scholarly journals Pattern of Organisms and Antibiotics Used in Treating Diabetes Foot Infection

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Joehaimey J ◽  
Mohamad Adam B ◽  
M Anwar Hau A ◽  
Kamil MK ◽  
SP Jaya Purany ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
First Line ◽  
Klebsiella Species ◽  
Diabetic Foot Infections ◽  
Number Of Patients ◽  
Study Results ◽  
Government Hospitals ◽  
Record Review ◽  
And Staphylococcus Aureus

Introduction: The aim of this study is to determine the most common organisms isolated in diabetic foot infection and the most utilised antibiotic regimes as the first line of treatment. Methods: This is a retrospective record review of the National Orthopaedic Registry Malaysia among diabetes mellitus type 2 patients who had foot infections. All identified cases admitted to 18 government hospitals in Malaysia from the 1st January 2008 until the 31st December, 2009 were included in the study. Results: A total of 416 patients were included in the study. The most common organisms cultured were Proteus species (17.5%), Klebsiella species (17.1%) and Staphylococcus aureus (17.9%), while the most commonly used antibiotic was ampicillin/sulbactam (67.5%). None of the patients was appropriately treated with metronidazole, cefoperazone or fucidic acid. All patients were given appropriate antibiotics to treat Serratia infection. Conclusion: Significant number of patients with diabetic foot infections were not treated using appropriate antibiotics as the first line treatment.

scholarly journals The diabetic foot risks profile in Selebi Phikwe Government Hospital, Botswana

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Stephane Tshitenge ◽  
Adewale Ganiyu ◽  
Deogratias Mbuka ◽  
Joseph M. Shama
Keyword(s):  
Diabetic Foot ◽  
Risk Groups ◽  
Risk Category ◽  
Government Hospital ◽  
Cross Sectional ◽  
Patients Âgés ◽  
Diabetic Clinic ◽  
Number Of Patients ◽  
Risk Categories

Aim: The present study aimed: (1) to evaluate the proportion of each diabetic foot (DF) risk category, according to the International Working Group on the Diabetic Foot (IWGDF) consensus, in patients attending the diabetic clinic in Selebi Phikwe Government Hospital (SPGH) and (2) to examine some of the factors that may be associated with the progression to higher risk categories such as anthropometric measurements, blood pressure, glycosylated haemoglobin (HbA1c) and lipid profile.Methods: A retrospective, cross sectional chart review of patients who had attended the diabetic clinic in SPGH from January 2013 to December 2013 was performed. Patients were included if they had undergone a foot examination. Patients with amputation due to accident were excluded. The DF risk category was assessed by determining the proportion of patients in each of four risk categories, as described by the IWGDF consensus.Results: The study encompassed 144 records from patients reviewed for foot examination from January to December 2013. Patients’ ages were between 16 and 85 years, 46 (40%) were male and 98 (60%) were female. The majority (122, [85%]) of patients were in DF risk category 0, whilst a limited number of patients were classified in risk category 1 (10, [6.9%]), risk category 2 (7, [4.9%]) and risk category 3 (5, [3.5%]). Most of the patients had the type 2 diabetes mellitus (139, [97%; 95% CI 92% − 99%]). Patients’ ages were associated with the progressively higher DF risk categories. The adjusted odd ratio was 1.1 (95% CI 1.03−1.14; p = 0.004).Conclusion: The present study revealed that about 15% of patients attending the SPGH diabetic clinic were categorised in higher risk groups for diabetic foot; patients’ ages were linked to the higher DF risk categories.

Further Analysis on Solution Treatment for Diabetes of Patients at Hospitals in Vietnam

2021 ◽  
Vol 19 (8) ◽  
pp. 88-93
Author(s):  
Vu Thanh Binh ◽  
Dinh Tran Ngoc Huy
Keyword(s):  
Blood Pressure ◽  
Sugar Content ◽  
Solution Treatment ◽  
Policy Implications ◽  
University Hospital ◽  
Masked Hypertension ◽  
Blood Pressure Monitor ◽  
Number Of Patients ◽  
Study Results

In recent years in Vietnam, preventing and treatment for diabetes of patients in hospitals has been rising as hot issues because the number of patients with diabetes tend to increase much. Our study uses mainly statistics and qualitative analysis synthesis and inductive methods, together with quantitative analysis with data and statistics. Vu Thanh Binh et al (2021) said that Monitoring blood pressure with a continuous blood pressure monitor to carry around to detect masked hypertension (MH) in type 2 diabetes patients who are on outpatient treatment at Thai Binh Medical University Hospital, Thai Binh, Vietnam. Our study results indicated that diabetes including type 1 and type 2 and can be identified at early stages and have prevention treatment solutions such as physical exercises, eating food with lipid, and Reduce the amount of foods with high starch and sugar content. Lat but not least, Strengthening knowledge and skills of nurses and doctors and quality of human resources operating in the field of diabetes. Finally, our paper will propose policy implications and recommendations.

scholarly journals DIABETIC FOOT INFECTIONS

2012 ◽  
Vol 19 (04) ◽  
pp. 475-481
Author(s):  
AYAZ GUL ◽  
JAVID IQBAL ◽  
ZIA UDDIN AFRIDI
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Detailed Knowledge ◽  
Type I ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Surgical Department ◽  
Diabetic Foot Infections ◽  
Study Results

Objective: The objective of this study is to know the frequency of methicillin resistant Staphylococcus aureus and its antibioticsensitivity in diabetic foot infections in our setup. Design: Cross sectional descriptive study. Setting: Surgical Department, Khyber TeachingHospital, Peshawar. Period: January 2008 to January 2010. Materials and Methods: A total of 84 patients, including 64 males and 20 females.Patient's identity, age, gender and the bacterial isolate on culture and sensitivity report were noted on a standardized proforma and analyzed onSPSS version 16.0. Patients of 18 years and both gender with type I & II Diabetes mellitus, diabetic foot ulcers of Wagner Classification SystemGrade 1 to 5 of 3 weeks duration, with infection and with no evidence of healing were enrolled in the study. Results: The overall mean age ofpatients was 60.8 years + 6.5SD with 9.2 + 0.5% HbA1c level. Frequency of methicillin resistant Staphylococcus aureus was 28.57%. Methicillinsensitive Staphylococcal aureus (51.19%), Pseudomonas aeruginosa (48.80%) and Escherichia coli (46.42%) were the common organismcultured. Methicillin resistant Staphylococcus aureus showed 100% sensitivity to Vancomicin, Linezolid, Meropenem, Imepenem andPipracillin/tazobactam. Conclusions: There is an alarming trend of increase in methicillin resistant Staphylococcus aureus because ofindiscriminate use of antibiotics in our set up which should be discouraged and a detailed knowledge of bacterial susceptibility to antimicrobialagents is necessary.

scholarly journals 110. MRSA nasal swab as a stewardship tool to guide IV Vancomycin in diabetic foot infections

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S169-S170
Author(s):  
Alex Lazo-Vasquez ◽  
Michael Piazza ◽  
Leopoldo Cordova ◽  
Lauren Bjork ◽  
Rolando A Zamora Gonzalez ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Nasal Swab ◽  
Positive Culture ◽  
Diabetic Foot Infections ◽  
Medication Utilization ◽  
Stewardship Program ◽  
Screen Result ◽  
Number Of Patients ◽  
Days Of Therapy ◽  
Mrsa Infection

Abstract Background The Infectious Disease Society of America (IDSA) guidelines suggest empiric Methicillin-Resistant Staphylococcus Aureus (MRSA) coverage for Diabetic Foot Infection (DFI) with a history of MRSA infection, if local prevalence is high, or if the infection is severe. However, data suggests that there is overutilization of vancomycin in this population and this medication is associated with toxicity. MRSA nasal screen has a high negative predictive value (NPV) for ruling out MRSA in pneumonia and other sites. We performed a medication utilization evaluation (MUE) for Vancomycin IV in DFI patients who had an MRSA nares screen to determine our own NPV of this test and feasibility to use it as an antibiotic stewardship program (ASP) tool to guide vancomycin use in this population. Methods We retrospectively reviewed 224 patients from January 2015 to January 2020 who had a diagnosis of DFI and an MRSA nasal screen. 139 patients had cultures done. For the NPV, we excluded patients who had any MRSA positive culture or screen up to a year from admission (Figure 1). Figure 1. Flowchart from our medication utilization evaluation showing patient’s distribution by MRSA-screen result Results We found 148 (66%) patients with DFI who had received IV vancomycin empirically during the admission and 196 of them were MRSA-nares negative (Figure 2). The average days of therapy (DOT) in the MRSA-nares negative patients was 5.2 days vs 4.8 in the MRSA-nares positive patients. Out of the 139 patients with a negative MRSA nasal swab, 124 had no MRSA in cultures, yielding an NPV of 89%. If we considered only the deep cultures, the NPV increased to 90%. Figure 2. Number of patients who received IV vancomycin grouped by MRSA-screen result Conclusion We identified overutilization of IV vancomycin in patients with a diagnosis of DFI in our institution. Also, our NPV of the MRSA-nasal screening to rule out MRSA infection in DFI was high at 89% similar to previous studies. Based on these findings, we plan to implement a local ASP protocol (Figure 3) using MRSA nasal swab screen to decrease the empiric use of vancomycin. The results of these efforts will be analyzed and published in future iterations with the hopes to share this knowledge to reduce the use of IV vancomycin in this population in other centers. Figure 3. Protocol draft to be used as an ASP tool to guide IV vancomycin de-escalation based on MRSA-nasal screen for DFI patients Disclosures All Authors: No reported disclosures

scholarly journals EFEKTIVITAS SPA KAKI DIABETIK TERHADAP SIRKULASI DARAH PERIFER PADA PASIEN DIABETES MELLITUS TIPE 2 DI WILAYAH KERJA PUSKESMAS WONOKROMO SURABAYA

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Rahmi Affiani ◽  
Puji Astuti
Keyword(s):  
Diabetes Mellitus ◽  
Treatment Group ◽  
Diabetic Foot ◽  
Peripheral Blood ◽  
Blood Circulation ◽  
Control Group ◽  
Public Health Centre ◽  
Study Results ◽  
Peripheral Blood Circulation

Diabetes mellitus type 2 is often occur and became chronic complication of vascular peripheral disease caused by decreasing peripheral blood circulation. One of therapy to improve peripheral blood circulation is diabetic foot spa, The purpose of this study is to find out the effectiveness of diabetic foot spa towards peripheral blood circulation. Design of this study is Quasy-Experiment. The population were all diabetes mellitus patients type 2 in Public Health Centre Wonokromo Surabaya. Number of sample was 46 person, divided into 2 group, that are treatment group and control group, with 23 person each group, taken by purposive sampling technique. Data analyzed by Mann-Whitney test with α=0.05. Study results on treatment group before giving diabetic foot spa majority (52.2%) of peripheral blood circulation in mild category and for control group mostly (60.9%) have blood circulation in mild category as well. After the foot spa was give to the treatment group, almost entirely (91.3%) had normal peripheral blood circulation, whereas in the control group majority (73.9%) remain mild. Analysis of MannWhitney test P=0.000 < α=0.05, which means diabetic foot spa is effective towards blood circulation. The more frequent perform of diabetic foot spa, the better peripheral blood circulation, it can prevent complications of diabetes mellitus.

scholarly journals Efektifitas Foot Spa Diabetic terhadap Nilai Ankle Brachial Index pada Pasien Diabetes Mellitus Tipe II

2019 ◽  
Vol 3 (1) ◽  
pp. 312-321
Author(s):  
Rizkan Halalan Djafar ◽  
Busjra M. Nur ◽  
Rohman Azzam
Keyword(s):  
Diabetes Mellitus ◽  
Treatment Group ◽  
Diabetic Foot ◽  
Health Centre ◽  
Ankle Brachial Index ◽  
Public Health Centre ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Study Results

The purpose of this study is to find out the effectiveness of diabetic foot spa towards ankle brachial index. Design of this study is Quasy-Experiment with two group. The population were all diabetes mellitus patients type 2 in Public Health Centre Wawonasa Manado. Number of sample was 32 person, divided into 2 group, that are treatment group during 3 and 5 time, with 16 person each group, taken by purposive sampling technique. Data analyzed by Mann-Whitney test with α=0.05. Study results on difference between ABI treatment 3 dan 5 time. Analysis of Mann-Whitney test P=0.112> α=0.05, with average ABI in treatment group during 3 and 5 time pre test 0.012 and post test 0.0562, which means diabetic foot spa 3 and 5 time is effective towards ABI.   Keywords: Ankle Brachial Index, DM Type 2, Foot Spa Diabetic

scholarly journals Correlation between superficial and intra-operative specimens in diabetic foot infections: results of a cross-sectional Tunisian study

2019 ◽  
Vol 19 (3) ◽  
pp. 2505-2514 ◽  
Author(s):  
Foued Bellazreg ◽  
Ahmed Guigua ◽  
Asma Ferjani ◽  
Zouhour Hattab ◽  
Jalel Boukadida ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Diabetic Foot ◽  
Susceptibility Testing ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diabetic Foot Infections ◽  
And Staphylococcus Aureus ◽  
Extremity Amputation

Objective: To determine the correlation between superficial, and intra-operative specimens in diabetic foot infections (DFIs).Methods: We conducted a cross-sectional study in patients with DFIs hospitalized in a Tunisian teaching hospital. Superficial specimens were collected for all patients, and intra-operative specimens were collected in operated patients. The specimens were processed using standard microbiology techniques. Antimicrobial susceptibility testing was carried out according to the protocol established by the European Committee on Anti-microbial Susceptibility Testing. Intra-operative and superficial specimens were considered correlated if they isolated the same microorganism(s), or if they were both negative.Results: One hundred twelve patients, 81 males and 31 females, mean age 56 years, were included. Superficial samples were positive in 77% of cases, and isolated 126 microorganisms. Among the positive samples, 71% were monomicrobial. The most frequently isolated microorganisms were Enterobacteriaceae (53%), followed by streptococci (21%) and Staphylococcus aureus (17%). Nine microorganisms (7%) were multi-drug resistant. Intra-operative samples were positive in 93% of cases. Superficial specimens were correlated to intra-operative specimens in 67% of cases. Initial antibiotic therapy was appropriate in 70% of cases. The lower-extremity amputation and the mortality rates were 41% and 1%, respectively.Conclusion: In our study, DFIs were most frequently caused by Enterobacteriaceae and superficial specimens were correlated to intra-operative specimens in only two thirds of cases. Clinicians should emphasize on the systematic practice of intraoperative specimens in all patients with DFIs treated surgically, while well-performed superficial specimens could be useful for prescribing appropriate antibiotic therapy in other patients.Keywords: Diabetic foot infections, superficial specimens, intra-operative specimens.

scholarly journals Review of current guidelines for the treatment of type 2 diabetes

2021 ◽  
pp. 7-12
Author(s):  
O. V. Kaminsky
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
First Line ◽  
Pharmacological Management ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Treatment Of Diabetes ◽  
New Guidelines

According to the WHO, diabetes is one of the five most dangerous chronic non-communicable diseases in the world. The annual increase in the number of patients with diabetes in Ukraine is about 5-10%. In 2020, the WHO published new guidelines for the diagnosis and treatment of diabetes and updated its classification. Along with the already familiar type 1 and 2 diabetes and gestational diabetes, a new category of disease has emerged – hybrid forms of diabetes. In the section «Pharmacological management of diabetes» the WHO gives priority to the level of glycemia, the control of which avoids the development of microvascular complications of type 2 diabetes. Initial treatment, according to the WHO 2020, should begin with the appointment of metformin - a drug of the first line of treatment of patients with this disease. It is important that metformin does not cause weight gain, does not provoke hypoglycemia and is recommended for the treatment of people who do not reach the desired level of glycemia through diet and physical activity. Secondgeneration sulfonylureas can be used as an initial first-line treatment when metformin is contraindicated or intolerant. However, this is quite rare: in most cases, metformin is well tolerated by patients if administered gradually. That is, metformin, and, if necessary, sulfonylureas - is an effective, safe and affordable choice compared to expensive novelties, the effectiveness and safety of which have not been proven in long-term studies. In addition, in type 2 diabetes, metformin drugs will form additional effects: cardioprotection, oncoprotection, hepatoprotection, nephroprotection, additional hypoglycemic effect and will fight insulin resistance.

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