scholarly journals Aerobic bacteria isolated from diabetic foot ulcers of Egyptian patients: types, antibiotic susceptibility pattern and risk factors associated with multidrug-resistant organisms

GERMS ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 570-582
Author(s):  
Mervat Mashaly ◽  
Mohamed Abo El kheir ◽  
Mohamed Ibrahim ◽  
Wael Khafagy
Keyword(s):  
Risk Factors ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Aerobic Bacteria ◽  
Diabetic Foot Ulcers ◽  
Susceptibility Pattern ◽  
Antibiotic Susceptibility Pattern ◽  
Factors Associated ◽  
Egyptian Patients ◽  
Multidrug Resistant Organisms

scholarly journals The Influence of Multidrug-Resistant Bacteria on Clinical Outcomes of Diabetic Foot Ulcers: A Systematic Review

2021 ◽  
Vol 10 (9) ◽  
pp. 1948
Author(s):  
Gianmarco Matta-Gutiérrez ◽  
Esther García-Morales ◽  
Yolanda García-Álvarez ◽  
Francisco Javier Álvaro-Afonso ◽  
Raúl Juan Molines-Barroso ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Mortality Rates ◽  
Multidrug Resistant ◽  
Healing Time ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Resistant Organism ◽  
Diabetic Foot Ulcers ◽  
Multidrug Resistant Organisms

Multidrug-resistant organism infections have become important in recent years due to the increased prevalence of diabetic foot ulcers and their possible consequences. This study aimed to systematically review and evaluate ulcer duration, healing time, hospital stay, amputation, and mortality rates in patients with diabetic foot ulcers caused by infection with multidrug-resistant organisms. PubMed, the Cochrane Library, and Web of Science were searched in May 2020 to find observational studies in English about the clinical outcomes of multidrug-resistant organism infection in diabetic foot ulcers. Eight studies met the inclusion criteria, and these studies included 923 patients. The overall methodological quality of the study was moderate. Ulcer duration was described in six studies, and there was no practical association with multidrug-resistant organisms. Two out of three studies reported a longer healing time in multidrug-resistant organism infections than in non-multidrug-resistant organism infections. Clinical outcomes included the duration of hospitalisation, surgeries, amputations, and deaths. Lower limb amputation was the most reported clinical outcome in the included studies, and was more prevalent in the multidrug-resistant organism infections. We concluded that there was not enough evidence that multidrug-resistant organisms hindered the healing of diabetic foot ulcers. In contrast to the clinical outcomes, multidrug-resistant organisms affect both amputation rates and mortality rates.

scholarly journals Risk Factors Associated with Amputation-Free Survival in Patient with Diabetic Foot Ulcers

2014 ◽  
Vol 55 (5) ◽  
pp. 1373 ◽  
Author(s):  
Sung Hun Won ◽  
Chin Youb Chung ◽  
Moon Seok Park ◽  
Taeseung Lee ◽  
Ki Hyuk Sung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Free Survival ◽  
Factors Associated

scholarly journals Risk factors for the diabetic foot infection with multidrug-resistant microorganisms in South India

2018 ◽  
Vol 5 (2) ◽  
pp. 675 ◽  
Author(s):  
Manikandan Kathirvel ◽  
Viswakumar Prabakaran ◽  
Jayalakshmi Jayarajan ◽  
Ajay Sivakumar ◽  
Vimalkumar Govindan
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Previous History ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Recurrent Ulcer ◽  
Multidrug Resistant Organisms ◽  
Recurrent Ulcers

Background: To analyse the risk-factors contributing to infection with multidrug-resistant organisms.Methods: 150 diabetic patients with foot ulcer were prospectively studied. Detailed clinical history and clinical examination of the ulcer were done for all patients. The microbiological profile was analyzed for each patient. Using internationally accepted criteria, the multidrug-resistant organisms were identified. Risk factors for acquiring MDRO infection were identified using appropriate statistical tools.Results: MDRO were isolated from 99 patients of 150 (66%). 54.8% (153 out of 279) of isolated organisms were multidrug-resistant organisms. By univariate analysis poor glycaemic control, previous hospitalisation, previous history of amputation, previous antibiotic usage, size of the ulcer, necrotic ulcer, recurrent ulcers, higher grade of ulcer, the presence of osteomyelitis, the presence of retinopathy, peripheral vascular disease, neuropathy and polymicrobial culture, were significantly associated with MDRO infected foot ulcers. Analysis by logistic regression indicated that only two factors significantly increased the risk of acquiring MDRO infection. They are recurrent ulcer (OR = 3.39, p <0.05, 95% CI = 1.081-10.664) and higher grade of ulcer (OR = 13.44, p <0.001, 95 % CI =3.595-50.278).Conclusions: The prevalence of MDRO is alarmingly high in infected diabetic foot ulcers. Recurrent ulcers and higher grade of ulcers are more prone to acquire MDROs.

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

2018 ◽  
Vol 06 (01) ◽  
pp. 040-047
Author(s):  
Javedh Shareef ◽  
Sandra Sunny ◽  
K Bhagavan
Keyword(s):  
Diabetic Foot ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Susceptibility Pattern ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative ◽  
Bacteriological Profile ◽  
Gram Negative Organisms

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.

scholarly journals Microbiological profile and antibiotic susceptibility pattern in Blood stream infections in patients with Acute Cholangitis: A prospective observational study

2020 ◽  
Vol 8 (2) ◽  
pp. 68-75
Author(s):  
Khan Md Nazmus Saqeb
Keyword(s):  
Risk Factors ◽  
Antibiotic Resistance ◽  
Nosocomial Infection ◽  
Acute Cholangitis ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Antibiotic Susceptibility Pattern ◽  
Factors Associated ◽  
Source Of Infection

Background: I analyzed the organisms isolated from the blood of patients with acute cholangitis and determined their antibiotic resistance characteristics. In addition, I evaluated risk factors associated with antibiotic-resistant bacteria and their impact on clinical outcomes. Methods: 113 consecutive cases of acute cholangitis who met the diagnostic criteria were included in the study. Acute cholangitis was defined by TG18 criteria. Blood culture was obtained from every patient. The microbiological results of blood cultures & the antibiotic susceptibility pattern of the organisms were analyzed by SPSSv22.0. Multivariate analysis was performed to identify risk factors associated with antibiotic resistance & mortality. Result: Among 113 patients, 71(62.8%) were male & the median age was 51 years. Choledocholithiasis was the most common underlying biliary disease followed by malignant and benign strictures. Severe cholangitis occurred in 17(15%) cases. 32(28.3%) cases had nosocomial infection. Causative organisms were isolated from 55(48.7%) of 113 blood cultures. Escherichia coli was the most common bacterium isolated (36.36%) from blood, followed by Klebsiella pneumoniae (23.64%), Pseudomonas aeruginosa (7.27%) & Enterococcus (7.27%). Anaerobic bacteria were isolated from 5(9.09%) specimens. Multiple organisms were isolated in 6(10.91%) specimens. Most organisms were susceptible to meropenem (86.7%), imipenem (83.1%), colistin (89.1%), amikacin (76.1%), piperacillin-tazobactam (79.6%) & polymyxin-B (83.3%). Multidrug resistant bacteria comprised 30.91% of blood isolates. Risk factors associated with antibiotic resistance were presence of an indwelling biliary device (OR:7.7), prior biliary intervention (OR:6.167) and a nosocomial source of infection (OR:9.09). Thirteen (11.5%) patients died from acute cholangitis. Risk factors associated with mortality were severe cholangitis (OR:6.9), malignant biliary obstruction (OR:8.4), nosocomial infection (OR:7.5) and isolation of multidrug resistant organisms in blood (OR:6.9). Conclusion: E. coli was the most common organism isolated, followed by Klebsiella, Pseudomonas & Enterococcus. Colistin, meropenem, polymyxin-B, imipenem, amikacin & piperacillin-tazobactam were the most effective of all antibiotics. Risk factors associated with isolation of multidrug resistant bacteria from blood were presence of an indwelling biliary device, prior biliary intervention and a nosocomial source of infection. Risk factors associated with mortality were severe cholangitis, malignant biliary obstruction, nosocomial infection and isolation of multidrug resistant organisms in blood. Bangladesh Crit Care J September 2020; 8(2): 68-75

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