A prospective, multi-center study: factors related to the management of diabetic foot infections

• Published in: European journal of clinical microbiology & infectious diseases 2012-09, Vol.31 (9), p.2345-2352
• Main Authors: Ertugrul, B. M., Oncul, O., Tulek, N., Willke, A., Sacar, S., Tunccan, O. G., Yilmaz, E., Kaya, O., Ozturk, B., Turhan, O., Yapar, N., Ture, M., Akin, F.
• Format: Article
• Language: English
• Subjects: Aged; Amputation; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - economics; Antibiotic resistance; Antibiotics; Associated diseases and complications; Bacteria; Bacteria - classification; Bacteria - drug effects; Bacteria - isolation & purification; Bacterial Infections - diagnosis; Bacterial Infections - drug therapy; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Biopsy; Diabetes; Diabetes. Impaired glucose tolerance; Diabetic Foot - complications; Drug Resistance, Bacterial; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Foot diseases; Hospitalization; Humans; Infections; Infectious diseases; Internal Medicine; Leg ulcers; Male; Medical Microbiology; Medical sciences; Medicine; Microbiology; Middle Aged; Patients; Prospective Studies; Regression analysis; Risk factors; Turkey; Working groups
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-012-1574-1

The Turkish Association of Clinical Microbiology and Infectious Diseases, Diabetic Foot Infections Working Group conducted a prospective study to determine the factors affecting the outcomes of diabetic foot infections. A total of 96 patients were enrolled in the study. Microbiological assessment was performed in 86 patients. A total of 115 causative bacteria were isolated from 71 patients. The most frequently isolated bacterial species was Pseudomonas aeruginosa ( n  = 21, 18.3%). Among cases with bacterial growth, 37 patients (43%) were infected with 38 (33%) antibiotic-resistant bacteria. The mean (±SD) antibiotics cost was 2,220.42 (±994.59) USD in cases infected with resistant bacteria, while it was 1,206.60 (±1,160.6) USD in patients infected with susceptible bacteria ( p  4.5 cm 2 ( p  = 0.041, OR = 2.8); and that related to the failure of the treatment was the growth of resistant bacteria ( p  = 0.016, OR = 5.333). Diabetic foot osteomyelitis is usually a chronic infection and requires surgical therapy. Amputation is the accepted form of treatment for osteomyelitis. Limited limb-saving surgery and prolonged antibiotic therapy directed toward the definitive causative bacteria are most appropriate. This may decrease limb loss through amputations. As a result the infections caused by resistant bacteria may lead to a high cost of antibiotherapy, prolonged hospitalization duration, and failure of the treatment.