Clinical and bacteriological profile of diabetic foot infections in a tertiary care

Abstract

Background: Diabetic foot infection is a worldwide health problem is commonly encountered in daily practice. This study was conducted to identify the microbiological profile and antibiotic sensitivity patterns of causative agents identified from diabetic foot infections (DFIs). In addition, the assessment included probable risk factors contributing to infection of ulcers that harbour multidrug-resistant organisms (MDROs) and their outcomes. Methods: We carried out a prospective analysis based on the DFI samples collected from 2016 till 2018. Specimens were cultured with optimal techniques in addition to antibiotic susceptibility based on recommendations from The Clinical and Laboratory Standards Institute (CLSI). A total of 1040 pathogens were isolated with an average of 1.9 pathogens per lesion in 550 patients who were identified with having DFIs during this interval. Results: A higher percentage of Gram-negative pathogens (54%) were identified as compared with Gram-positive pathogens (33%) or anaerobes (12%). A total of 85% of the patients were found to have polymicrobial infections. Pseudomonas aeruginosa (19%), Staphylococcus aureus (11%) and Bacteroides species (8%) appeared to be the predominant organisms isolated. In the management of Gram-positive bacteria, the most efficacious treatment was seen with the use of Vancomycin, while Imipenem and Amikacin proved to be effective in the treatment of Gramnegative bacteria. Conclusion: DFI's are common among Malaysians with diabetes, with a majority of cases displaying polymicrobial aetiology with multi-drug resistant isolates. The data obtained from this study will be valuable in aiding future empirical treatment guidelines in the treatment of DFIs. This study investigated the microbiology of DFIs and their resistance to antibiotics in patients with DFIs that were managed at a Tertiary Care Centre in Malaysia.

Bacterial Profile in Urine, Burns, and Wounds in Diabetic and non-Diabetic Patients

“…In Malaysia, it was concluded that Pseudomonas aeruginosa (19%), Staphylococcus aureus (11%) and bacteroides species (8%) were isolated from diabetic foot infections 1 .…”

“…The most common sites of infection in diabetic patients are the skin and urinary tract. Malignant or necrotizing otitis externa principally occurs in diabetic patients older than 35 years and is almost due to Pseudomonas aeruginosa 1 . Diabetic foot ulcers is a common complication of diabetes and frequently associated with the presence of Staphylococcus aureus 2 .…”

A Mini-review: Silver Nanoparticles (AgNPs) as Antimicrobial in Magical Socks

“…Silver is a natural antibacterial agent that has been medically confirmed to destroy most bacteria that trigger foot odor and other sweaty foot issues [61]. Silver ions are released from the silver fibers and bond with the DNA chains of odor-producing bacteria [64]. By targeting the bacterial membrane, AgNPs destabilize plasma membrane potential and deplete levels of intercellular adenosine triphosphate, resulting in bacterial cell death.…”

Diabetic Foot Infection with Bacteroides pyogenes

“…Diabetes mellitus represents major health problem worldwide with diabetic foot infections being the most common complication necessitating hospital admissions. [ 1 ] The severe forms of diabetic foot infections are polymicrobial in nature with involvement of both aerobic ( Klebsiella spp., Escherichia coli , and Staphylococcus aureus ) and anaerobic ( Bacteroides spp. and anaerobic streptococci) microflora.…”

“…and anaerobic streptococci) microflora. [ 1 ] The genus Bacteroides consist of Gram-negative, nonsporing anaerobic rods that form the integral part of the colonic microflora in humans. Bacteroides spp.…”