. The Kirby-Bauer testing method was used to assess antibiotic susceptibility. Results A total of 200 patients received a diagnosis of diabetic foot ulcer at the hospital during the study period. The age of the patients ranged from 24 to 92 years, with a mean age of 58.12 years (standard deviation (SD) = 12.494). The mean HbA1c level was 9.33% (SD = 2.050). The mean duration of diabetes mellitus was 12.3 years (SD = 6.181). In total, 96 (66.2%) isolates were gram-negative bacteria, while 49 (33.8%) were grampositive bacteria. Among the gram-negative bacteria, Pseudomonas spp. was the most reported (15.9%), whereas methicillin-resistant Staphylococcus aureus was the most reported gram-positive bacteria (20.7%). Amikacin was found to be the most effective (45%) in treating diabetic foot ulcers, followed by tineam and meropenem being equally effective at a susceptibility of 44%. The highest resistance of the microbes was to the drug trimethoprim (44.5%). Conclusions The pathogens causing diabetic foot ulcers show sensitivity to many of the routinely used medications. However, resistance is being developed to some of the antibiotics such as trimethoprim. Therefore, the culture of the specimen to identify the causative agent and adequate knowledge of the susceptibility pattern are critical for the appropriate management of diabetic foot ulcers.
2020
Aim of the study; to determine the diabetic foot ulcer infection rate, bacterial etiology and antibiotic susceptibility. Research design: A cross sectional study design was utilized to fulfill the aim of this study. Setting: The study was conducted in outpatient diabetes clinic at Asyut University Hospital. Patients: A total of two hundred adult patients (both males and females) having type I or type II diabetes, with a foot ulcer. One tool was used for data collection of this study; structured diabetic patient interview questionnaire sheet with the following parts: Part I: Diabetic Patients demographic characteristics, Part II: Medical profile of the studied patients and Part III: Laboratory tests: Glycosylated Hemoglobin (Hg A1C) and Pus culture and sensitivity results. Results: The present study revealed that 53.5 % of the studied sample was female, 56.5 % were married, 45.5 % were in the age group between 50 to less than 65 years and 39.5 % were illiterate. 56 % of the sample was having type II diabetes, mean duration of diabetes in years was 13.14 ± 7.36, mean body mass index was 26.95 ± 6.75, regarding treatment regimen; 46.5 % were taking insulin, 53 % were in poor glycemic control, 28 % fair and 19 % were in good glycemic control. 51 % of the studied patients their duration of foot ulcer was less than a month, 27 % from 1-2 months, 69 % of the studied sample was having a superficial ulcer.89 % was having a positive pus culture result out of which 23 % was related to pseudomonas aeruginosa, followed by Escherichia coli (20 %), Staphelococcus aureus (19 %) and the least common organism was Citrobacter isolates (2 %). 37 % of the causative organisms were sensitive to Piperacillin tazobactam, 22 % were sensitive to Gentamicin, 16 % to Vancomycin, 13 % to Azithromycin and 12 % were sensitive to Levofloxacin.
Journal of Social Health and Diabetes
Introduction:Diabetic foot ulcer and infections are one of the major complications in diabetic patients leading to frequent hospitalization and increased mortality. Knowledge about the microbes that cause infections will be helpful for providing appropriate antimicrobial therapy. Aim:To evaluate the bacteriological profile of patients with diabetic foot ulcers and their antibiotic susceptibility pattern. Methodology:A cross-sectional study was carried out for a period of eight months in the Department of surgery in patients with diabetic foot ulcer at a tertiary care teaching hospital. Patient data relevant to the study were collected using a standard data collection form designed as per the need of the study. Details of the organisms isolated and susceptibility pattern were collected from microbiology department. Results:A total of 122 pathogens were identified from 71 patients with male (63.38%) predominance over females (36.61%). Out of the 71 patients, 38 (53.52%) patients had m...
Journal of Ayub Medical College, Abbottabad : JAMC
Foot ulcers are one of the most important complications of diabetes mellitus and often lead to lower limb amputation. Diabetic foot ulcers are susceptible to infection. The objective of this study was to determine the frequency of common bacteria infecting these ulcers and their antibiotic sensitivity pattern. This descriptive cross-sectional study was performed in the Departments of Medicine and Surgery, Khyber Teaching Hospital, Peshawar from April, 2011 to February, 2012. Specimens collected from ulcers of 131 patients were inoculated on Blood Agar and MacConkey Agar, and antibiotic sensitivity was tested using standard disc diffusion method. Out of 131, specimens from 120 patients yielded 176 bacteria. Sixty-six patients had monomicrobial infection while polymicrobial growth was obtained in 54 patients. Overall, Staphylococcus aureus (38.6%) was the most common isolate followed by Pseudomonas aeruginosa (27.3%). Staphylococcus aureus was most often sensitive to Moxifloxacin, Imi...
Bacterial Profile of Diabetic Foot Ulcer with duration and Types of Diabetes and Antibiotic Therapy
Pakistan Journal of Medical and Health Sciences
Objective: To find out the gram negative bacteria causing the diabetic foot ulcers and most effective antibiotic therapy. Study Design: Cross-sectional descriptive study Place and Duration of Study: Diabetic Center Hayatabad, Kabir Medical College Peshawar from 1st September 2021 to 28th February 2022. Methodology: Sixty nine admitted patients for the treatment of diabetes having type 1 diabetes mellitus and type 2 diabetes mellitus were enrolled. All the patients were on treatment of antibiotic such as gentacin, augmentin, amikacin and clindamycin. The specimens were analyze in microbiology laboratory and extracted by needle aspiration of material from the infected site and inoculate within 1hour after collection using gram staining smear for the detection or cytology of bacteria and its presence and absence in a specimens, for the isolation specimens were plated onto chocolate, phenyl ethyl alcohol (PEA) and MacConkey agar plate. To check the antibiotic susceptibility pattern Kirb...
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...
2016
Foot infections are one of the foremost causes of mortality and morbidity in developing countries. Diabetes is the principal cause of nontraumatic lower extremity amputations and accounts for more than 85% of amputations. The determination of antimicrobial susceptibility of a clinical isolate is often essential for the most advantageous antimicrobial therapy of infection. Infection with multidrug resistant organisms (MDR) may enhance the length of hospital stay, cost of management and may cause further morbidity and mortality. Aims of this study were to determine the bacterial spectrum in diabetic foot ulcers and institute the appropriate antibiotic therapy to avoid further complications. Deep wound swab were cultured from 37 patients, who were receiving the treatment for the diabetic foot infections. Specimens were tested by Gram stain, culture & antibiotic sensitivity. Results showed that Gram negative aerobes were the most frequently isolated bacteria constituting 26 isolates (87...
National Journal of Medical Research, 2012
Introduction: A Prospective study “Spectrum of Microbial flora in diabetic foot ulcer and its antibiotic sensitivity pattern” was carried out in a tertiary care hospital, Ahmedabad on 125 patients in which 85 were male patients and 40 were female patients. Material and Methods: Swabs samples were collected from the edge and margins of ulcers and organism were identified by gram staining culture and biochemical reactions. Results: Out of 125 specimens 108 specimens showed growth of organisms. Total 157 aerobic organisms were isolated from culture positive specimens. It represents an average of 1.25 organisms per case. Among these organisms, 130 gram negative and 27 gram positive organisms were isolated. Pseudomonas aeruginosa (30.57%) was predominant organism followed by Klebsiella spp. (22.29%). Staphylococcus aureus were 12.74% in which Methicillin resistant S. aureus (MRSA) was 55%. Conclusion: incidence of growth was 86.4% in which Pseudomonas aeruginosa (30.57%) is most common isolate. Organisms in mixed infections showed multidrug resistance as compared to single isolated strain. Diabetic foot infections are polymicrobial in nature. As the Wagner’s grade increased, the prevalence of isolates also increased.
STUDY OF BACTERIAL PATHOGENS WITH THEIR ANTIBIOGRAM CAUSING DIABETIC FOOT ULCERS.
International Journal of Advanced Research (IJAR), 2019
Globally and nationally, Diabetes mellitus with its complications has become the contemporary and challenging health problem. Diabetic foot ulcers are the most serious complication of the disease. Diabetes mellitus appears to be an independent risk factor for infection with multi drug resistant organisms causing several abnormalities of the host defense mechanisms that might result in a higher risk of certain infections. Hence early diagnosis of microbial infections will aim to appropriate antibiotic therapy to avoid further complications such as cellulitis, gas gangrene and amputation. Hence this study had been done to evaluate the microbial pathogens causing diabetic foot ulcers along with its antibiogram. Pus samples were collected from 100 patients with diabetic foot ulcers attending Department of Surgery, Government General Hospital, Vijayawada and sent to Microbiology department, Siddhartha Medical College for processing. Diabetic patients of all age groups and both gender were included and those patients who were on antibiotic therapy were excluded . Out of 100 samples processed 90(90%) were culture positives, of which 101 pathogens were isolated, 70(69.3%) were Gram negative and 31(30.6%) were Gram positive Pseudomonas ssp were found to be predominant followed by Escherichia.coli and Staphylococcus aureus. All the pathogens were found to be highly sensitive to Piperacillin- tazobactam, Gentamicin and least sensitivity to Azithromycin. The results of this study therefore alert us to the need for proper management of antibiotics to optimize patient care and improve clinical outcome.