A study on clinical grading and bacteriological profile of diabetic foot ulcers in tertiary care centre (original) (raw)
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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...
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...
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 CLINICAL AND DIAGNOSTIC RESEARCH
Introduction: Globally, about 425 million people are living with diabetes mellitus. Diabetic Foot Ulcers (DFU) are one of the severe complications of poorly controlled diabetes and over the time, about 50% of DFUs become infected which may require hospitalization. Aim: To find out the DFU infection severity pattern and its predictors among T2DM patients. Materials and Methods: This cross-sectional study was conducted at Integrated Diabetes and Gestational Diabetes Clinic (IDGDC), IQ City Medical College and Multispecialty Hospital, Durgapur, West Bengal, India, among Type 2 Diabetes Mellitus (T2DM) patients from June 2018 to November 2018. Total 1534 T2DM patients attended IDGDC during data collection period of 4 months and 132 of them had diabetic foot ulcer. After taking written informed consent, detailed data were collected from 132 of study participants using predesigned, semi structured and pre tested schedule developed with the help of Infectious Disease Society of America (ID...
Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques
International Journal of Research in Medical Sciences, 2017
Background: Diabetic foot ulcers (DFU) are the complications of diabetes mellitus. The diabetic foot ulcer infections are polymicrobial in nature. If they are not recognized and controlled it leads to many devastating consequences like limb amputation, sepsis, and even mortality. Hence, the present study was undertaken to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques and the antimicrobial sensitivity pattern of the isolates.Methods: A total number of 103 patients with a foot ulcer of Wagner’s grade II or more and evidence of purulent exudates or edema were included in the study. Swab samples were obtained from the base of ulcers and were sent for bacteriological study. The specimen was processed in the microbiology laboratory for Gram stain, aerobic culture, and anaerobic culture. The organisms isolated were identified by standard procedures and antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method.Results: ...
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.
ABSTRACT Background: The study is to determine the relation between severity of the diabetic foot ulcers and the organisms isolated from the wounds; its implications and prognosis with particular reference to the differences in the final outcome depending upon the type of organism infecting the wound. The study try to correlate the severity of the diabetic foot infection according to Meggit-Wagner classification, the incidence of amputation and the impact on the hospital stay with the difference of bacterial flora isolated from the wounds. This is an observational study done in 53 patients who were admitted in the surgical ward of a large private medical college in Jadavpur, India. It has been found from this study that the incidence and severity of diabetic foot ulcer is more in patients with some particular type of bacteria found in their wounds. A strong correlation is found in patients whose wounds were infected with some particular bacteria had resulted in more severe type of foot ulcers with higher incidence of amputation and concomitant longer hospital stay. Methods: An observational study was done in 53 patients who were admitted in the surgical ward of a teaching hospital in Kolkata, India. The youngest patient was aged 28 years and the oldest patient was 83 years of age. All of them presented with clinically infected foot ulcers. The patients were explained about the study methods in their own language and due consent was taken. A standardized proforma in English, Hindi and the vernacular languages was made for recording the necessary data. The standard X-ray plates were taken into consideration for determination of the involvement of underlying bones. The microbiological studies were done in all patients from the wound swabs of the foot ulcers. The outcome of the diabetic foot ulcer was assessed from the severity of the disease, the presence of the different bacterial flora in their wounds, the incidence of amputation and the duration of hospital stay. Results: The positive wound culture was found in 67.92 of patients, Methicillin resistant Staph. aureus (MRSA) was the commonest isolated organism (44.44%) followed by mixed bacterial flora (Staph. aureus, Streptococcus epidermidis, Peptococcus, and Bacteroides fragilis) in 16.98% of patients. ESBL Klebsiella was found in 13.89% of patients, Pseudomonas aeruginosa and Enterococcus feacalis were isolated in 8.33% of patients. 80% of ESBL infected wounds presented with Grade IV ulcers. The incidence of amputation was highest in patients whose wounds were colonized by MRSA and 60% of patients with ESBL Klebsiella infected wounds had hospital stay of more than three weeks. Conclusions: The study observed that the prognosis and outcome of a diabetic foot ulcer vary considerably with the specific type of bacteria colonizing the wound. Keywords: Diabetic foot ulcer, Wagner classification of diabetic foot ulcers, Bacterial flora and diabetic wounds, Amputation and diabetic foot ulcer disease, Hospital stay and diabetic foot ulcer disease.
International Journal of Medical Laboratory Research, 2019
Aim: To study the clinical profile with co-morbidities of patients admitted with Diabetic foot ulcer (DFU) infection. Also, to study the microbiological flora causing the infection, along with antibiotic susceptibility pattern of the pathogens isolated from these ulcers. Material and method: A prospective study was carried out on 95 diabetic patients with foot ulcers for a period of 1½ years. The demographic details of the patients with Diabetic foot ulcer (DFU) along with Wagner's grade and treatment profile were also collected. The tissue sample were collected and processed as per standard microbiological procedure and antibiotic susceptibility testing was done as per Clinical & Laboratory Standards Institute (CLSI). The data was analyzed by percentage and correlated. Results: A total of 95 patients were included in the study with 83 males. The majority of patients with DFU were below the age of 40 years. Around 36.48% patients developed DFU following 6-10 years of diagnosed as Diabetes mellitus. Hypertension (26.88%) and neuropathy (20%) were the most common co-morbidity and complications among these patients. A total of 92 pathogens isolated from these patients, with Gram negative pathogens being predominant. The most common pathogens isolated were Pseudomonas aeruginosa (30%), followed by Escherichia coli(28.8%) and Staphylococcus aureus (72.5%) among Gram negative and Gram positive pathogens, respectively. Minimal resistance was noted for high end antimicrobials like Beta lactam-Beta lactamase inhibitors & carbapenems. But, for empirical therapy, fluoroquinoles and aminoglycosides may be considered as alternative for cephalosporins. Conclusion: Diabetic foot ulcer infection is mainly seen in individuals with > 5 years of diabetes and complications especially peripheral neuropathy and nephropathy. Gram negative bacteria, coliforms are predominant pathogens isolated. Flouroquinolones and aminoglycoside group of antimicrobials can be considered for empirical therapy provided antibiogram is monitored on regular basis.