DIABETIC FOOT ULCERS

Abstract

(SUMMARY) Aim: To determine common pathogens isolated in diabetic foot ulcers & in vitro antimicrobial activity. Setting:Muhammad Medical College Hospital, Mirpurkhas and Liaquat University of Medical & Health Sciences Jamshoro. Period: 1s t November2007 to 30th June 2008. Research Methodology: Pus samples for bacterial culture were collected from 60 patients admitted with diabeticfoot infections. Anti-microbial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommendedby the National Committee for Clinical Laboratory Standards. Microbroth dilution test was arranged for susceptibility of anaerobic organismsto metronidazole and amoxicillin/clavulanate. A vancomycin screen agar (6 Lig/ml) was used to detect vancomycin intermediate isolatesof Staphylococci. Results: Clinical grading and bacteriological study of 60 patients revealed, 44 (73.33%) patients had gram-negativeorganisms, & Pseudomonas aeruginosa was the most common. While 16 (26.66%) patients had gram-positive organisms & Staphylococciwas the most common organism. Infection with anaerobes was observed in one patient (1.66%). Both gram-positive and -negative organismswere seen in 8 (13.33%). Pseudomonas aeruginosa & S.aureus exhibited a high frequency of resistance to the antibiotics tested. All theisolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin. Conclusions: Pseudomonas aeruginosa,Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis and Proteus were the most common causes of diabetic foot infectionsin this study. And the rate of antibiotic resistance was 66.66% among the isolates. All the isolates were uniformly susceptible to fosfomycin,levofloxacin, amikacin and vancomycin.