Abstract
BackgroundDiabetic 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.MethodsWe 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.ResultsA 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.ConclusionDFI’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.
Highlights
Diabetic foot infection is a worldwide health problem is commonly encountered in daily practice
The aim of this study was to further enhance understanding on the bacteriology of diabetic foot ulcers alongside the assessment of the in vitro antimicrobial susceptibility of the offending pathogens in the General Hospital of Melaka, which is located in the historical state of Melaka, Malaysia and Universiti Kebangsaan Malaysia Medical Centre which is located in central Kuala Lumpur, both with a capacity to accommodate nearly one thousand patients
diabetic foot infections (DFIs) are a burgeoning predicament in Malaysia owing to the high incidence of Diabetes Mellitus (DM) among Malaysians where 1/ 5th of the population aged more than 30 years old were diagnosed with DM Type 2 reported by Bajuri et al [16]
Summary
Diabetic foot infection is a worldwide health problem is commonly encountered in daily practice. Goh et al Journal of Foot and Ankle Research (2020) 13:36 not have good control of their DM are at risk of developing complications arising from diabetes which are macrovascular and microvascular. Among these complications are neuropathy, retinopathy and pedal ulcers with or without gangrene [3]. Almost 15% of patients with DM eventually end up developing foot ulcers that can progress to osteomyelitis [6] The progression of these wounds from superficial to debilitating infections are facilitated by impaired defence mechanisms of the body and delayed treatment. Diabetic foot infections (DFIs) are complex, rampant and costly ramifications of DM. In 2003, Frykberg concluded that most mild infections are commonly monomicrobial in which Gram-positive cocci such as Streptococcus species and Staphylococcus aureus were identified
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call