Type II diabetes mellitus is a significant health problem that developed globally. This study was carried out on patients with diabetic foot ulcer (DFU) to assess the bacterial and fungal flora, susceptibility, and drug-resistant isolates and devises an empiric antimicrobial therapy. Clinical data and patient samples were collected from 300 diabetic foot ulcer patients between September 2014, and September 2016 and samples were processed as per CLSI guidelines. Most of the pathogenic isolate recovered according to the Wagner classification system in DFU. The most commonly found isolates in our Study was Pseudomonas aeruginosa (22%), Staphylococcus aureus (15%) Escherichia coli (11%) followed by others. Antimicrobial resistance appears in aerobic, anaerobic as well as candida isolates in our study. Our results show most gram-negative bacteria were sensitive to colistin and tigecycline, and 44% of Gram-negative bacteria were ESBL producers, and among 20% of the gram-negative isolates were Multidrug resistant (MDR) organisms. Proper diagnosis of the causative agents, surveillance monitoring on the susceptibility of the isolates and determining the drugs for the empirical treatment of diabetic foot ulcers will prevent prolonged hospital stay and amputation.
The aim of our present study was to estimate the prevalence of Candida infection in foot ulcer patients and spectrum of Candida species and their drug resistant pattern. A total of 100 Swabs was taken from diabetic foot ulcer patients from January 2016 to June 2016. Samples were cultured on SDA agar medium. Candida spp. were differentiated by culture on Hi CHROM agar, Sugar assimilation test, fermentation test and antifungal sensitivity test. Out of 100 samples obtained from diabetic patients with a foot ulcer, 32 (32%) were positive for Candida sp by culture. It was more significant in males 22 (68.75%) than females 10 (31.25%) Candida albicans was found to be the predominant isolate followed by C.tropicalis. Resistance to fluconazole was observed 17 (17%) in our study. C.albicans was more resistant to azoles than non albicans. Our results will help physicians to treat fungal infections of diabetic foot ulcers, as well as their drug resistant pattern. Fluconazole resistance is a public health concern and the rational use of this drug is important in community.
Diabetes mellitus is a significant health problem worldwide that affects approximately 171 million people; severe complications lead to the development of diabetic foot ulcers. Diabetic ulcer infections are mainly polymicrobial in nature and multidrug-resistant (MDR), which is capable of forming a biofilm, which is the important virulence factor results in treatment failure. The main objectives of this study to investigate the etiologic agents of diabetic foot infections, their antimicrobial resistance and biofilm formation. A total of 200 patient samples were taken from diabetic foot ulcer patients between September 2015 and February 2016. Isolation and identification of microorganism were made according to standard microbiological procedures. Antibiotic Susceptibility testing performed by Kirby Bauer disc diffusion method and the biofilm production was performed by the tube method and Congo Red Method. Out of 200 samples processed, 110 (55%) were polymicrobial, 50 (25%) monomicrobial and 40(20 %)culture Sterile. The most common organism isolated were 82(39%) Pseudomonas aeruginosa,45(21%) Staphylococcus aureus, 48(23%) Candida sp followed by others. Biofilm production was seen in 112 (53%) of the isolates. Antimicrobial drug resistance was higher among 92(82%) biofilm producers than non-biofilm 20(18%) producing microorganisms. Organisms isolated from chronic diabetic foot ulcers cases were multidrug-resistant and biofilm producers. Our study shows the importance of biofilm screening with the usual antibiogram, as a routine technique in diabetic foot ulcers patients for effective treatment.
Diabetes is one of the leading causes for end stage renal disease and nephropathy. Increases of blood urea and serum creatinine are due to abnormal renal function and also reduction in glomerular filtration rate. So, Urea and Creatinine are the ideal biomarkers to correlate the progression of diabetic nephropathy. Aim of the study is to evaluate the blood urea & serum creatinine with HbA1C in Diabetes mellitus patients.: A total of 50 cases and 30 controls were selected in our study. Blood samples were collected for blood urea, serum creatinine, HbA1C, Fasting plasma glucose and Post prandial blood sugar with age limit of 35-65 years. Mean ±SD was calculated for all these parameters. Blood urea and Serum creatinine are statistically significant in Diabetic patients when compared to the controls.Our study shows that blood urea and serum creatinine can be used as biomarkers in the early detection of diabetic nephropathy. These parameters help in reducing the severity of renal failure.
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