scholarly journals Microbiological and clinical characteristics of diabetic foot infections in northern India

2012 ◽  
Vol 6 (04) ◽  
pp. 329-332 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy D Pratyush ◽  
Awanindra Dwivedi ◽  
Sanjiv K Gupta ◽  
Madhukar Rai ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Clinical Characteristics ◽  
Clinical Evidence ◽  
Gram Positive ◽  
Bacteriological Study ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Diabetic Foot Infections ◽  
Microbial Infections ◽  
Leukocyte Counts

Introduction:  India has the largest diabetic population of 50.8 million that could reach an epidemic proportion by 2030. Diabetic foot infection is one of the dreaded complications of diabetes.  Only a few studies that focus on patterns of diabetic foot infection in our region, where diabetic foot care is inadequate, are available. This study evaluated microbial and clinical characteristics of diabetic foot infections that will be helpful in taking appropriate measures for their management. Methodology: In this prospective study conducted during 2008-2009, sixty-two diabetic foot patients underwent detailed history, clinical examination, and laboratory investigations including parameters of systemic infections. Microbial culture and sensitivity were performed at the time of presentation. Results: Among 62 cases, 43.5% had mono-microbial infection, 35.5% had poly-microbial infections, and 21% had sterile culture. Among 82 bacteria isolated, 68% were Gram negative and 32% were Gram positive. Leukocyte counts were higher (16928±9642 versus 14593±6687 cells/mm3) and haemoglobin (7.9±2.4 versus 9.2±2.2 mg/dl) lower in poly-microbial compared to mono-microbial infections. Haemoglobin counts were lower and leukocyte counts higher in Gram-negative compared to Gram-positive infections. Patients with sterile cultures also had clinical evidence of persistent infection. Escherichia coli were the most common isolate and piperacillin/tazobactam showed highest sensitivity. Conclusions: Gram-negative bacteria were most prevalent in diabetic foot infection. It is not uncommon to have culture reports negative despite clinical evidence of infection. This study suggests that piperacillin/tazobactam should be the treatment of choice on an empirical basis prior to a definitive bacteriological study and in cases with negative culture reports.

Bacterial Diversity, Antibiotic Resistance, and the Risk of Lower Limb Amputation in Younger and Older Individuals With Diabetic Foot Infection

2021 ◽  
pp. 153473462199229
Author(s):  
Stefan Dörr ◽  
Ann-Kathrin Holland-Letz ◽  
Gregor Weisser ◽  
Apostolos Chatzitomaris ◽  
Ralf Lobmann
Keyword(s):  
Bacterial Diversity ◽  
Diabetic Foot ◽  
Care Center ◽  
Bacterial Load ◽  
Limb Amputation ◽  
Older Individuals ◽  
Foot Care ◽  
Gram Positive ◽  
Gram Negative ◽  
Diabetic Foot Infection

Introduction A diabetic foot infection (DFI) contributes to high mortality and morbidity in diabetics due to its often rapid progressive and intricately treatable infection. DFIs are usually a polymicrobial infection and characterizing the entire bacterial load is still challenging. Prompt and effective treatment of DFI is nevertheless mandatory to safe limbs and lives. It is therefore crucial to know the local pathogen spectrum and its antibiotic susceptibility. Methods and Material For a 12-month period, we investigated 353 individuals with infected diabetic foot ulcer, their bacterial diversity, and antimicrobial susceptibility at fist-time visit in a Diabetic Foot Care Center in southern Germany. Results Cultures yielded 888 species, most of them gram-positive cocci (primary Staphylococcus aureus). The gram-negative sector was mainly formed by Pseudomonas aeruginosa and Enterobacteriacae. Because the prevalence of multiresistant species was surprisingly low (0.9% of isolated strains), we suggest penicillins with β-lactamase inhibitor in case of gram-positive–dominated infection or piperacillin/tazobactam or rather carbapenems with equal efficacy when gram-negative species are involved.

scholarly journals How Do Preoperative Antibiotics Affect Culture Yield in Diabetic Foot Infections?

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Heather Young ◽  
Whitney Miller ◽  
Randy Burnham ◽  
Susan Heard ◽  
Chrystal Berg ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Negative Results ◽  
Diabetic Foot Infections ◽  
Preoperative Antibiotics ◽  
The Impact ◽  
Culture Negative ◽  
Culture Yield

abstractThe impact of preoperative antibiotics on culture of diabetic foot infection samples has not been studied. We found that increasing exposure to preoperative antibiotics was associated with less frequent growth of streptococci and anaerobes and more culture-negative results. In contrast, the yield of Staphylococcus aureus and Gram-negative bacilli was unaffected.

scholarly journals The microbiology of diabetic foot infections: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katherine E. Macdonald ◽  
Sophie Boeckh ◽  
Helen J. Stacey ◽  
Joshua D. Jones
Keyword(s):  
Diabetic Foot ◽  
Meta Analysis ◽  
National Income ◽  
Gross National Income ◽  
Healthcare Provision ◽  
Gram Positive ◽  
Diabetic Foot Infection ◽  
E Coli ◽  
Diabetic Foot Infections ◽  
Multiple Datasets

Abstract Background Diabetic foot ulcers are a common complication of poorly controlled diabetes and often become infected, termed diabetic foot infection. There have been numerous studies of the microbiology of diabetic foot infection but no meta-analysis has provided a global overview of these data. This meta-analysis aimed to investigate the prevalence of bacteria isolated from diabetic foot infections using studies of any design which reported diabetic foot infection culture results. Methods The Medline, EMBASE, Web of Science and BIOSIS electronic databases were searched for studies published up to 2019 which contained microbiological culture results from at least 10 diabetic foot infection patients. Two authors independently assessed study eligibility and extracted the data. The main outcome was the prevalence of each bacterial genera or species. Results A total of 112 studies were included, representing 16,159 patients from which 22,198 microbial isolates were obtained. The organism most commonly identified was Staphylococcus aureus, of which 18.0% (95% CI 13.8–22.6%; I2 = 93.8% [93.0–94.5%]) was MRSA. Other highly prevalent organisms were Pseudomonas spp., E. coli and Enterococcus spp. A correlation was identified between Gross National Income and the prevalence of Gram positive or negative organisms in diabetic foot infections. Conclusion The microbiology of diabetic foot infections is diverse, but S. aureus predominates. The correlation between the prevalence of Gram positive and negative organisms and Gross National Income could reflect differences in healthcare provision and sanitation. This meta-analysis has synthesised multiple datasets to provide a global overview of the microbiology of diabetic foot infections that will help direct the development of novel therapeutics.

scholarly journals Bacteriology of diabetic foot infections and their antibacterial susceptibility

2018 ◽  
Vol 6 (10) ◽  
pp. 3276
Author(s):  
Alex Aiswariya ◽  
Kalagara Pavani ◽  
Bhanudas Surpam Rajendra
Keyword(s):  
Diabetic Foot ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Gram Positive ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Antimicrobial Susceptibility Pattern ◽  
Diabetic Foot Infections ◽  
Microbiological Techniques ◽  
Gram Positive Cocci

Background: Diabetic foot infections are the most common bacterial infections encountered in patients with diabetes mellitus and remain the leading complication requiring frequent hospitalization.  Hence, this study was carried out to determine the prevalence of bacteria in diabetic foot infections and their antibiogram which can help to inform therapeutic choices.Methods: A prospective study conducted on clinical specimens taken from patients with diabetic foot infections, over 3 years duration. The clinical specimens were processed by using the standard microbiological techniques. The antimicrobial susceptibility pattern was studied by the Kirby-Bauer disc diffusion method.Results: Among 103 cases studied, 97 were culture positive. Out of these specimens, 25 (25.77%) had monomicrobial flora and 72 (74.23%) had polymicrobial flora. A total of 176 bacteria were obtained which include 62 gram positive cocci and 114 gram negative bacilli. All gram negative bacilli showed good sensitivity to imipenem (97.30%), followed by cefaperazone sulbactam (81.98%), piperacillin-tazobactam (75.68%) and amikacin (72.97%). All gram positive cocci remained 100% sensitive to Vancomycin and Linezolid followed by clindamycin (not tested for Enterococci Spp.) and gentamicin  in a range of  91.43 % to 72.88%. The prevalence of multidrug resistant organisms among aerobic isolates were 59.66%.Conclusions: Diabetic foot infections are polymicrobial. Pseudomonas aeruginosa and Staphylococus aureus were the most common isolates. The most sensitive antibiotics are imipenem for gram negative bacilli while vancomycin and linezolid were effective for gram positive cocci. The antibiogram of isolates will be helpful in determining the drugs for the empirical treatment of diabetic foot infection.

scholarly journals Dalbavancin in the treatment of patients with Gram-positive diabetic foot infection: a case report

2020 ◽  
Vol 23 (2) ◽  
pp. 139
Author(s):  
Stroffolini, G.
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Treatment Protocol ◽  
Indirect Costs ◽  
Healthcare Systems ◽  
Gram Positive ◽  
Diabetic Foot Infection ◽  
Direct And Indirect Costs ◽  
Diabetic Foot Infections ◽  
Causative Agents

Dalbavancin is a potent lipoglycopeptide active against Gram+ bacteria with a favorable pharmacokinetic/pharmacodynamic (PK/PD) and safe­ty profile, suitable for numerous challenging infections. Dalbavancin has been approved for ABSSSIs, but its range of application and the relative posology is still debated. Diabetic foot infections are a major challenge and a leading source of complications, involving high direct and indirect costs for healthcare systems and for patients in terms of morbidity and disability. Gram+ bacteria are often causative agents in diabetic foot infections. We discuss here the case of a 43 yars old patient with complicated diabetic foot infection and the successful application of a dalbavancin secondary monotherapy treatment protocol. The patient, after suffering a two months complex hospitalisation gained wound haeling and limb rescue without any complication. We were also able to measures dalbavancin plasma lev­els determining its long half-life and high microbial killing ability. KEY WORDS dalbavancin, diabetic foot, gram-positive.

scholarly journals Parallels of infections of diabetic foot syndrome at inpatient and outpatient stages of treatment

2021 ◽  
pp. 68-76
Author(s):  
A. B. Zemlianoi ◽  
T. A. Zelenina ◽  
V. V. Salukhov
Keyword(s):  
Diabetic Foot ◽  
Acute Infection ◽  
Multidrug Resistant ◽  
Diabetic Foot Syndrome ◽  
Gram Positive ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Infectious Process ◽  
Group 2 ◽  
Group 1

Introduction. Long-lasting ulcerative defects in patients with diabetic foot syndrome (DFS) are prone to reinfection, persistence of primary and hospital-acquired infection, and the infectious process is often caused by multidrug-resistant organisms (MDRO).Aim of the study: to compare the prevalence and specific characteristics of the severe diabetic foot infection pathogens during the inpatient and outpatient stages of treatment.Materials and methods. We included 62 type 2 diabetic inpatients (group 1) with severe foot infection and 102 diabetic foot outpatients (group 2) with postoperative wounds, who had been operated on and discharged from the hospital, in to the study.Cultures were obtained after surgery interventions immediately and on 14 days of hospitalization in group 1 of patients and in group 2 of patients with clinical signs of infection. Microbe species and resistant of pathogens to antibiotic were assessed.Results and discussion. Severe infection connected with polymicrobe pathogens in both groups of patients. However, the prevalence of Gram-positive and Gram-negative bacilli was different. The most frequently isolated pathogens were Gram-positive bacteria in the wound samples of group 1 of patients with acute infection obtained after surgery interventions immediately. In the wound cultures of group 1 on 14 day of hospitalization and group 2 the prevalence of Gram-positive and Gram-negative bacilli was the same. It should be noted that there is still a high total frequency of isolation of non-fermenting Gram-negative bacilli among Gram-negative pathogens in complicated diabetic foot infection both at the inpatient and outpatient stages of treatment.Conclusion. The great finding of the study is the identification of a parallel of the same prevalence of Gram-positive and Gramnegative pathogens in a prolonged infection at the inpatient and outpatient stages of treatment. The role of Enterobacterales increased with duration of infection. The prevalence of multidrug resistant Enterobacterales makes this group of microorganisms as important as Staphylococcaceae in the complicated course of the infectious process. Polyvalent microbial spectrum of pathogens significantly reduces the effectiveness of treatment.

scholarly journals A Bacteriological Study of Diabetic Foot Infection in an Urban Tertiary Care Hospital in Dhaka City

1970 ◽  
Vol 3 (2) ◽  
pp. 50-54
Author(s):  
Samir Paul ◽  
Lovely Barai ◽  
Ashraf Jahan ◽  
J Ashraful Haq
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
Care Hospital ◽  
Esbl Production ◽  
Bacteriological Study ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Gram Negative Organisms

Identification of organisms and effective antibiotic therapy is an important component of treatment of diabetic foot infections. This study was undertaken to determine the organisms associated with diabetic foot infection (DFI) and their antibiotic sensitivity pattern. A total of 75 patients having type 2 diabetes mellitus with Wagner's grade 1-5 foot ulcers attending BIRDEM hospital were included in the study. Specimens were processed for aerobic culture. The bacteriological isolation and antimicrobial sensitivity tests of the isolates were done by standard microbiological methods. Gram negative bacilli were tested for extended spectrum â lactamase (ESBL) production by double disc diffusion method. Culture was positive in 92% of the cases which yielded 135 pathogens. Of the positive culture, 75.3% had multiple organisms. Polymicrobial infection was more in higher grade of foot ulcers. Gram negative organisms were most frequently isolated (80%) bacteria. Pseudomonas (48%) and Proteus sp.(33%) was the most common Gram negative organisms isolated. Staphylococcus aureus was the most commonly isolated gram positive organism (21.3%). ESBL production was noted in 31.5% Gram negative bacilli and methicillin resistance was noted in 43.8% of Staphylococcus aureus. Most of the Gram negative bacilli were resistant to various classes of antibiotics. Imepenem was the most effective agent against Gram negative organisms, while vancomycin was for staphylococcus. The present study has shown that infection with multidrug resistant Gram negative bacilli is the most common cause of DFI in BIRDEM hospital. Ibrahim Med. Coll. J. 2009; 3(2): 50-54   DOI: 10.3329/imcj.v3i2.4216

Microbiota and Its Antibiotic Susceptibility in Diabetic Foot Infections: Observations From Polish Nonmetropolitan Hospital, 2015-2016

2020 ◽  
pp. 153473462095368
Author(s):  
Irmina Maria Michalek ◽  
Kryspin Mitura ◽  
Agnieszka Krechowska ◽  
Florentino Luciano Caetano dos Santos
Keyword(s):  
Diabetic Foot ◽  
Antibiotic Susceptibility ◽  
Anaerobic Bacteria ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Facultatively Anaerobic ◽  
Diabetic Foot Infections ◽  
Empiric Antibiotic ◽  
Surgery Department

In current clinical practice, in case of symptoms-based suspicion of diabetic foot infection, immediate empiric antibiotic therapy is recommended. Prevailing guidelines do not provide region-specific therapy schemes. To validate existing recommendations, there is an urgent need for a report on diabetic foot infection microbiota patterns in Central Europe. This study aimed to describe diabetic foot infections microbiota and its antibiotic susceptibility in Poland. We conducted a single-center descriptive study at the General Surgery Department, Siedlce Hospital, Poland. Data for all patients diagnosed with diabetic foot infection between January 1, 2015, and December 31, 2016, and corresponding antimicrobial susceptibility tests were extracted. A total of 54 patients were included in the study, with a total of 102 microbiological samples. Among 81 positive samples, 77.1% of the isolated bacteria were Gram-negative. A total of 93.4% of the isolates were facultatively anaerobic bacteria. No obligatory anaerobic bacteria and no yeasts were isolated. Facultatively anaerobic, Gram-negative bacteria, mainly Proteus spp and Escherichia coli, were the most common organisms cultured in diabetic foot infections. This study suggests that the currently implemented treatment recommendations might not be adequate in Poland.

scholarly journals Bacteriological Profile and Antibiotic Susceptibility Pattern of Diabetic Foot Infection in a Tertiary Care Hospital in Lampung, Indonesia

2021 ◽  
Vol 28 (5) ◽  
pp. 42-53
Author(s):  
Iswandi Darwis ◽  
◽  
Hidayat Hidayat ◽  
Gusti Ngurah P Pradnya Wisnu ◽  
Sekar Mentari ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Medical Records ◽  
Antibiotic Susceptibility ◽  
Gram Negative Bacteria ◽  
High Susceptibility ◽  
Gram Positive ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Gram Positive Bacteria ◽  
Wound Culture

Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus and identification of the causative bacteria is an essential step in selecting the appropriate antibiotic therapy. This study aimed to evaluate the bacterial pattern and antibiotic susceptibility of the bacteria causing DFI in Lampung Province in Indonesia. Methods: This study is a retrospective study reviewing the medical records of DFI patients admitted to the Dr Hi Abdul Moeloek Regional General Hospital in 2017–2019. DFI patients with complete medical record data were included in this study. Demographic, clinical, laboratory, wound culture and antibiotic susceptibility data were collected from the medical records using a short structural chart. The data obtained then reviewed. Results: In this study, 131 DFI patients met the study criteria and were included. Based on the wound culture results, Gram-negative bacteria were obtained in 112 (85.5%) subjects with Enterobacter spp. as the predominant bacteria. Gram-positive bacteria were found in 19 (14.5%) subjects with Staphylococcus spp. as the predominant bacteria. Gram-negative bacteria found in this study showed high susceptibility to amikacin, meropenem and sulbactam/cefoperazone. Meanwhile, the Gram-positive bacteria showed high susceptibility to meropenem, sulbactam/ cefoperazone and amikacin. Conclusion: The findings of the study revealed Enterobacter spp. as the most predominant bacteria causing DFI in the studied population. The highest antibiotic susceptibility was seen for amikacin, meropenem and sulbactam/cefoperazone.

scholarly journals Diabetic Foot Infection: An Indian Scenario

2016 ◽  
Vol 3 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Ashu Rastogi ◽  
Anil Bhansali
Keyword(s):  
Diabetic Foot ◽  
Bacterial Species ◽  
Asia Pacific ◽  
The West ◽  
Gram Negative ◽  
Diabetic Foot Infection ◽  
Diabetic Foot Infections ◽  
Foot Complications ◽  
Foot Problems ◽  
Indian Scenario

ABSTRACT Introduction Diabetes mellitus is assuming epidemic proportions and with that an increasing burden of diabetic foot complications. Diabetic foot infections (DFIs) contribute not only to morbidity, amputation, and increased health-care costs but also to mortality. Aim To review the literature regarding the epidemiology and management of DFIs in India. Results The socioepidemiology of diabetic foot and its complications in India is different from the West. There is a considerable delay in seeking a physician for foot problems, as patients continue invalidated and indigenous methods of treatment. At presentation, most of the foot ulcers are chronic, harbor infection, and neuropathic in origin compared to the West with predominantly neurovascular ulcers. A predominance of Gram-negative bacterial species is reported in DFIs, with Pseudomonas aeruginosa as the most common isolated organism. An initial empirical antibiotic choice covering Gram-negative bacteria is suggested. Conclusion There are very few studies on the countrywide prevalence of foot complications from India. In India, DFIs behave differently from the West because of sociocultural and economic differences. We need indigenous ways for prevention and management of DFIs in India. How to cite this article Rastogi A, Bhansali A. Diabetic Foot Infection: An Indian Scenario. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):71-79.

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