ASSESSMENT OF ANTIBIOTIC SENSITIVITY PATTERN IN DIABETIC FOOT ULCER PATIENTS AT A TERTIARY CARE TEACHING HOSPITAL IN KERALA

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.

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Bacteriological Profile and Antibiotic Sensitivity Pattern in Infected Diabetic Foot Ulcers

Esculapio ◽

10.51273/esc20.2516322 ◽

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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Microbiological Pattern and Antibiotic Sensitivity in Diabetic Foot Ulcer in a Tertiary Care Center- A Cross Sectional Study

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i12.13 ◽

2017 ◽

Vol 5 (12) ◽

Author(s):

Dr Sreenivasan M ◽

Keyword(s):

Diabetic Foot ◽

Care Center ◽

Tertiary Care ◽

Foot Ulcer ◽

Antibiotic Sensitivity ◽

Diabetic Foot Ulcer ◽

Cross Sectional Study ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

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Prevalence of Microorganisms and Antibiotic Sensitivity Among Patients with Diabetic Foot Ulcer in Sulaimani City, Iraq

Hospital Practices and Research ◽

10.34172/hpr.2020.11 ◽

2020 ◽

Vol 5 (2) ◽

pp. 56-63

Author(s):

Aso Nasih Qadir ◽

Bakhtiar Mohamed Mahmoud ◽

Taha Othman Mahwi ◽

Delman Mohammed Raoof Arif Al-Attar ◽

Safeen Othman Mahmood

Keyword(s):

Teaching Hospital ◽

Diabetic Foot ◽

Foot Ulcer ◽

Antibiotic Sensitivity ◽

Diabetic Foot Ulcer ◽

Empirical Therapy ◽

Cross Sectional Study ◽

Foot Care ◽

Cross Sectional ◽

Gram Negative

Background: Diabetic foot ulcers (DFUs) are responsible for days of costly hospitalization and are the major cause of medical lower limb amputations. Determining the appropriate antimicrobial therapy for DFUs is highly dependent on recognizing the microorganisms that cause them. Many reports have indicated that there has been a remarkable increase in antibiotic resistance. Objectives: The present study examined various cultures of patients with DFUs to detect the prevalence of microorganisms and their antibiotic sensitivity profiles. Methods: This cross-sectional study was carried out on 92 patients with DFUs admitted to Shar Teaching Hospital and Shahid Hemin Teaching Hospital. Wagner Classification was used to assess the severity and location of the DFUs. Patients were asked questions about their practices of foot care and hygiene, and their answers were recorded. Samples required for testing were taken using sterile swabs. Results: A total of 100 microorganisms were isolated from 92 patients with DFUs, 10 of which were polymicrobial and 2 were culture-negative. There was a highly significant association between the isolated gram-negative microorganisms and higher grades of DFU (P<0.001). A highly significant association was also observed between bad patient knowledge of hygiene practices and gram-negative microorganisms (P<0.001). Osteomyelitis was present in 40 (43.4%) patients. Conclusion: Among gram-positive and gram-negative bacteria, Staphylococcus spp. and E. coli were, respectively, the most frequent organisms isolated. The antibiotic imipenem was found to be effective against microorganisms. Tetracycline, erythromycin, and ceftriaxone, however, were highly resistant to antibiotics. To sum up, since different microorganisms are involved and multidrugresistant strains might emerge, clinicians are recommended to take cultures into account before they initiate empirical therapy.

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