scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

scholarly journals Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tadesse Tolossa ◽  
Belayneh Mengist ◽  
Diriba Mulisa ◽  
Getahun Fetensa ◽  
Ebisa Turi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Diabetic Foot ◽  
Meta Analysis ◽  
Self Care ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Care Practice ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

Abstract Background Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it. Methods We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. Results The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81–18.15) in diabetic patients in Ethiopia. Sub-group analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84–4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47–24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58–4.56)), poor self- care practice ((OR = 1.47, 95%CI: 1.25–1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22–0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11–0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21–0.92)). Conclusion The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.

scholarly journals SELF CARE PADA PASIEN DIABETES MELITUS DENGAN PENYULIT ULKUS KAKI DIABETIK

2021 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Sri Dewi Megayanti ◽  
Ns. Putu Inge Suantika, S.Kep.,M.Kep
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Self Care ◽  
Foot Ulcer ◽  
Sampling Technique ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Convenience Sampling

ABSTRAKLatar Belakang: Diabetes self-care merupakan perilaku perawatan diri pasien diabetes yang meliputi pengaturan diet, penggunaan insulin, olahraga dan perawatan kaki. Diabetes self-care memiliki efek langsung pada kontrol glikemik dalam terjadinya ulkus kaki diabetic. Skor PEDIS merupakan form pemeriksaan yang digunakan perawat dalam menilai keparahan ulkus kaki. Keterbatasan intervensi ulkus kaki yang diberikan oleh perawat saat ini disebabkan oleh terbatasnya data tentang self-care pada pasien diabetes. Tujuan penelitian mengetahui self-care pasien diabetes dengan komplikasi ulkus kaki menggunakan metode pengukuran skor PEDIS yang teridiri dari pemeriksaan perfusi, luas luka, kedalaman luka, keberadaan infeksi dan sensasi kaki.Metode: Penelitian ini termasuk penelitian kuantitatif, dimana penentuan responden menggunakan teknik Convenience sampling dengan jumlah sampel adalah 125, analisa data yang digunakan dengan metode  deskriptif.Hasil: Pada penelitian ini 53,8 % reponden memiliki diabetes self-care yang adekuat dan rata- rata responden memiliki Skor PEDIS 2,08.Kesimpulan: dalam penelitian ini sebagian besar responden memiliki diabetes self-care yang tidak adekuat.  Nilai Diabetes self-care dapat digunakan oleh perawat untuk mengetahui tingkat kualitas perawatan diri pasien selama ini sehingga memudahkan dalam menentukan intervensi yang tepat untuk mencegah terajadinya perburukan ulkus kaki. Kata kunci: diabetes mellitus tipe 2, diabetes self-care, dan ulkus kaki diabetik. ABSTRACTBackground: Diabetes self-care is a diabetes patient self-care behavior that includes diet management, insulin use, exercise and foot care. Diabetes self-care has a direct effect on glycemic control in the occurrence of diabetic foot ulcers. The PEDIS score is an examination form that nurses use in assessing the severity of foot ulcers. The limitations of the foot ulcer intervention given by nurses at this time are due to limited data on self-care in diabetic patients. The aim of this study was to determine the self-care of diabetic patients with complications of foot ulcers using the PEDIS score measurement method which consists of examination of perfusion, wound area, wound depth, presence of infection and foot sensation.Methods: This research is a quantitative study, where the determination of the respondents using the convenience sampling technique with a sample size of 125, the data analysis used is the descriptive method.Results: In this study 53.8% of respondents had adequate diabetes self-care and the mean of respondents had a PEDIS score of 2.08. Conclusion: in this study most of the respondents had inadequate self-care diabetes. The value of diabetes self-care can be used by nurses to determine the level of quality of patient self-care so far, making it easier to determine the right intervention to prevent worsening of foot ulcers. Keywords: type 2 diabetes mellitus, diabetes self-care, and diabetic foot ulcers. 

scholarly journals Methicillin-Resistant Staphylococcus aureus (MRSA) Infection of Diabetic Foot Ulcers at a Tertiary Care Hospital in Accra, Ghana

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 937
Author(s):  
Ramzy B. Anafo ◽  
Yacoba Atiase ◽  
Nicholas T. K. D. Dayie ◽  
Fleischer C. N. Kotey ◽  
Patience B. Tetteh-Quarcoo ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistance ◽  
Teaching Hospital ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Mrsa Infection

Aim: This study investigated the spectrum of bacteria infecting the ulcers of individuals with diabetes at the Korle Bu Teaching Hospital in Accra, Ghana, focusing on Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA), with respect to their prevalence, factors predisposing to their infection of the ulcers, and antimicrobial resistance patterns. Methodology: This cross-sectional study was conducted at The Ulcer Clinic, Department of Surgery, Korle Bu Teaching Hospital, involving 100 diabetic foot ulcer patients. The ulcer of each study participant was swabbed and cultured bacteriologically, following standard procedures. Antimicrobial susceptibility testing was done for all S. aureus isolated, using the Kirby-Bauer method. Results: In total, 96% of the participants had their ulcers infected—32.3% (n = 31) of these had their ulcers infected with one bacterium, 47.9% (n = 46) with two bacteria, 18.8% (n = 18) with three bacteria, and 1.0% (n = 1) with four bacteria. The prevalence of S. aureus and MRSA were 19% and 6%, respectively. The distribution of the other bacteria was as follows: coagulase-negative Staphylococci (CoNS) (54%), Escherichia coli (24%), Pseudomonas spp. (19%), Citrobacter koseri and Morganella morgana (12% each), Klebsiella oxytoca (11%), Proteus vulgaris (8%), Enterococcus spp. (6%), Klebsiella pneumoniae (5%), Proteus mirabilis and Enterobacter spp. (4%), Klebsiella spp. (2%), and Streptococcus spp. (1%). The resistance rates of S. aureus decreased across penicillin (100%, n = 19), tetracycline (47.4%, n = 9), cotrimoxazole (42.1%, n = 8), cefoxitin (31.6%, n = 6), erythromycin and clindamycin (26.3% each, n = 5), norfloxacin and gentamicin (15.8% each, n = 3), rifampicin (10.5%, n = 2), linezolid (5.3%, n = 1), and fusidic acid (0.0%, n = 0). The proportion of multidrug resistance was 47.4% (n = 9). Except for foot ulcer infection with coagulase-negative Staphylococci, which was protective of S. aureus infection of the ulcers (OR = 0.029, p = 0.001, 95% CI = 0.004–0.231), no predictor of S. aureus, MRSA, or polymicrobial ulcer infection was identified. Conclusions: The prevalence of S. aureus and MRSA infection of the diabetic foot ulcers were high, but lower than those of the predominant infector, coagulase-negative Staphylococci and the next highest infecting agent, E. coli. Diabetic foot ulcers’ infection with coagulase-negative Staphylococci protected against their infection with S. aureus. The prevalence of multidrug resistance was high, highlighting the need to further intensify antimicrobial stewardship programmes.

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

scholarly journals Effect of Health Education on Improving the Knowledge among Diabetes Mellitus Patients in the Prevention of Diabetic Ulcer in Regional Hospital of Tidore Island

2021 ◽  
Vol 4 (4) ◽  
pp. 379-384
Author(s):  
Haeril Amir ◽  
Nur Wahyuni Munir
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers

International  Diabetes  Federation  (IDF) reported that the number of diabetes mellitus patients worldwide increases every year. Diabetes mellitus is a chronic disease due to damage to the pancreas in producing enough insulin and characterized by impaired metabolism of fats, increased blood sugar, carbohydrates and protein both absolutely and relatively. Diabetic foot ulcers (DFU) are among the most common complications in diabetic patients and are associated with high mortality, morbidity, and health costs.   This study was to determine the effect of health education on knowledge improvement about diabetic ulcers in the regional hospital of Tidore Islands.  This research is a quasi-experimental type with a pretest-posttest without a control group design. The research sample consisted of 30 respondents who met the inclusion criteria. Data were analyzed using a paired test and processed with statistic version 21. Based on the research results, there was an improved knowledge in pre and post-health education counseling, where the average score before health education counseling was 11.6. After health counseling, the average value was 15.0. The results showed the effect of knowledge in the prevention of diabetic ulcers with a p-value =0,000.  Health education is an effort to improve patient's ability to prevent diabetic foot ulcers that have been proven in several scientific studies. Health education methods provide additional information so that patients who previously wondered about their disease can directly ask health workers. Health education affects the knowledge improvement of Diabetes Mellitus patients in the Regional hospital of Tidore Islands  

scholarly journals “ ASSESSMENT OF SEVERITY OF DIABETIC FOOT ULCERS USING DIABETIC ULCER SEVERITY SCORE.”

2020 ◽  
pp. 19-21
Author(s):  
Aarushi Mishra ◽  
Anilkumar P. Bellad ◽  
M.I. Uppin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
The Past

INTRODUCTION : Diabetes mellitus is a common metabolic disorder, prevalence steadily increasing over the past few decades. The complications associated with it , hence , has also increased. Diabetic foot ulcer is one of the most serious complications , utilizing resources, significantly contributing to the morbidity of the patient. There is hence, a need to correctly identify the severity of the diabetic foot ulcer so as to plan the appropriate management and to help in counselling of such patients. AIM : To assess severity in diabetic foot ulcer using diabetic ulcer severity score. MATERIAL AND METHODOLOGY : This is a hospital based longitudinal study , conducted on 93 study subjects admitted with diabetic foot ulcers. Diabetic ulcer severity score was calculated for each patient . The score was calculated by adding scores of the respective parameters constituting site of ulcer, number of ulcers, presence/absence of pedal pulsations, presence/ absence of bone involvement. Each patient was followed up for a period of 6 months , or earlier in case of patient undergoing minor/major amputation. After the study was conducted , analysis was done by calculating various percentages of healing /amputation with respect to the score. RESULTS : Out of the total 93 study subjects , 74.2% were males. The mean age was calculated to be 59.6 years with maximum number of subjects being in 55-60 years of age group range. Majority of them had diabetic ulcer severity score of 2 (42%). Out of the total study subjects , 58% had a complete healing , 28% underwent minor amputation whereas 14% underwent major amputation. 100% of the study participants with score 0 had healing of ulcer which decreased to 85% for score 1 , 53.8% for score 2 , 6.25% for score 3 and 0% for score 4. This was suggestive of poorer chances of healing as the diabetic ulcer severity score increases. CONCLUSION : With the increasing incidence of patients diagnosed with diabetes mellitus , the rate of complications of diabetes has also increased over the past few decades including the risk and occurence of diabetic foot ulcers There is an increasing need for diabetic foot ulcer prognostication systems and universal use of the same. Thus ,we recommend the use of diabetic ulcer severity score as a prognostic tool to assess the severity of the diabetic foot which will further enhance communication and counselling of the patient and will help in providing the appropriate treatment to such patients.

scholarly journals The Effectiveness of the 15 Psi Irrigation Technique in Wound Cleansing to Reduce the Number of Bacteria on Patients with Diabetic Foot Ulcers

2018 ◽  
Vol 1 (1) ◽  
pp. 88-97
Author(s):  
Lestari Makmuriana (Corresponding author) ◽  
Suriadi ◽  
Yani Sofiani ◽  
Fitrian Rayasari
Keyword(s):  
Normal Saline ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Clinical Test ◽  
Diabetic Foot Ulcers ◽  
Double Blind ◽  
Saline Irrigation ◽  
Number Of Bacteria

The increasing population of diabetic patients leads to the increasing number of diabetic foot ulcer (DFU) cases. To avoid the expansion of the infection, the wound cleansing is conducted through the irrigation and pressure methods. The aim of this research was to identify the effectiveness of wound cleansing using 0.9% normal saline technique with the pressure of 15 Psi in reducing the number of bacteria. This research used the randomized control trial method with a double blind design which had been approved by the ethnical committee of Muhammadiyah University of akarta with the ethnical committee number 261/PMK-UMJ/IV/2017. There were as many as 31 samples in each group collected through consecutive sampling technique with randomization. It had been found that there was a signi fi cant difference in the number of bacteria before and after wound cleansing. Thus, it could be concluded that from the statistical test and clinical test, wound cleansing with normal 0.9% saline technique with the pressure of 15 Psi could decrease the number of bacteria in diabetic foot ulcers. Wound cleansing with 0.9% normal saline irrigation technique pressurized at 15 Psi was recommended as a safe wound cleansing method for diabetic foot ulcers.

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

scholarly journals DIABETIC FOOT ULCERS;

2017 ◽  
Vol 24 (05) ◽  
pp. 707-712
Author(s):  
Imran Ali Shaikh ◽  
Naila Masood ◽  
Fouzia Aijaz Shaikh ◽  
Munir A Shaikh
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Calcium ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
P Value ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

Objectives: To know the correlation of foot ulcers to the nutritional status oftype 2 Diabetic patients of Hyderabad. Study Design: Cross sectional study. Place of Study:Private clinics of consultants of Hyderabad, Sindh, Pakistan. Duration of study: February 2015to June 2016. Methodology: 387 diabetic type 2 patients were selected from different clinicsof physicians, orthopedics and diabetic consultants of sadder Hyderabad Sindh Pakistan. Themean age was 40±11.5 years. All patients were enrolled on prescribed proforma. Thoroughclinical examination was done. Wagner’s classification was used to categorize diabetic footulcers. Nutritional status was classified on Mini Nutritional Assessment score and patients weredivided into three groups according to Mini nutritional score. Blood samples were obtained forHemoglobin%, blood sugar, serum calcium and serum albumin estimation. All patients wereassessed radiologically by x-rays of involved foot. ANOVA test was used and p value <0.05was considered statically significant. Results: There was linear correlation in between Mininutritional assessment and severity of diabetic foot ulcer (p <0.03). Biochemical parameterwere also significantly associated with the severity of ulcers. Serum albumin was decreasedin grade 4 ulcer significantly (p value <0.04), while hemoglobin was also decreased in grade4 ulcer, p value (<0.05). There was no association of serum calcium to severity of foot ulcer,(p value >0.07). Conclusion: Diabetic foot ulcers are common in type 2 diabetic patients andnutritional status is strongly associated with grade of severity. It is important to assess nutritionalstatus of all diabetic patients.

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