scholarly journals Bacterial Profile and Antibiotic Resistance in Patients with Diabetic Foot Ulcer in Guangzhou, Southern China: Focus on the Differences among Different Wagner’s Grades, IDSA/IWGDF Grades, and Ulcer Types

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Xiaoying Xie ◽  
Yunwen Bao ◽  
Lijia Ni ◽  
Dan Liu ◽  
Shaona Niu ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Diabetic Foot ◽  
Southern China ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Resistance Pattern ◽  
Ischemic Ulcer ◽  
Resistance Patterns ◽  
Resistance Rates

Objective. To understand the bacterial profile and antibiotic resistance patterns in diabetic foot infection (DFI) in different Wagner’s grades, IDSA/IWGDF grades, and different ulcer types in Guangzhou, in order to provide more detailed suggestion to the clinician about the empirical antibiotic choice. Methods. 207 bacteria were collected from 117 DFIs in Sun Yat-sen Memorial Hospital from Jan.1, 2010, to Dec.31, 2015. The clinical data and microbial information were analyzed. Results. The proportion of Gram-negative bacteria (GNB) was higher than Gram-positive bacteria (GPB) (54.1% versus 45.9%), in which Enterobacteriaceae (73.2%) and Staphylococcus (65.2%) were predominant, respectively. With an increasing of Wagner’s grades and IDSA/IWGDF grades, the proportion of GNB bacterial infection, especially Pseudomonas, was increased. Neuro-ischemic ulcer (N-IFU) was more susceptible to GNB infection. Furthermore, with the aggravation of the wound and infection, the antibiotic resistance rates were obviously increased. GPB isolated in ischemic foot ulcer (IFU) showed more resistance than the N-IFU, while GNB isolates were on the opposite. Conclusions. Different bacterial profiles and antibiotic sensitivity were found in different DFU grades and types. Clinician should try to stay updated in antibiotic resistance pattern of common pathogens in their area. This paper provided them the detailed information in this region.

Empirical Antibiotic Treatment in Diabetic Foot Infection: A Study Focusing on the Culture and Antibiotic Sensitivity in a Population From Southern China

2017 ◽  
Vol 16 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Wen-xia Wu ◽  
Dan Liu ◽  
Yi-wen Wang ◽  
Chuan Wang ◽  
Chuan Yang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Southern China ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Severe Infection ◽  
Third Generation ◽  
Diabetic Ulcer ◽  
Significant Difference

Diabetic foot and subsequent diabetic ulcer infections are the most devastating complication of diabetes. This study was conducted to explore the bacterial spectrum, sensitivity of microbials, and analysis of the empirical antibiotic regimens in our health center. The study included patients with diabetic foot ulcer infection (DFI) seen from 2009 to 2014. The patients included had all information covering the physical examination, laboratory tests, and image examinations. We sent appropriately obtained specimens for culture prior to starting empirical antibiotic therapy in all participants. A total of 312 patients were included: 52, 112, 95 and 53 patients within uninfected, mild, moderate, and severe infection groups. The total percentages of Gram-positive cocci (GPCs) and Gram-negative rods (GNRs) were 54% and 48.8% ( P = 0.63). The most common GPC was Staphylococcus aureus (22.4%) and GNR was Pseudomonas aeruginosa (11.9%). Methicillin-resistant Staphylococcus aureus was isolated from 21 patients (6.7%). Even in the mild infection group, there was no significant difference between GPC and GNR infection, irrespective of recent antibiotic use ( P = 0.053). The most frequently used empirical antibiotics in our center were second-/third-generation cephalosporin ± clindamycin, both in the mild and moderate/severe infection groups. In our center, the amoxicillin/clavulanate or ampicillin/sulbactam (β-L-ase 1) and second-/third-generation cephalosporins were highly resistant to the common GNR (30%-60%). The ticarcillin/clavulanate, piperacillin/tazuobactam (β-L-ase 2), fluoroquinolone, and group 2 carbapenem had good sensitivity. This study presents a comprehensive microbiological survey of diabetic foot ulcers in inpatients and provides reliable evidence of the local microbial epidemiology and sensitivity of antibiotics, which may help us improve clinical outcomes in DFI patients.

scholarly journals Diabetes a risk for antimicrobial resistance?

2017 ◽  
Vol 6 (12) ◽  
pp. 2811 ◽  
Author(s):  
Vasavi Gedela ◽  
Sree Lakshmi Gosala
Keyword(s):  
Antimicrobial Resistance ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Resistance Pattern ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Diabetic Foot Infections ◽  
Significant Difference ◽  
Resistance Rates

Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections.

Effects of pH on the Antibiotic Resistance of Bacteria Recovered from Diabetic Foot Ulcer Fluid

2018 ◽  
Vol 108 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Carla D. McArdle ◽  
Katie M. Lagan ◽  
David A. McDowell
Keyword(s):  
Antibiotic Resistance ◽  
Diabetic Foot ◽  
Bacterial Infections ◽  
Clinical Decision Making ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Clinical Decision ◽  
Wound Fluid ◽  
Ph Values ◽  
Diabetic Foot Infections

Background: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs. Methods: Thirty bacterial isolates were recovered from DFU wound fluid, including Staphylococcus spp, Staphylococcus aureus, Escherichia coli, Streptococcus spp, Pseudomonas spp, and Pseudomonas aeruginosa. The resistances of these isolates to a panel of antibiotics currently used in the treatment of infected or potentially infected DFUs, ie, ciprofloxacin, amoxicillin-clavulanate, doxycycline, and piperacillin-tazobactam, at the previously mentioned pH values were determined by a modification of the Kirby-Bauer assay. Results: The resistance of DFU isolates to clinically relevant antibiotics was significantly affected by the pH levels in DFU wound fluid. Conclusions: These findings highlight the importance of a more comprehensive understanding of the conditions in DFUs to inform clinical decision making in the selection and application of antibiotics in treating these difficult-to-heal wounds. The scale of the differences in the efficacies of antibiotics at the different pH values examined is likely to be sufficient to suggest reconsideration of the antibiotics of choice in the treatment of DFU infection.

scholarly journals Drug Utilisation Pattern for Diabetic Foot

2021 ◽  
Vol 10 (4) ◽  
Author(s):  
Girish Gowda A ◽  
M Kumarswamy ◽  
Rajesh Venkataramn ◽  
Mary Cheriyan ◽  
Asha Shaji
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Diabetic Foot ◽  
Drug Utilisation ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Public Health Problem ◽  
Diabetic Foot Ulcer ◽  
Therapeutic Outcome ◽  
Study Population

Introduction: Diabetic mellitus is a chronic disorder which is rapidly raising, major public health problem. Having DM are more prone to multifarious complication like diabetic foot ulcer, which is highly susceptible to infection. Prevalence of bacterial flora in foot ulcer of this study population indicate current medical scenario of increased multidrug resistant diabetic foot infection, appropriate selection of antibiotic plays important role in DFU management increasing prevalence of antibiotic resistance is a major factor for morbidity or mortality in DFU. The main objective of this study was to asses microbial sensitive resistance to antibiotic and also to know the drug utilisation of antibiotics in DFU. Method: A prospective observational study was carried out in 123 inpatients, after taking written informed consent from those met the study criteria. The study was done from October 2017 to march 2018 in surgery department. Patient case sheet were reviewed and assessed on daily basis. Culture report form and all other relevant data were collected to assess the utilisation of antibiotic, it’s sensitivity and resistant interaction, drug interactions and ADR were assessed by using Micromedex and other resources available in the department Result: In this study population, about 87(70.3%) patients were male and 36(29.27%) female. Mainly patients of age range 41-50 is 47(38.21%)followed by 51-60 is 33(26.83%)then 61-70 is 23(18.70%).Hospital Conclusion: Diabetic foot infections are real public health problem and early diagnosis along with appropriate treatments are essential. Different bacterial profiles and antibiotic sensitivity were found in different DFU. Clinician should try to stay updated in antibiotic sensitivity and resistant pattern of common pathogen in their area for better therapeutic outcome and to minimize medication errors. Keywords: Diabetic foot ulcer, sensitivity, resistant, utilization of antibiotics, therapeutic outcome.  

scholarly journals Antibiotic Resistance Pattern of Staphylococcus Aureus Isolated From Pediatrics With Ocular Infections: A 6-Year Hospital-Based Study in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiao-Yu Zheng ◽  
Bonnie Nga Kwan Choy ◽  
Ming-Ming Zhou ◽  
Zheng-Yan Zhao
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Resistance Rate ◽  
Resistance Pattern ◽  
Ocular Infection ◽  
Ocular Infections ◽  
Resistance Patterns ◽  
Mrsa Infection ◽  
Resistance Rates ◽  
Antibiotic Resistance Patterns

Staphylococcus aureus (S. aureus) is an important pathogen of ocular infections in pediatrics. The study aimed to identify the prevalence and resistance pattern of S. aureus, especially methicillin-resistant S. aureus (MRSA), in Chinese children with ocular infections. All patients with S. aureus infections were reviewed at a tertiary children's hospital during 2015–2020, and those with ocular infections were investigated for susceptibility results. Of 1,668 S. aureus strains, there were 177 unique isolates from ocular infection. Among them, 45 (25.4%) were MRSA and 132 (74.6%) were methicillin-sensitive S. aureus (MSSA). The proportion of MRSA did not change over time. Most of the strains were obtained from the neonate ward and ophthalmology department (n = 88, 49.7%, and n = 85, 48.0%, respectively), while eye secretion and pus were the main specimen types (n = 128, 72.3%, and n = 37, 20.9%, respectively). MRSA was significantly resistant against penicillin class (97.8%), erythromycin (71.1%), clindamycin (71.1%), and tetracycline (32.1%), with a high multidrug resistance (MDR) rate of 71.1%. However, MRSA was highly sensitive to levofloxacin. Resistance rates against erythromycin and ciprofloxacin as well as MDR percentage all increased among MSSA in children above 1 year of age, ophthalmology department, and outpatient population and decreased in eye secretion specimen. The mean resistance percentage remained stable for MRSA and MSSA during the study period. The survey of ocular S. aureus pathogens in pediatrics and their antibiotic resistance patterns helps in clinical treatment. MRSA with many strains demonstrating MDR is highly prevalent in children with ocular infections in Southeast China. Levofloxacin is an effective topical antibiotic for ocular MRSA infection, while erythromycin has a high resistance rate. The antibiotic resistance patterns of MRSA and MSSA differs and varies by different stratifications. A cautious use of antibiotics should be considered.

scholarly journals Bacterial Profile and Antibiotic Susceptibility Pattern among Diabetic Foot Ulcer Patients

2021 ◽  
Vol 12 (1) ◽  
pp. 160-168
Author(s):  
Steffy Ligi Binu ◽  
Abhishek Chandran ◽  
Chaitrashree ◽  
Abhijith Shetty ◽  
Sharad Chand ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Antibiotic Susceptibility ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
High Sensitivity ◽  
Resistance Pattern ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Gram Negative

The current study was undertaken to analyze the bacteriological profile among diabetic foot ulcer patients and to determine the antibiotic susceptibility and resistance pattern of the organisms isolated. This was a prospective observational study conducted among 102 patients for six months. All patients, aged above 18 years diagnosed with diabetic foot ulcers and performed with culture and sensitivity tests in the department of general surgery, were enrolled in the study. All the relevant details of the study were collected and analyzed. Out of 102 patients enrolled, 72 were males and 30 were females. The majority of the bacteria that were isolated from the culture samples were found to be gram-negative, 119 (79.33%) and 31 (20.97%) were found to be gram-positive. Methicillin-resistant coagulase-negative Staphylococcus was the most frequently isolated gram-positive micro-organism. It was found to have more sensitivity to both vancomycin and teicoplanin (100%) whereas it showed high resistance to benzylpenicillin (84.6%). Among various gram-negative organisms, Pseudomonas aeruginosa was the most commonly isolated. It showed high sensitivity to doripenem (70.9%) and was found to be more resistant to levofloxacin (51.6%). Our study concluded on the predominance of gram-negative bacteria among the enrolled patients. Among the 22 different types of bacteria identified, Pseudomonas aeruginosa was the most frequently isolated species.

scholarly journals A clinical study of commonly isolated organism and its antibiotic sensitivity in diabetic foot ulcers in Sri Manakula Vinayagar Medical College and Hospital, Pondicherry

2020 ◽  
Vol 7 (8) ◽  
pp. 2512
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian ◽  
Sudha Selvam
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Sugar ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Empirical Therapy ◽  
Gram Negative ◽  
Medical College ◽  
Diabetic Foot Infections

Background: Diabetic foot ulcer is one of the major surgical problem leading to hospital admission. Diabetic foot ulcer patients with uncontrolled diabetes may end up in forefoot amputation. Early aggressive debridement, control of blood sugar and empirical antibiotic therapy would reduce the morbidities in patients with diabetic foot ulcer. Further the knowledge of commonly isolated microbes and their antibiotic sensitivity pattern would be helpful to start empirical therapy. The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents.Methods: This cross-sectional study was conducted in 115 patients admitted with diabetic foot ulcer over a period of 9 months from October 2015 to June 2016 at the department of general surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Tissue scrapping samples were collected and processed as per standard guidelines.Results: 167 organisms were isolated from 115 patients. 52% of culture showed polymicrobial growth. There was increased prevalence of gram-negative organisms 53% compared to gram positive organisms 47%. When comes to individual isolate, Staphylococcus aureus was the most common organism isolated 24.6% followed by Pseudomonas aeruginosa 21%. All gram-positive aerobes were sensitive to vancomycin and gram-negative isolates were sensitive to amikacin, piperacillin-tazobactum, gentamycin and cefotaxime.Conclusions: Staphylococcus aureus and Pseudomonas were the common pathogens isolated. This study recommends use of vancomycin along with piperacillin-tazobactum as an empirical therapy along with adequate blood sugar control and early debridement of devitalized tissues in patients with diabetic foot infections.

scholarly journals A study on clinical grading and bacteriological profile of diabetic foot ulcers in tertiary care centre

2020 ◽  
Vol 7 (7) ◽  
pp. 2342 ◽  
Author(s):  
Mohammed Hamza ◽  
Thomas K. Thomas
Keyword(s):  
Treatment Outcome ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Tertiary Care Centre ◽  
Wagner’S Grade

Background: Diabetes is one of the commonest diseases worldwide and diabetic foot ulcer and its complications are associated with significant morbidity and even amputation. Early detection of colonizing agent of these ulcers help in reduced morbidity and hospital stay. We targeted this subgroup of patients to study Wagner’s grade, identify the bacterial agent and its antibiotic sensitivity and ankle-brachial pressure index (ABPI) assessment to detect PAD, for the best treatment outcome of diabetic foot ulcers.Methods: The present study was conducted in the Department of Surgery of SGMCRF, Venjaramoodu on 210 patients with diabetic foot ulcers between November 2017 and May 2019. Wagner’s grading of ulcer, culture and antibiotic sensitivity of microbe were done as well as ABPI was measured. Outcome of ulcers was compared to ABPI and ABPI was compared to time of healing.Results: Out of 210 patients 122 were males and 88 females, 62.9% had neuropathy and 66.7% had vasculopathy. Most patients presented with Wagner’s grade-II ulcers.  Most common microbe isolated was pseudomonas aeruginosa which was most sensitive to piperacillin and tazobactam combination. Majority of lesions 62.9% had ABPI in range of 0.5-0.89.Conclusions: Wagner’s grading and presence of neuropathy are predictors of major amputation. Piperacillin and tazobactam should be empirical choice of antibiotic. ABPI was inversely related to time of healing and has got significant association with treatment outcome.

scholarly journals Bacteriological Profile and Antibiotic Sensitivity Pattern in Infected Diabetic Foot Ulcers

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Afshan Zia
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Empiric Therapy ◽  
Sensitivity Pattern ◽  
Pseudomonas Species ◽  
Third Generation Cephalosporins ◽  
Proteus Species

Objectives: To identify the common bacterial pathogens responsible for infection in diabetic foot ulcer and their sensitivity pattern to different antibiotics. Methods: This prospective observational study was conducted from 24th June 2019 to 27th December 2019 at Services Institute of Medical Sciences Lahore. Specimens of discharge from diabetic foot ulcers (DFU) were received from Diabetes Management Centre (DMC). Cultures were put up and bacteria isolated were identified by standard methods. Antibiotic sensitivity was determined by Kirby-Bauer disc diffusion method. Results: Samples from DFU of 50 patients were processed. Thirty-six (72%) samples were from males and 14(28%) were from females; mean age of patients was 53±9.5 years. Forty-nine (98%) patients had unsatisfactory glycemic control. Forty three (86%) samples were growth positive while 07(14%) were bacteriologically sterile. Monomicrobial infection was observed in 38 (76%) cases while polymicrobial infection was seen in 12 cases (24%). The most common isolates were Staphylococcus aureus 14(28%), Pseudomonas species 11 (22%) and Proteus species 10 (20%). Forty three percent of Staphylococcus aureus, were methicillin resistant (MRSA). All MRSA remained sensitive to vancomycin and linezolid. In Pseudomonas species, resistance to third generation cephalosporins, ceftazidime , was 27%, while resistance to imipenem was seen in 3 (9%) of isolates. In Proteus species, resistance to third generation cephalosporins was 90% while to imipenem resistance was 60%. Resistance to commonly prescribed quinolones was more than 70% among all the bacterial isolates. Conclusions: Common Gram positive and Gram negative organisms responsible for infection in DFU were Staphylococcus aureus, Pseudomonas species and Proteus species. The isolates were multi-drug resistant (MDR). Resistance to antibiotics used as empiric therapy was high. Keywords: Diabetic foot ulcer, antibiotic resistance, empiric therapy

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