Epidemiology of diabetic foot infections in a reference tertiary hospital in India

Abstract

IntroductionThe present study attempts to examine the microbial profile and antibiotic susceptibility of diabetic foot infections in the intensive care unit of a tertiary referral centre for diabetic foot. As part of the study, we also attempted to find the prevalence of blaNDM-like gene among carbapenem-resistant gram negative infections.MethodologyA prospective study of 261 patients with diabetic foot infections was performed during the period between January 2014 and June 2014.ResultsA total of 289 isolates were obtained from 178 tissue samples from 261 patients, 156 (59.7%) males and 105 (40.2%) females, with a mean age of 58 years (−15 years), having diabetic foot infection. No growth was seen in thirty eight (17.6%) tissue samples. Out of the total samples, 44.3% were monomicrobial and 55.7% were polymicrobial. Gram negative pathogens were predominant (58.5%). Seven of the total isolates were fungal; 0.7% showed pure fungal growth and 1.7% were mixed, grown along with some bacteria. The most frequently isolated bacteria were Staphylococcus aureus (26.9%), followed by Pseudomonas aeruginosa (20.9%). Of the 58.5% gram negative pathogens, 16.5% were Enterobacteriaceae resistant to carbapenems. Among these isolates, 4 (25%) were positive for blaNDM-like gene. Among the rest, 18.6% were carbapenem-resistant Pseudomonas, among which 4 (36.3%) were blaNDM. Among the Staphylococci, 23.7% were methicillin-resistant Staphylococcus aureus.ConclusionsOur results support the recent view that gram negative organisms, depending on the geographical location, may be predominant in DFIs. There is an increase in multidrug-resistant pathogens, especially carbapenem resistance and this is creeping rapidly. We need to be more judicious while using empiric antibiotics.

Antibiotic Susceptibility Pattern of Methicillin Sensitive and Resistant Staphylococcus aureus from Clinical Isolates in a Tertiary Care Hospital at Mathura, Western Uttar Pradesh

“…Data on the prevalence of MRSA is not uniform. Literature has documented a significant variation in the prevalence rate from different parts of India and between countries [1][2][3][4][5][6][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] . Studies from India report MRSA prevalence ranging from 6.9% to 87% 9 .…”

“…In the early 1960s, Methicillin Resistant S.aureus (MRSA) emerged as a potential pathogen causing nosocomial colonization, several outbreaks and difficult-to-treat infections like bacteremia, infective endocarditis, osteoarticular and pleuropulmonary infections. They also causes device related infections like central line associated blood stream infections, ventilator associated pneumonia and catheter associated urinary tract infections [1][2][3][4][5] . It always remains a challenge for physicians to treat and control MRSA infections.…”

Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments

“…), followed by Escherichia coli, Proteus spp., Enterobacter spp., and Citrobacter spp. [23,[27][28][29]. In a microbiome characterization study of new and recurrent DFUs using 16S amplicon sequencing (16S AS), S. aureus was isolated in 72% of culture-positive samples, whereas the most commonly detected bacteria in all ulcers were Peptoniphilus spp., Anaerococcus spp., and Corynebacterium spp.…”

Diabetic Foot Infection, Biofilm & New Management Strategy

“…Diabetic foot infections (DFI) are polymicrobial in nature, involving both aerobes and anaerobes. A recent prospective study including 289 isolates obtained from 178 tissue samples of patients (n=261) with DFIs revealed that 44.3% of DFIs were monomicrobial and 55.7% DFIs were polymicrobial [16]. Etiological agents reported in DFIs are enlisted in Fig-2 [15].…”