Clinico microbiological profile of Pseudomonas aeruginosa isolated from diabetic foot ulcer

Abstract

Diabetes mellitus is a major health problem, rapidly expanding worldwide. In India, it is projected that around 80 million will be affected by DM. Asia contributes to >60% of the world's population with diabetes, of which two nations; India and China contribute the largest. In developing countries like India, diabetic foot ulcerations and infections are one of the most common causes of hospitalization and often resulting in amputation, osteomyelitis, mortality and morbidity. Infection is most often a consequence of foot ulceration, which typically follows trauma to a neuropathic foot. The present study was conducted to know the prevalence and sensitivity pattern of P. aeruginosa from diabetic foot infections and to assess their susceptibility to the commonly used antibiotics. This was a retrospective study conducted at a tertiary care hospital in South India conducted from January 2013 to August 2013. Culture materials from all the wounds were obtained, either by washing the wound with sterile physiological saline and then making a puncture-aspiration from the base of the wound or by applying a sterile cotton swab to the wound. A total of 77 patients were included in the study. 104 bacteria were isolated from 77 patients. Out of 104 bacteria, 39 (37.5%) were P. aeruginosa. Infection was polymicrobial is some cases and Gram negative bacteria were the most common organisms isolated. P. aeruginosa showed resistnce to most commonly used antibiotics, highest resistance was seen with Ciprofloxacin and Ofloxacin and least with Aztreonam an Imipenem. Other studies have reported similar findings. The major concern is emergence of resistance to third and fourth generation of Cephalosporins and even more alarming is Carbapenem resistance surfacing nowadays. The increasing prevalence of multi drug resistance in P. aeruginosa is a cause for concern. The selection of the antibiotic treatment should be based on the predominant organisms which are isolated and their antimicrobial susceptibility patterns.