Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus and identification of the causative bacteria is an essential step in selecting the appropriate antibiotic therapy. This study aimed to evaluate the bacterial pattern and antibiotic susceptibility of the bacteria causing DFI in Lampung Province in Indonesia. Methods: This study is a retrospective study reviewing the medical records of DFI patients admitted to the Dr Hi Abdul Moeloek Regional General Hospital in 2017–2019. DFI patients with complete medical record data were included in this study. Demographic, clinical, laboratory, wound culture and antibiotic susceptibility data were collected from the medical records using a short structural chart. The data obtained then reviewed. Results: In this study, 131 DFI patients met the study criteria and were included. Based on the wound culture results, Gram-negative bacteria were obtained in 112 (85.5%) subjects with Enterobacter spp. as the predominant bacteria. Gram-positive bacteria were found in 19 (14.5%) subjects with Staphylococcus spp. as the predominant bacteria. Gram-negative bacteria found in this study showed high susceptibility to amikacin, meropenem and sulbactam/cefoperazone. Meanwhile, the Gram-positive bacteria showed high susceptibility to meropenem, sulbactam/ cefoperazone and amikacin. Conclusion: The findings of the study revealed Enterobacter spp. as the most predominant bacteria causing DFI in the studied population. The highest antibiotic susceptibility was seen for amikacin, meropenem and sulbactam/cefoperazone.

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, with 15 of them were from the Gram-negative monomicrobial group. The results of the Fischer Exact test on mortality and bacterial characteristics among monomicrobial infections (p=0.688) indicate no relationship between the characteristics of the infectious pathogen and mortality in diabetic foot ulcers. Keywords: bacteria, diabetes, diabetic foot ulcers, mortalityCorrespondence: iswandi.darwis@gmail.com