Clinical Profile of Diabetic Foot Infections
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 1
Abstract
Background: Diabetic foot infections (DFIs) are associated with substantial morbidity and mortality. Patients with a DFI should be evaluated comprehensively, and employing multidisciplinary foot teams improve outcomes. Aims and Objectives: To study the clinical profile and microbial flora of diabetic wound infections along with antibiotic therapy. Methods: This study included 253 patients admitted in the department of general medicine between March 2015 and August 2016. A thorough clinical examination was done. Peripheral neuropathy was evaluated by monofilament and vibration sense. Wound ulcer was graded according to Wagner grading. A basic laboratory workup along with fundus examination was done to rule out microvascular and macrovascular complication of diabetes. ECG and 2D ECHO were done for patients with CAD. Wound swab from the ulcer edge was taken after removing the necrotic material and sent for culture. Pus swab was also sent for culture. Antibiotic therapy and duration was calculated. Results: The study included 253 patients, 169 males and 84 females. 65 patients presented with Grade I ulcer, 175 with Grade II ulcer, and 13 had Grade III ulcer. 12 patients required ICU care and 241 patients were managed in the ward. The mean age was 57.57. Mean fasting and post-prandial sugars were 157.48 and 244.21, respectively. The mean HbA1c was 9.49 with a mean duration of hospital stay of 12.44 days. 40 patients grew Staphylococcus aureus, 40 patients grew coagulase-negative Staphylococcus (CONS), 28 Escherichia coli, 20 Streptococcus species, 20 Enterococcus species, 10 Proteus species, 12 Klebsiella species, 25 Pseudomonas species, and 6 Candida species. Polymicrobial growth was seen in 26 patients. 25 patients had no growth in cultures. A majority of S. aureus was sensitive to penicillin and cloxacillin (MRSA was found in two patients), Streptococcus to penicillin and clindamycin, CONS to clindamycin and linezolid, and Enterococcus was sensitive to linezolid and ampicillin. Conclusion: The present study revealed the increased incidence of diabetic foot ulcers and is more common above the fifth decade of life with male preponderance. Our study has showed that 90% and 9.6% of DFIs were monomicrobial and polymicrobial, respectively. CONS and S. aureus were the most commonly identified Gram-positive microorganisms, respectively. E. coli and Pseudomonas aeruginosa were the most commonly identified Gram-negative organisms.
Authors and Affiliations
K Vasanthan, P Surendran
Keywords
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