Prospective Observational Study of Microbiology of Infected Diabetic Foot Ulcers in a Tertiary-Care Hospital

Abstract

Introduction: Diabetic foot ulcers (DFUs) are a major cause of morbidity and mortality in people with diabetes mellitus. DFUs are the leading cause of hospitalisation for diabetic patients worldwide, especially in developing countries such as India. This study presents the microbiology profile of DFUs in a tertiary care hospital in the eastern part of India. Methodology: We conducted a prospective observational study for 150 DFU patients over a period of two years. We took samples from the DFUs of these patients, cultured them, and tested their antimicrobial susceptibility. Results: Most diabetic foot infections (DFIs) in our study patients were caused by Gram-negative bacteria, mainly Escherchia coli ( E. coli ) (19.3%), Pseudomonas (14%), and Staphylococcus aureus ( S. aureus ) (12%). The majority of Gram-positive bacteria were susceptible to linezolid, followed by vancomycin and amoxycillin, while the majority of Gram-negative bacteria were susceptible to imipenem and meropenem, followed by ampicillin with sulbactam, amikacin, gentamicin, and ciprofloxacin. Our study revealed that 88.3% of the isolates were monomicrobial. Conclusion: These findings demonstrated the importance of a local antibiogram, a microbiological exam, and antimicrobial susceptibility testing before starting antibiotic treatment for infections caused by DFUs. This protocol is different from the recommended guidelines for using empirical antibiotics.