The Bacteriology of Diabetic Foot Ulcers, with a Special Reference to Multidrug Resistant Strains

Abstract

Introduction: A diabetic foot infection is one of the most feared complications of Diabetes mellitus. Many studies have reported on the bacteriology of Diabetic Foot Infections (DFIs) over the past 25 years, but the results have been varied and often contradictory. Aims and Objectives:This study was carried out to determine the bacterial profiles of infected ulcers and the antibiotic resistance pattern of the isolates. Materials and Methods:Samples were collected from 50 patients with diabetic foot ulcers by using sterile swabs and they were processed.Results: A total of 75 bacterial isolates were obtained from 50 patients with diabetic foot ulcers. The age group of these patients ranged from 35 to 80 years and the maximum number of patients was in the age group of 60 to 65 years. Gram negative bacilli were more prevalent (65.1%) than gram positive cocci (34.9%). The commonest isolate was Pseudomonas spp (16%), followed by Escherichia coli (14.6%) and Staphylococcus aureus (13.3%).The antibiotic sensivity profiles of the bacteria were also studied. 37.5% of the gram negative bacilli were ESBL producers and 31% were carbapenemase producers. Conclusion:This study showed a preponderance of gram negative bacilli among the isolates from the diabetic foot ulcers. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining the drugs for the empirical treatment of diabetic ulcers.Priyadarshini shanmugam, Jeya m, Linda susan s

Prevalence of TEM and SHV Genes among Extended Spectrum Beta-Lactamase (ESBL) Producing Escherichia coli Isolates from Infected Diabetic Foot Ulcers in a Tertiary Care Hospital

“…The percentage of ciprofloxacin and gentamicin resistant E.coli were 60.53%, 52.63% respectively. All the 38 (100%) isolates were sensitive to imipenem and is in concordant with these following studies, Varaiya et al, (2008), Bansal et al, (2008) and Shanmugam et al, (2013).…”

“…Many studies in India had reported aerobic gram negative bacillary organisms to be more predominant in diabetic foot ulcer infection than aerobic gram positive cocci (Shankar et al, 2005;Bansal et al, 2008;Shanmugam et al, 2013;Gadepalli et al, 2006;Swarna et al, 2012). Out of 173 organisms isolated 118 (68%) were gram negative bacilli and 55 (32%) were gram positive cocci in this study.…”

“…The production of extended spectrum beta lactamase (ESBL) by gram negative bacilli is one of them (Gadapelli et al, 2006;Shanmugam et al, 2013). The enzymes with hydrolytic ability against penicillins, second and third generation cephalosporins and monobctams but not against cephamycins with beta lactamse inhibitor susceptibility are called as "extended spectrum beta-lactamases" (ESBL).…”

Diabetic Foot Infections with Pseudomonas: Jabir Abueliz Diabetic Center Khartoum Experience

“…Fidelis Mbunda et al [9] and Lim et al [10] reported similar results. Priyadarshini Shanmugam, Jeya M, and Linda Susan S stated that the commonest isolate was Pseudomonas spp (16%) [18]. These findings also correlate well with those of Pappu K et al [19], who reported that 76% of the organisms which were isolated were gram negative bacilli, Pseudomonas being the predominant pathogen (23%), followed by Staphylococcus aureus (21%).…”

Smoking increases the risk of diabetic foot amputation: A meta-analysis

“…Diabetic foot is characterized by sensory, motor and autonomic neuropathy and peripheral vascular disease, which may lead to the development of ulceration, infection and gangrene (2). The ultimate outcome of diabetic foot is amputation, which is associated with relatively high morbidity and mortality (3).…”