Microbiological profile of diabetic foot ulcers and its antibiotic susceptibility pattern in a teaching hospital, Gujarat

Mehta, Vaidehi J.; Kikani, Kunjan M.; Mehta, Sanjay

doi:10.5455/2319-2003.ijbcp20140209

Cited by 18 publications

(16 citation statements)

References 11 publications

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“…Unlike Western countries reporting Gram-positive aerobes as predominant pathogens (Wang et al, 2010; Roberts and Simon, 2012), there has been a changing trend in the microorganisms causing DFI, with Gram-negative bacteria replacing Gram-positive bacteria in India (Ramakant et al, 2011; Umadevi et al, 2011). Interestingly, we have also observed the predominance of Gram-negative organisms in DFUs in our study and the same has also been reported by Mehta et al (2014) and Shankar et al (2005). However, previous studies reported the dominance of Gram-positive aerobes in diabetic foot infection (Mantey et al, 2000; Fejfarová et al, 2002).…”

Section: Discussionsupporting

confidence: 92%

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Culture-Based Screening of Aerobic Microbiome in Diabetic Foot Subjects and Developing Non-healing Ulcers

et al. 2016

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The study was carried on diabetic foot patients to deduce clinical attributes, the occurrence of the range of aerobic microbial flora and to assess their comparative in vitro susceptibility to the customarily used antimicrobials. We also studied the potential risk factors involved in the development of non-healing ulcers. A total of 87 organisms were isolated from 70 specimens, including Escherichia coli (19.5%) among the Gram-negative and Staphylococcus aureus (18.4%) among the Gram-positive as the predominant aerobes explored. Pseudomonas aeruginosa and E. coli were predominant isolates of non-healing ulcers. The antimicrobial sensitivity pattern revealed that vancomycin (100%) and amikacin (90.4%) exhibited highest sensitivity to Gram-positive cocci, while all strains of P. aeruginosa were sensitive toward imipenem (100%). The prevalent uncontrolled glycemic status, altered lipid spectra, the existence of neuropathy, and peripheral vascular disease, suggested predisposition toward the development of non-healing lesions. The study has underlined the need for continuous surveillance of bacteria and their antimicrobial sensitivity blueprints to provide the basis for empirical therapy and to minimize the risk of complications. Further, stringent clinical evaluation, and medical history will help in revealing the risk of developing non-healing status in diabetic foot ulcers.

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Section: Discussionsupporting

confidence: 92%

“…All strains of S. aureus including MRSA were sensitive to vancomycin, which is similar to the findings of Reghu et al (2016), Kandati et al (2015), and Mehta et al (2014), but against the findings of Girish and Kumar (2011). …”

Section: Discussionsupporting

confidence: 88%

Culture-Based Screening of Aerobic Microbiome in Diabetic Foot Subjects and Developing Non-healing Ulcers

et al. 2016

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“…Diabetic foot is the most common, long-term and feared complication of diabetes and it is the principal cause of hospitalization among patients with diabetes (1). Diabetic foot is characterized by sensory, motor and autonomic neuropathy and peripheral vascular disease, which may lead to the development of ulceration, infection and gangrene (2).…”

Section: Introductionmentioning

confidence: 99%

Smoking increases the risk of diabetic foot amputation: A meta-analysis

et al. 2017

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Abstract. Accumulating evidence suggests that smoking is associated with diabetic foot amputation. However, the currently available results are inconsistent and controversial. Therefore, the present study performed a meta-analysis to systematically review the association between smoking and diabetic foot amputation and to investigate the risk factors of diabetic foot amputation. Public databases, including PubMed and Embase, were searched prior to 29th February 2016. The heterogeneity was assessed using the Cochran's Q statistic and the I 2 statistic, and odds ratio (OR) and 95% confidence interval (CI) were calculated and pooled appropriately. Sensitivity analysis was performed to evaluate the stability of the results. In addition, Egger's test was applied to assess any potential publication bias. Based on the research, a total of eight studies, including five cohort studies and three case control studies were included. The data indicated that smoking significantly increased the risk of diabetic foot amputation (OR=1.65; 95% CI, 1.09-2.50; P<0.0001) compared with non-smoking. Sensitivity analysis demonstrated that the pooled analysis did not vary substantially following the exclusion of any one study. Additionally, there was no evidence of publication bias (Egger's test, t=0.1378; P=0.8958). Furthermore, no significant difference was observed between the minor and major amputation groups in patients who smoked (OR=0.79; 95% CI, 0.24-2.58). The results of the present meta-analysis suggested that smoking is a notable risk factor for diabetic foot amputation. Smoking cessation appears to reduce the risk of diabetic foot amputation.

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“…6 But, as per Vaidehi et al, Klebsiella was second common isolate. 7 So, common organism isolated from wound was different in various studies. In our study, proteus was more common than staphylococcus, which is similar to the study of Gangania and Singh et al 8 In our study, we have found that Escherichia coli was less sensitive to cephalosporin and around 40% to 60% of the isolates were sensitive to quinolones, 60% of E. coli were sensitive to chloramphenicol, but they very much sensitive to imipenem.…”

Section: Discussionmentioning

confidence: 99%

A Study of Bacteriological Profile and Antimicrobial Spectrum of Diabetic Foot Ulcer

Kumar¹,

M²,

Acharya³

2017

jebmh

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BACKGROUND There are various pathophysiological factors, which along with hyperglycaemic state is responsible for diabetic foot ulcer. Out of these, there are three important components, which play important role that is vascular changes, neuropathy and immune changes. Glycosylation of nerve proteins, endothelial dysfunction and increased lymphocyte apoptosis is the major pathology that leads to above dysfunction. MATERIALS AND METHODS A total of 60 cases were included in this study. For collection of sample, transport culture and sensitivity, we have followed standard operative procedure, samples collected were plated on blood agar, nutrient agar and MacConkey agar. Conventional method was followed for identification of organism isolated from agar plate like Gram staining, motility testing, oxidase testing and catalase testing. RESULTS In our study, out of 60 culture positive patient, we have found that Escherichia coli was 12 in number that is 20%. Klebsiella was found in 18 samples that is 30%. Pseudomonas was isolated in 12 specimen that is 20% and 10% of the wound having staphylococcus aureus infection. Proteus was found in nine specimens. Rest like CONSA, citrobacter and candida was present in one sample each. CONCLUSION The most common organism isolated out of 60 culture positive specimen was Klebsiella that is 30% of the isolate followed by Pseudomonas aeruginosa and Escherichia coli that is 20% each. We have come to conclusion that chloramphenicol, piperacillintazobactam, amikacin and imipenem adequately covered such infection.

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Microbiological profile of diabetic foot ulcers and its antibiotic susceptibility pattern in a teaching hospital, Gujarat

Cited by 18 publications

References 11 publications

Culture-Based Screening of Aerobic Microbiome in Diabetic Foot Subjects and Developing Non-healing Ulcers

Culture-Based Screening of Aerobic Microbiome in Diabetic Foot Subjects and Developing Non-healing Ulcers

Smoking increases the risk of diabetic foot amputation: A meta-analysis

A Study of Bacteriological Profile and Antimicrobial Spectrum of Diabetic Foot Ulcer

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