Spectrum of microbial flora in diabetic foot ulcers

Bansal, Ekta; Garg, Ashish; Bhatia, Sanjeev; Attri, AK; Chander, Jagdish

doi:10.4103/0377-4929.41685

Cited by 143 publications

(33 citation statements)

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“…Our findings on the sensitivity of amikacin for Enterobacteriace are in tune with Girish and Kumar (2011), who reported the highest sensitivity of amikacin to Citrobacter species (100%), followed by Proteus species (99%), E. coli (86%) and Klebsiella species (72%). Our study also indicates that Pseudomonas infection can respond better to imipenem, which is corroborated by the earlier reports quoting imipenem, the best sensitive drug to P. aeruginosa (Mantey et al, 2000; Bansal et al, 2008). …”

Section: Discussionsupporting

confidence: 92%

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%

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

et al. 2016

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“…In this study, DFU was a complication seen exclusively in diabetic patients and it developed usually in the sixth and the seventh decades of life which was compatible with other studies 14,15 . It usually developed at 5-to 10years duration of diabetes mellitus.…”

Section: Resultsupporting

confidence: 92%

Management of Diabetic Foot Ulcer in a Tertiary Level Hospital-Faridpur

Gaddafi¹,

Dk²,

Faruque

et al. 2019

Bangladesh Heart J

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A descriptive type of cross sectional study among 210 diabetic patients with foot ulcer was carried out in Diabetic Association Medical College during the period of May 2016 to April 2017 and were categorized based on Meggitt-Wagner system to find out the complications, management, below knee amputation rate and mortality rate. The aim of this study was to practise a profile of diabetic foot ulcer (DFU), complications and its management to assess the outcome of the surgical interventions. Majority of the patients were male 112(53%), and most of them 116 patients (55.23%) presented within Wegner grade - 2 and grade-3 diabetic foot ulcers. The duration of diabetes more than 10 years was 116 (55%). 99 (47%) patients out of 210 patients developed diabetic neuropathy. 76 (36%) patients presented with CKD. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center, associated habit of smoking are all factors which lead to incidence of DFU at an earlier age than that seen in other studies. After admission of diabetic foot ulcer patients, diabetic foot ulcer is classified according to Wagner grading and treated the diabetic foot ulcer patients as the using protocol ’!1.Assesment whether it was conservative or surgical. 2. Optimal blood sugar control. 3. Systemic antibiotic. 4. Moist wound environment. 5. Offloading such as total contact casting. 6. Improves peripheral arterial circulation due to lack of vascularity. 7. Surgical debridement or minor amputation or major amputation. In case of G-4 or G-5 patients, ischemia was treated before debridement or amputation so that vascular circulation improved in the ulcer area and then healing potential was fastened. Bangladesh Heart Journal 2019; 34(1) : 52-57

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“…And although many infections are polymicrobial, most studies are still performed with a single species. We chose to study interactions between S. aureus and P. aeruginosa because these two species are the first and second most common causes of chronic wound infections and because they are the two species most commonly found together in polymicrobial wound infections (7)(8)(9)(10)(11)(15)(16)(17). While there is some evidence that P. aeruginosa and S. aureus cause more-severe infections together than alone (12)(13)(14), difficulties in growing these two microbes together in vitro have hampered progress in understanding their interspecies interactions.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence suggests that dual P. aeruginosa and S. aureus infections are more virulent and/or result in worse patient outcomes than single infections (12)(13)(14), and both species are notorious for their resistance to antimicrobials (15)(16)(17). Methicillin-resistant S. aureus (MRSA) alone accounts for a large portion of hospital-acquired infections (18), and one third of P. aeruginosa clinical isolates are resistant to three or more antibiotics, including third-generation cephalosporins and imipenem, which have been the gold standard antibiotics for P. aeruginosa infection (19).…”

mentioning

confidence: 99%

Synergistic Interactions of Pseudomonas aeruginosa and Staphylococcus aureus in an In Vitro Wound Model

et al. 2014

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cIn individuals with polymicrobial infections, microbes often display synergistic interactions that can enhance their colonization, virulence, or persistence. One of the most prevalent types of polymicrobial infection occurs in chronic wounds, where Pseudomonas aeruginosa and Staphylococcus aureus are the two most common causes. Although they are the most commonly associated microbial species in wound infections, very little is known about their interspecies relationship. Evidence suggests that P. aeruginosa-S. aureus coinfections are more virulent than monoculture infection with either species; however, difficulties in growing these two pathogens together in vitro have hampered attempts to uncover the mechanisms involved. Here we describe a simple and clinically relevant in vitro wound model that supported concomitant growth of P. aeruginosa and S. aureus. We observed that the ability of P. aeruginosa and S. aureus to survive antibiotic treatment increased when they were grown together in planktonic cocultures and that antibiotic tolerance was further enhanced when they were grown together in the wound model. We attributed this enhanced tolerance to both the "host-derived" and "bacterium-derived" matrix components. Taken together, our data indicate that P. aeruginosa and S. aureus may benefit each other by coinfecting wounds and that the host-derived matrix may serve as important a role as the bacterium-derived matrix in protecting bacteria from some antibiotics.

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Spectrum of microbial flora in diabetic foot ulcers

Cited by 143 publications

References 0 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

Management of Diabetic Foot Ulcer in a Tertiary Level Hospital-Faridpur

Synergistic Interactions of Pseudomonas aeruginosa and Staphylococcus aureus in an In Vitro Wound Model

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