Origin of Organisms Infecting Ventricular Shunts

Abstract Results of skin cultures obtained before 413 of 505 operations for cerebrospinal fluid-diverting ventricular shunt placement or revision in a pediatric population from April 1980 to May 1983 are analyzed and compared to results of cultures from 20 subsequent shunt infections. Sensitivities to 11 different antibiotics were determined for each isolate cultured. The total operative infection rate was 20 of 505 (4%). Gram-negative bacilli alone accounted for 3 of 20 (15%) shunt infections. One gram-negative bacillus/Staphylococcus aureus infection occurred. Factors predisposing for gramnegative bacillus shunt infection were found in all 4 cases. The majority of shunt infections were caused by typical resident skin organisms: Staphylococcus epidermidis alone, 9/20 (45%); Staphylococcus aureus alone, 4/20 (20%); Corynebacterium sp., 1/20 (5%); α-Streptococcus with S. epidermidis, 1/20 (5%); and Micrococcus with S. epidermidis, 1/20 (5%). Only 4 (20%) of the 20 shunt infections were due to organisms identical to those originally grown from the skin. Another 4 (20%) seemed to be infected with a strain of organism different from that initially recovered from the skin. The remaining skin organism shunt infections may or may not have come from the patient's skin. The data suggest that not all skin organism shunt infections arise from contamination by resident skin bacteria at the incision sites at the time of operation. Alternate sources for the infecting organisms are discussed. The antibiotic sensitivity data on skin isolates and shunt isolates suggest that vancomycin is the antibiotic best suited for prophylaxis against shunt infection at our institution.

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Progression of cerebrospinal fluid cell count and differential over a treatment course of shunt infection

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.8.peds11236 ◽

2011 ◽

Vol 8 (6) ◽

pp. 613-619 ◽

Cited By ~ 11

Author(s):

Daniel H. Fulkerson ◽

Ahilan Sivaganesan ◽

Jason D. Hill ◽

John R. Edwards ◽

Mohammadali M. Shoja ◽

...

Keyword(s):

Propionibacterium Acnes ◽

Shunt Infection ◽

Gram Negative ◽

Cell Counts ◽

Wide Range ◽

Pmn Leukocytes ◽

Gram Negative Organisms ◽

Wbc Count ◽

Shunt Infections ◽

Infecting Organisms

Object The physiological reaction of CSF white blood cells (WBCs) over the course of treating a shunt infection is undefined. The authors speculated that the CSF WBC count varies with different infecting organisms in peak level and differential percentage of polymorphonuclear (PMN) leukocytes, lymphocytes, monocytes, and eosinophils. The authors hope to identify clinically useful trends in the progression of CSF WBCs by analyzing a large group of patients with successfully treated shunt infections. Methods The authors reviewed 105 successfully treated cases of shunt infections at Riley Hospital for Children. The study dates ranged from 2000 to 2004; this represented a period prior to the routine use of antibiotic-impregnated shunt catheters. They analyzed the following organisms: coagulase-negative staphylococci, Staphylococcus aureus, Propionibacterium acnes, Streptococcal species, and gram-negative organisms. The initial CSF sample at diagnosis was analyzed, as were levels over 14 days of treatment. Model fitting was performed to generate curves for the expected progression of the WBC counts and the differential PMN leukocytes, lymphocyte, monocyte, and eosinophil percentages. Results Gram-negative organisms resulted in a higher initial (p = 0.03) and peak WBC count with a greater differential of PMN leukocytes compared with other organisms. Propionibacterium acnes infections were associated with a significantly lower WBC count and PMN leukocytes percentage (p = 0.02) and higher eosinophil percentage (p = 0.002) than other organisms. The pattern progression of the CSF WBC count and differential percentages was consistent for all infections. There was an initial predominance of PMN leukocytes, followed by a delayed peak of lymphocytes, monocytes, and eosinophils over a 14-day course. All values trended toward zero over the treatment course. Conclusions The initial and peak levels of CSF WBCs vary with the infecting organisms. The CSF cell counts showed a predictable pattern during the treatment of shunt infection. These trends may be useful to the physician in clinical decision making, although there is a wide range of variability.

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Clinico-microbial profile in chronic suppurative otitis media and its management in tertiary care centre

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185301 ◽

2018 ◽

Vol 5 (1) ◽

pp. 135

Author(s):

Rashmi Ramashesh ◽

Samira Abdul Wajid ◽

Smitha Chandra

Keyword(s):

Staphylococcus Aureus ◽

Otitis Media ◽

Antibiotic Sensitivity ◽

Chronic Suppurative Otitis Media ◽

Health Concern ◽

Research Centre ◽

Suppurative Otitis Media ◽

Gram Negative ◽

Sensitivity Pattern ◽

Pseudomonas Species

Background: Chronic suppurative otitis media (CSOM) is an ever growing concern of preventable hearing loss and is a major health concern especially in tropical countries. Lack of cleanliness, overcrowding, poverty, malnutrition and medical ignorance are few of the contributing factors. The microbiological flora is constantly changing due to indiscriminate use of antibiotics with rapid change in the antibiotic sensitivity patterns. Hence, this study was undertaken to determine the epidemiological profile, bacteriological profile and the antibiotic sensitivity pattern which would help in establishing a protocol in management of CSOM patients in the hospital.Methods: A total of 100 patients of CSOM attending the ENT Outpatient Department of The Oxford medical College, Hospital and Research Centre were included in the study. The samples were immediately sent to the Microbiology laboratory for further processing according to standard procedure. Results: Out of 100 cases, 74 were active mucosal type and 26 were active squamous, with Pseudomonas species (33.6%) being the predominant organism. Staphylococcus aureus was the next common organism with MSSA (16.3%) and MRSA (12.5%), CONS were 6.7%. Among the 28 gram-negative bacilli, Klebsiella pneumoniae (7.7%), was followed by Escherichia coli (5.7%), and Proteus mirabilis (4.8%).Conclusions: Pseudomonas species and Staphylococcus aureus are the commonest organisms of CSOM. Ciprofloxacin can be used as a topical agent for treating gram-negative bacilli. Among systemic antibiotics- Linezolid, Amikacin and Imepenam remains the drug of choice.

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Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2967 ◽

2013 ◽

Vol 7 (10) ◽

pp. 707-712 ◽

Cited By ~ 27

Author(s):

Vedat Turhan ◽

Mesut Mutluoglu ◽

Ali Acar ◽

Mustafa Hatipoglu ◽

Yalcın Onem ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Diabetic Foot ◽

Geographical Location ◽

Antibiotic Sensitivity ◽

Diabetic Patients ◽

Tissue Samples ◽

Gram Negative ◽

Diabetic Foot Infections ◽

Pseudomonas Species ◽

Gram Negative Organisms

Introduction: In the present study, we sought to identify the bacterial organisms associated with diabetic foot infections (DFIs) and their antibiotic sensitivity profiles. Methodology: We retrospectively reviewed the records of wound cultures collected from diabetic patients with foot infections between May 2005 and July 2010. Results: We identified a total of 298 culture specimens (165 [55%] wound swab, 108 [36%] tissue samples, and 25 [9%] bone samples) from 107 patients (74 [69%] males and 33 [31%] females, mean age 62 ± 13 yr) with a DFI. Among all cultures 83.5% (223/267) were monomicrobial and 16.4% (44/267) were polymicrobial. Gram-negative bacterial isolates (n = 191; 61.3%) significantly outnumbered Gram-positive isolates (n = 121; 38.7%). The most frequently isolated bacteria were Pseudomonas species (29.8%), Staphylococcus aureus (16.7%), Enterococcus species (11.5%), Escherichia coli (7.1%), and Enterobacter species (7.1%), respectively. While 13.2% of the Gram-negative isolates were inducible beta-lactamase positive, 44.2% of Staphylococcus aureus isolates were methicillin resistant. Conclusions: Our results support the recent view that Gram-negative organisms, depending on the geographical location, may predominate in DFIs.

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Microbiological Profile of Uropathogens and their Antibiotic Susceptibility Pattern in Pediatric Population from A Tertiary Care Hospital in Amritsar, Punjab

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2021.1011.034 ◽

2021 ◽

Vol 10 (11) ◽

pp. 306-312

Author(s):

Manpreet Kaur Bhatha Loveena Oberoi ◽

Sapna Soneja Anuradha Malhotra ◽

Kamaldeep Singh

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Susceptibility ◽

Pediatric Population ◽

Age Group ◽

Susceptibility Pattern ◽

Gram Positive ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative ◽

Gram Negative Organisms ◽

Gram Positive Cocci

Urinary tract infection(UTI) is one of the most commonest bacterial infection encountered in the pediatric age group. Early diagnosis is of utmost importance to preserve renal function and reduce long term complications such as renal scarring. The objective of this study was to determine the prevalence of UTI in pediatric population, identify the common uropathogens and study the antibiotic susceptibility pattern of bacterial isolates. Materials and Methods: A retrospective study was carried out in Department of Microbiology, GMC Amritsar for a period of 6 months from 1 Jan 2021 till 30 June 2021 amongst the pediatric patients (1 month-12 years age group) with clinically suspected UTI including both indoor and outdoor patients. Clean catch midstream urine samples received in the laboratory were processed as per the standard microbiological guidelines. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: A total of 549 samples were received and processed during study period from which 164(29.87%) were culture positive. Culture positivity was more prevalent in females (61.58%) than males (38.41%). Gram negative organisms were predominant (74.4%) followed by gram positive cocci (22.56%) and Candida (3.05%). Among gram negative organisms Escherichia coli was most predominant followed by Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Proteus spp. and Citrobacter spp. Among gram positive cocci Staphylococcus aureus was most predominant followed by Coagulase negative Staphylococci and Enterococcus spp. Majority of gram negative bacilli were resistant to fluroquinolones, 3rd generation cephalosporins and co-trimoxazole while nitrofurantoin, piperacillin-tazobactam and gentamicin were most sensitive drugs. Among Staphylococcus aureus, methicillin resistance was seen in 17% isolates. High sensitivity was seen to linezolid and vancomycin in gram positive cocci. Conclusion: This study highlights increased prevalence of MDR uropathogens in pediatric population which indicates that antibiotic selection should be based on knowledge of local prevalence of bacterial organisms and their antibiotic sensitivities with rational use of antibiotics.

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The association between dental health and procedures and developing shunt infections in pediatric patients

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.8.peds1444 ◽

2014 ◽

Vol 14 (5) ◽

pp. 508-513 ◽

Cited By ~ 3

Author(s):

Alan A. Moazzam ◽

Ernest Nehrer ◽

Stephanie L. Da Silva ◽

José C. Polido ◽

Anush Arakelyan ◽

...

Keyword(s):

Bacterial Infections ◽

Pediatric Patients ◽

Pediatric Population ◽

Dental Health ◽

Shunt Infection ◽

Dental Procedure ◽

Gingival Health ◽

Dental Procedures ◽

Dental Records ◽

Shunt Infections

Object Cerebrospinal fluid–diverting shunts are often complicated by bacterial infections. Dental procedures are known to cause transient bacteremia that could potentially spread hematogenously to these implanted devices. No literature currently exists to inform practitioners as to the need for prophylactic antibiotics for patients who possess these implants. The authors performed a retrospective study to assess whether dental procedures and poor oral health were associated with a higher likelihood of developing CSF-diverting shunt infections. Methods Neurosurgical and pediatric dental records from January 2007 to December 2012 were reviewed for shunt surgeries and dental encounters. Indications for shunt surgery and infection rates were recorded. Dental records were reviewed for several markers of overall dental health, such as a DMFT (decayed, missing, and filled teeth) score and a gingival health/oral hygiene score. The association between these scores and the incidence of shunt infections were studied. Moreover, the relationship between the incidence of shunt infections and the timing and invasiveness of preceding dental encounters were analyzed. Results A total of 100 pediatric patients were included in our study, for a total of 204 shunt surgeries. Twenty-one shunt infections were noted during the 6-year study period. Five of these shunts infections occurred within 3 months of a dental procedure. The odds ratio (OR) of developing a shunt infection within 3 months of a dental procedure was 0.98 (95% confidence interval [CI] 0.27–3.01), and was not statistically significant. The OR of developing a shunt infection after a high-risk dental procedure compared with a low-risk dental procedure was 1.32 (95% CI 0.02–16.29), and was not statistically significant. There was no significant association between measures of dental health, such as DMFT and gingival health score, and the likelihood of developing a shunt infection. The ORs for these 2 scores were 0.51 (95% CI 0.04–4.96) and 1.58 (95% CI 0.03–20.06), respectively. The study was limited by sample size. Conclusions Dental health status and the number and type of dental procedures performed do not appear to confer a higher risk of developing a CSF-diverting shunt infection in this pediatric population.

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Factors contributing to the medical costs of cerebrospinal fluid shunt infection treatment in pediatric patients with standard shunt components compared with those in patients with antibiotic-impregnated components

Neurosurgical FOCUS ◽

10.3171/foc.2007.22.4.11 ◽

2007 ◽

Vol 22 (4) ◽

pp. 1-4 ◽

Cited By ~ 30

Author(s):

Daniel M. Sciubba ◽

Li-Mei Lin ◽

Graeme F. Woodworth ◽

Matthew J. McGirt ◽

Benjamin Carson ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Pediatric Patients ◽

Pediatric Population ◽

Medical Costs ◽

Shunt Infection ◽

Csf Shunt ◽

Shunt Insertion ◽

Average Hospital ◽

Infection Treatment ◽

Shunt Infections

Object Antibiotic-impregnated shunt (AIS) systems may decrease the incidence of cerebrospinal fluid (CSF) shunt infections. However, there is a reluctance to use AIS components because of their increased cost. In the present study the authors evaluated factors contributing to the medical costs associated with the treatment of CSF shunt infections in a hydrocephalic pediatric population, those implanted with AIS systems compared with those implanted with standard shunt systems. Methods The authors retrospectively reviewed data obtained in all pediatric patients who had undergone CSF shunt insertion at their institution over a 3-year period. All patients were followed up for 12 months after surgery. The independent association between AIS catheter use and subsequent shunt infection was assessed by performing a multivariate proportional hazards regression analysis. Factors contributing to the medical costs associated with shunt infection were evaluated. Results Two hundred eleven pediatric patients underwent 353 shunting procedures. Two hundred eight shunts (59%) were placed with nonimpregnated catheters and 145 shunts (41%) were placed with AIS catheters. Twenty-five patients (12%) with non-AIS catheters experienced shunt infection, whereas only two patients (1.4%) with AIS catheters had a shunt infection within the 6-month follow-up period (p < 0.01). Among infected patients, infected patients with standard shunt components had a longer average hospital stay, more inpatient complications related to infection treatment, and more multiple organism infections and multiple antibiotic regimens, compared with those with AIS components. Conclusions Although individual AIS components are more expensive than standard ones, factors contributing to medical costs are fewer in pediatric patients with infected shunts when the components are antibiotic-impregnated rather than standard.

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Bacterial etiology and antimicrobial susceptibility pattern of neonatal sepsis at a tertiary care hospital in Nepal

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20211671 ◽

2021 ◽

Vol 8 (5) ◽

pp. 830

Author(s):

Kiran Sharma ◽

Love Kumar Sah ◽

Prince Pareek ◽

Sanjay Shah ◽

Reema Garegrat

Keyword(s):

Staphylococcus Aureus ◽

Neonatal Sepsis ◽

Late Onset ◽

Antibiotic Sensitivity ◽

Care Hospital ◽

Gram Negative ◽

Common Organism ◽

Early Onset Sepsis ◽

Sensitivity Pattern ◽

Gram Negative Organisms

Background: Sepsis is the second major cause of mortality among neonates. Present study was done to identify the common organisms which cause early and late onset neonatal sepsis in neonates admitted in our department and their antibiotic sensitivity patterns.Methods: All neonates weighing more than 1500 gms and born to mothers with pre-existing infection, admitted to neonatal intensive care unit for suspected neonatal sepsis were included in the present study. They underwent blood culture and antibiotic sensitivity profiling.Results: 210 newborns were admitted to the NICU of our department for suspected neonatal sepsis. Longer duration of rupture of membranes was found to be significantly associated with growth of organisms. Amongst the cases with gram positive organisms, most were due to Coagulase-negative staphylococci (CoNS) (n=25), followed by Staphylococcus aureus (n=14), and, Enterococcus (n=4). Gram negative organisms isolated constituted 17 organisms. Amongst the cases with gram negative organisms, mostly were due to Klebsiella (n=10), followed by Pseudomonas (n=5) and E. coli (n=2). The most common organism causing early onset sepsis was CoNS, while Staphylococcus aureus was the most common organism causing late onset sepsis. CoNS was fully sensitive to Vancomycin and Amikacin. Staphylococcus aureus was fully sensitive to Amikacin, α-hemolytic. Streptococcus were sensitive to Amikacin, Vancomycin and Piperacillin and Tazobactum and Enterococcus was sensitive to Amikacin and Vancomycin.Conclusions: Antimicrobial surveillance of neonatal septicaemia is required to know the antibiotic sensitivity pattern and thus to formulate policies on use of antibiotics and to know the changing spectrum of antimicrobial sensitivity patterns.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20203032 ◽

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.

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Catheter-Associated Urinary Tract Infection and Obstinate Biofilm Producers

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/7624857 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Govinda Maharjan ◽

Priyatam Khadka ◽

Gomik Siddhi Shilpakar ◽

Ganesh Chapagain ◽

Guna Raj Dhungana

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Antibiotic Sensitivity ◽

Diffusion Method ◽

Klebsiella Pneumonia ◽

Gram Positive ◽

Gram Negative ◽

Control And Prevention ◽

Amoxicillin Clavulanate

Background. Biofilms, or colonies of uropathogen growing on the surface of indwelling medical devices, can inflict obstinate or recurring infection, thought-provoking antimicrobial therapy.Methods. This prospective analysis included 105 urine samples from catheterized patients receiving intensive care. Ensuing phenotypic identification, antibiotic sensitivity test was performed by modified Kirby–Bauer disc diffusion method following CLSI guidelines; MDR isolates were identified according to the combined guidelines of the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC). Biofilm-forming uropathogens were detected by the tissue culture plate (TCA) method.Results. The predominant uropathogen in catheter-associated UTIs (CAUTIs) wasEscherichia coli57%, followed byKlebsiella pneumonia15%,Pseudomonas aeruginosa12%,Staphylococcus aureus8%,Enterobacterspp. 3%,Enterococcus faecalis,Acinetobacterspp., andProteus mirabilis1.5%, of which 46% isolates were biofilm producers. Prime biofilm producers wereEscherichia coli33%, followed byKlebsiella pneumoniae30%,Pseudomonas aeruginosa20%,Staphylococcus aureus10%,Acinetobacter, andEnterobacter3.33%. Multidrug resistance associated with biofilm producers were greater than biofilm nonproducers. The Gram-negative biofilm producers found 96.15%, 80.76%, 73.07%, 53.84%, 53.84%, 46.15%, 19.23%, and 11.5% resistant to amoxyclave, ceftazidime, tetracycline, gentamicin, meropenem, nitrofurantoin, amikacin, imipenem, and fosfomycin, respectively. Gram-positive biofilm producers, however, were found 100% resistant to tetracycline, cloxacillin, and amoxyclave: 66.67% resistant to ampicillin while 33.33% resistant to gentamicin, ciprofloxacin, and nitrofurantoin.Conclusion. High antimicrobial resistance was observed in biofilm producers than non-biofilm producers. Of recommended antimicrobial therapies for CAUTIs, ampicillin and amoxicillin-clavulanate were the least active antibiotics, whereas piperacillin/tazobactam and imipenem were found as the most effectual for gram-negative biofilm producer. Likewise, amoxicillin-clavulanate and tetracycline were the least active antibiotics, whereas vancomycin, fosfomycin, piperacillin-tazobactam, and meropenem were found as the most effective antibiotic for Gram-positive biofilm producer. In the limelight, the activity fosfomycin was commendable against both Gram-positive and Gram-negative biofilm producers.

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Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734618793557 ◽

2018 ◽

Vol 17 (3) ◽

pp. 161-168 ◽

Cited By ~ 5

Author(s):

Mousab Yousef Al Ayed ◽

Mutasem Ababneh ◽

Asirvatham Alwin Robert ◽

Aus Alzaid ◽

Rania Ahmed Ahmed ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Saudi Arabia ◽

Diabetic Foot ◽

Antibiotic Sensitivity ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Gram Positive ◽

Gram Negative ◽

Klebsiella Spp

We sought to define the type and antibiotic sensitivity response of pathogens isolated from diabetic foot ulcers based on ulcer location and Wagner classification. This retrospective analysis was done among 126 patients between 40 and 70 years of age at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia, using the swab culture method for microbiological assessment. Data on demographic variables, ulcer sites (location), and depth of ulcer (Wagner classification) were also collected. A total of 134 pathogens were isolated from 126 patients. The most common gram-negative pathogen identified was Pseudomonas aeruginosa (15.6%), followed by Klebsiella spp (6.7%). The most common gram-positive pathogen was Staphylococcus aureus (35%), followed by Streptococcus (8.9%). The most widely accepted antibiotic to which the gram-negative bacteria were sensitive was gentamycin (20.1%), followed by ciprofloxacin (19%). The most routinely used antibiotic in the treatment of the gram-positive bacteria was erythromycin (16%), with trimethoprim-sulfamethoxazole (14.1%) being the next most effective. In conclusion, Pseudomonas aeruginosa, Klebsiella spp, Staphylococcus aureus, and Streptococcus were the most common causes of diabetic foot infections. However, the frequency of encountered pathogens and respective sensitivity to antibiotic therapy may be influenced by the location site and severity of the ulceration.

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