scholarly journals Microbiological Study of Diabetic Foot Ulcer

2019 ◽  
Vol 10 (1) ◽  
pp. 50-55
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin
Keyword(s):  
Diabetes Mellitus ◽  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Proteus Mirabilis ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Klebsiella Pneumonia ◽  
Coagulase Negative Staphylococci

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening diabetic infections are usually polymicrobial involving multiple aerobic and anaerobic organisms. Methodology: The present study was a cross sectional study, conducted in the department of surgery and microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September' 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is 'any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus'. Results: Majority 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillin-clavulanic acid, amikacin, piperacillin-tazobactam. In Coagulasenegative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem. Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Escherichia coli and Citrobacter spp. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 50-55

scholarly journals Microbiological Study of Diabetic Foot Ulcer

2018 ◽  
Vol 8 (3) ◽  
pp. 251-256
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin
Keyword(s):  
Diabetes Mellitus ◽  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Klebsiella Pneumonia ◽  
Diabetic Patients ◽  
Coagulase Negative Staphylococci

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening infection in diabetic patients are usually polymicrobial involving both multiple aerobic and anaerobic organisms.Methods: The present study was a cross sectional study, conducted in the Department of Surgery and Microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September’ 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is ‘any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus’.Results: 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillinclavulanic acid, amikacin, piperacillin-tazobactam. In Coagulase-negative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem.Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Citrobacter spp.Birdem Med J 2018; 8(3): 251-256

scholarly journals In Vitro Activities of Doripenem and Six Comparator Drugs against 423 Aerobic and Anaerobic Bacterial Isolates from Infected Diabetic Foot Wounds

2007 ◽  
Vol 52 (2) ◽  
pp. 761-766 ◽  
Author(s):  
Ellie J. C. Goldstein ◽  
Diane M. Citron ◽  
C. Vreni Merriam ◽  
Yumi A. Warren ◽  
Kerin L. Tyrrell ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Proteus Mirabilis ◽  
Diabetic Foot ◽  
Bacteroides Fragilis ◽  
Bacterial Isolates ◽  
Diabetic Foot Infections ◽  
Aerobic And Anaerobic

ABSTRACT Against 182 anaerobe and 241 aerobe strains obtained from diabetic foot infections, doripenem was the most active carbapenem against Pseudomonas aeruginosa (MIC90, 2 μg/ml), more active than imipenem against Proteus mirabilis, and ertapenem was more active against Escherichia coli and Klebsiella spp. The MIC50 and MIC90 values were ≤0.125 μg/ml for methicillin-sensitive Staphylococcus aureus and all streptococci and 0.25/1 for Bacteroides fragilis.

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 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 Efeito antimicrobiano do extrato de Cranberry sobre micro-organismos causadores de infecção urinária

2016 ◽  
Vol 11 (31) ◽  
pp. 113-122
Author(s):  
Carla Franco Porto Belmont Souza ◽  
Luiz Eduardo Souza da Silva Irineu ◽  
Renan Silva De Souza ◽  
Renato da Silva Teixeira ◽  
Ivina Sanches Pereira ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Enterococcus Faecalis ◽  
Proteus Mirabilis ◽  
Enterococcus Faecium ◽  
Vaccinium Macrocarpon ◽  
Mueller Hinton

A resistência microbiana tem se mostrado um problema de proporções mundiais, causando estado de morbidade e mortalidade em diversos pacientes. Em vista disso, tem crescido a busca por métodos alternativos naturais de profilaxia. A investigação clínica sugere que o Extrato de Cranberry está entre as melhores propostas de prevenção natural. O Cranberry (Vaccinium macrocarpon) é um fruto que tem crescido comercialmente pelo sabor e propriedades benéficas à saúde. Dentre as formas comercializadas estão: o suco, o chá e as cápsulas contendo o extrato seco. A ação desta planta está relacionada ao tratamento de doenças do trato urinário, por possuir substâncias que inibem a adesão bacteriana ao epitélio do trato urinário, dificultando sua proliferação e reprodução. Dentre todas as infecções relacionadas à assistência a saúde, a Infecção do Trato Urinário é a mais frequentemente associada a procedimentos invasivos. Se não for tratada, pode resultar em complicações como pielonefrite aguda, bacteremia e pionefrose. Portanto, cranberry pode ser uma nova alternativa para o combate das infecções uroepiteliais, por ser um produto natural de preço acessível, e com formas de comercialização diversificada, ao contrário dos antimicrobianos convencionais, que por sua vez são caros e podem acabar causando resistência nos micro-organismos. Este trabalho teve como objetivo avaliar in vitro a atividade antimicrobiana do extrato de Cranberry, adquirido em farmácia de manipulação, sobre 8 micro-organismos isolados de infecções urinárias. As cepas utilizadas, adquiridas da coleção da FIOCRUZ, foram: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Serratia marscecens, Staphylococcus aureus, Enterococcus faecalis e Enterococcus faecium. No estudo, foram utilizados o caldo Mueller Hinton (MH), Extrato de Cranberry e as bactérias patogênicas. O ensaio foi realizado em triplicata, com o uso de um controle de crescimento dos micro-organismos e o experimento para avaliação do crescimento bacteriano na presença do extrato. A turbidez foi medida com o auxílio de um espectrofotômetro, no comprimento de onda de 600 nm, antes e após 24 horas de incubação à 37 ºC. O procedimento forneceu a Densidade Ótica, do qual possibilitou a identificação da inibição microbiana. Para análise estatística foi utilizado o Teste t de Student. O Extrato de Cranberry apresentou atividade antimicrobiana sobre as bactérias Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Serratia marscecens e Enterococcus faecalis (p < 0,05), confirmando seu efeito benéfico em infecções urinárias. No entanto, não teve efeito inibitório significativo sobre Pseudomonas aeruginosa, Proteus mirabilis e Enterococcus faecium (p > 0,05).

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

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 Factors Affecting Hospital Length of Stay in Patient with Diabetic Foot Ulcer

2019 ◽  
Vol 47 (2) ◽  
pp. 3-16
Author(s):  
Patrianef Darwis ◽  
Bakti H Simanjuntak ◽  
Grace Wangge ◽  
Deddy Pratama ◽  
Ahmad Bakri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Smoking History ◽  
Ulcer Size

Background. Foot ulcer is one of the most common complications in diabetes mellitus patients. This condition prolongs hospital length of stay (LOS) and increases hospitalization cost. This study aims to assess factors that affect the LOS in patients with the mentioned condition. Methods. This is a retrospective cohort study of diabetes mellitus patients with foot ulcer who were hospitalized in Cipto Mangunkusumo General Hospital from January 2015 to April 2016. There were 120 patients recruited and then divided into two groups according to their hospitalization duration, which was short and long. Univariate analysis was conducted in predicted factors including gender, ankle-brachial index, ulcer size, ulcer depth, leukocyte count, treatment, cardiovascular comorbidity, blood pressure, smoking history, septicemia, ketoacidosis, hypoalbuminemia, and upper respiratory tract infection. Chi-Square tests were performed to analyze the association of those factors with LOS. The odds ratio of each variable was evaluated using logistic regression analysis. Result. In this study, the mean of LOS was 26 days (2 – 87 days). Factors that significantly correlated with LOS were ankle-brachial index (p 0.041, OR 2.275, CI 95 % 1.025 – 5.041), ulcer size (p 0.044, OR 3.038, CI 95 % 1.032 – 9.942), smoking history (p 0.022, OR 2.434, CI 95 % 1.125 – 5.265), sepsis (p < 0.001, OR 4.240, CI 95 % 1.908 – 9.423), and ketoacidosis (p < 0.001, OR 8.611, CI 95 % 3.396 – 21.835) In multivariate analysis, the most significant factor was ketoacidosis (p < 0.001, OR 8.360, CI 95 % 3.209 – 21.780). Conclusion. Ketoacidosis is the most significant factor that prolonged hospital stays in a patient with diabetic foot ulcer. Keywords: Diabetic foot ulcer, Length of stay

scholarly journals Pathogenesis and management of diabetic foot ulcers

2018 ◽  
Vol 5 (11) ◽  
pp. 4953 ◽  
Author(s):  
Yousif Alsanawi ◽  
Hassan Alismail ◽  
Mustafa AlabdRabalnabi ◽  
Hattan Alturki ◽  
Abdullah Alsuhaibani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Management Strategies ◽  
Blood Glucose Control ◽  
Disease Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Wound Debridement ◽  
Significant Impairment

Diabetes mellitus is a major healthcare issue worldwide, and the trends keep rising. Diabetic foot ulcer is a morbidity associated with the disease process and causes significant impairment in quality of life due to its severe complications including infection, gangrene, and amputation. In this study, we aim to understand the pathogenesis of diabetic foot ulcer, its complications, and management strategies. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1970 to March 2017. The following search terms were used: diabetic foot ulcer, complications of diabetes mellitus, foot gangrene, surgical debridement of foot ulcer, osteomyelitis. Diabetic foot ulcer is a common morbidity in patients with diabetes mellitus, which can lead to lower limb amputation unless a prompt, rational, multidisciplinary approach to therapy is taken. Proper management can ensure successful and fast healing which includes patient education, blood glucose control, wound debridement, advanced dressing, offloading, and surgery.

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