Study on bacteriological profile and antibiotic susceptibility pattern in patients with diabetic foot ulcers in a tertiary care teaching hospital

Abstract

Introduction:Diabetic foot ulcer and infections are one of the major complications in diabetic patients leading to frequent hospitalization and increased mortality. Knowledge about the microbes that cause infections will be helpful for providing appropriate antimicrobial therapy. Aim:To evaluate the bacteriological profile of patients with diabetic foot ulcers and their antibiotic susceptibility pattern. Methodology:A cross-sectional study was carried out for a period of eight months in the Department of surgery in patients with diabetic foot ulcer at a tertiary care teaching hospital. Patient data relevant to the study were collected using a standard data collection form designed as per the need of the study. Details of the organisms isolated and susceptibility pattern were collected from microbiology department. Results:A total of 122 pathogens were identified from 71 patients with male (63.38%) predominance over females (36.61%). Out of the 71 patients, 38 (53.52%) patients had monomicrobial infections and 33 (46.47%) patients had polymicrobial infections. Of the total 122 organisms, 79(64.75%) organisms were found to be gram negative organisms and 43(35.24%) were gram positive. Pseudomonas aeruginosa found in 22 (18.03%) patients was the predominant pathogen isolated followed by Klebsiella pneumonia found in 18 (14.75%) patients. The gram-positive organisms isolated showed maximum susceptibility towards antibiotics Teicoplanin and Linezolid while the gram-negative organisms showed susceptibility to Imipenem, Meropenem, and Piperacillin/Tazobactum combination. Conclusion:The study showed a preponderance of gram-negative bacilli among the isolates from the diabetic foot ulcers. It is recommended that antimicrobial sensitivity testing is necessary for initiating appropriate antibiotic regimen which will help to reduce the drug resistance and minimize the healthcare costs.

Bacterial Etiology and Antibiotic Resistance Pattern of Diabetic Foot Infection in Patients Admitted to Shiraz Hospitals, Iran

“…These injuries are not restricted to specific subcutaneous tissues and are the result of uncontrolled diabetes and poor health care [9,10] . In this study, the mean age of patients was 55.8± 13.2 years, which is similar to the results reported in other studies by Anvarnejad et al ( 2015) [11] and Akhi et al ( 2015) [5] in Iran as well as Sundresh et al (2014) [12] and Shareef et al (2018) [13] in India. In this study, the prevalence of infection was higher among males than females, which is consistent with other studies in this field [5,11,13,14] .…”

“…In this study, the mean age of patients was 55.8± 13.2 years, which is similar to the results reported in other studies by Anvarnejad et al ( 2015) [11] and Akhi et al ( 2015) [5] in Iran as well as Sundresh et al (2014) [12] and Shareef et al (2018) [13] in India. In this study, the prevalence of infection was higher among males than females, which is consistent with other studies in this field [5,11,13,14] . This could be to the fact that men are more active outdoors than women and are more likely to engage in physical activity, increasing the risk of injury for men.…”

“…Contrary to this study results, Anvarnejad et al (2015) in Shiraz reported a higher prevalence rate for Gram-positive bacteria [11] . Unlike most previous studies, the most prevalent bacterium isolated in the present study was S. epidermidis [5,11,13,19,20] .…”

“…The highest frequency was associated with hypertension (27%), followed by heart disease (21.1%) and kidney disease (13.9%), respectively. Other studies have also found that hypertension is the most important comorbidity in these patients [13,15,16] . In the current study, 52% of the isolated organisms were Gram-negative, and 48% were Grampositive, which is similar to previous studies results [17,18] .…”