Clinical and bacteriological profile of diabetic foot infections in a tertiary care

Wiley - Tập 13 - Trang 1-8 - 2020
Teik Chiang Goh1,2, Mohd Yazid Bajuri1, Sivapathasundaram C. Nadarajah2, Abdul Halim Abdul Rashid1, Suhaila Baharuddin3, Kamarul Syariza Zamri1
1Department of Orthopaedic and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Hospital Canselor Tunku Muhriz, Cheras, Malaysia
2Department of Orthopaedic and Traumatology, Hospital Melaka, Melaka, Malaysia
3Department of Microbiology, Hospital Melaka, Melaka, Malaysia

Tóm tắt

Diabetic foot infection is a worldwide health problem is commonly encountered in daily practice. This study was conducted to identify the microbiological profile and antibiotic sensitivity patterns of causative agents identified from diabetic foot infections (DFIs). In addition, the assessment included probable risk factors contributing to infection of ulcers that harbour multidrug-resistant organisms (MDROs) and their outcomes. We carried out a prospective analysis based on the DFI samples collected from 2016 till 2018. Specimens were cultured with optimal techniques in addition to antibiotic susceptibility based on recommendations from The Clinical and Laboratory Standards Institute (CLSI). A total of 1040 pathogens were isolated with an average of 1.9 pathogens per lesion in 550 patients who were identified with having DFIs during this interval. A higher percentage of Gram-negative pathogens (54%) were identified as compared with Gram-positive pathogens (33%) or anaerobes (12%). A total of 85% of the patients were found to have polymicrobial infections. Pseudomonas aeruginosa (19%), Staphylococcus aureus (11%) and Bacteroides species (8%) appeared to be the predominant organisms isolated. In the management of Gram-positive bacteria, the most efficacious treatment was seen with the use of Vancomycin, while Imipenem and Amikacin proved to be effective in the treatment of Gram-negative bacteria. DFI’s are common among Malaysians with diabetes, with a majority of cases displaying polymicrobial aetiology with multi-drug resistant isolates. The data obtained from this study will be valuable in aiding future empirical treatment guidelines in the treatment of DFIs. This study investigated the microbiology of DFIs and their resistance to antibiotics in patients with DFIs that were managed at a Tertiary Care Centre in Malaysia.

Tài liệu tham khảo

Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001;24(1):84–8.

Wayne PA. Performance standards for antimicrobial disk susceptibility tests. Approved standard, Ninth edition. Document M2-A9. CLSI; 2006.

Wayne PA, National Committee for Clinical Laboratory Standards. Performance Standards for antimicrobial susceptibility testing: 14th Informational Supplement NCCLS Document M100-S14. 2004.

Padzil AWM, Bajuri MY. Virtual amputation as a conservative surgical approach in treating diabetic foot osteomyelitis- a case series. J Clin Diagn Res. 2019;13(3):1–4. https://doi.org/10.7860/JCDR/2019/39994.12648.

Cauton-Valera R, Lianes LRI, Pena AC. Clinical, microbiological profile and outcome of diabetic patients with foot ulcers admitted at the Quirino memorial medical center: January 2000-may 2001. Philipp J Microbiol Infect Dis. 2001;30(3):101–7.

Altrichter Loan C, Legout L, Assal M, Rohner P, Hoffmeyer P, Bernard L. Severe Streptococcus agalactiae infection of the diabetic foot: a deleterious role of Streptococcus agalactiae? Press Medicale. 2005;34(7):491–4.