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

• Published in: Journal of foot and ankle research 2020-06, Vol.13 (1), p.36-n/a
• Main Authors: Goh, Teik Chiang, Bajuri, Mohd Yazid, C. Nadarajah, Sivapathasundaram, Abdul Rashid, Abdul Halim, Baharuddin, Suhaila, Zamri, Kamarul Syariza
• Format: Article
• Language: English
• Subjects: Abscesses; Adult; Age; Aged; Aged, 80 and over; Amikacin; Amputation; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteriology profile; Classification; Debridement; Diabetes; Diabetes mellitus; Diabetic foot; Diabetic Foot - drug therapy; Diabetic Foot - microbiology; Diabetic foot infections; Drug Resistance, Bacterial; E coli; Feet; Female; Foot diseases; Gangrene; Gender; Gram-negative bacteria; Gram-Negative Bacteria - classification; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - isolation & purification; Gram-positive bacteria; Gram-Positive Bacteria - classification; Gram-Positive Bacteria - drug effects; Gram-Positive Bacteria - isolation & purification; Health aspects; Hospitals; Humans; Imipenem; Infection; Infections; Laboratories; Leg ulcers; Male; Microbial drug resistance; Microbial Sensitivity Tests; Middle Aged; Multidrug resistance; Organisms; Pathogens; Patients; Prospective Studies; Retrospective studies; Risk factors; Skin; Skin Diseases, Bacterial - drug therapy; Skin Diseases, Bacterial - microbiology; Staphylococcal infections; Tertiary Care Centers; Ulcers; Vancomycin
• ISSN: 1757-1146; 1757-1146
• DOI: 10.1186/s13047-020-00406-y

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 Gram‐negative 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.