Risk factors for infection of the diabetic foot with multi-antibiotic resistant microorganisms O ¨ zlem Kandemir a, *, Esen Akbay b , Elif S xahin a , Abtullah Milcan c , Ramazan Gen b a Department of Clinical Microbiology and Infectious Diseases, Mersin University, Faculty of Medicine, Zeytinli Bahc ¸e caddesi, 33079 Mersin, Turkey b Department of Endocrinology and Metabolism, Mersin University, Faculty of Medicine, Zeytinli Bahc ¸e caddesi, 33079 Mersin, Turkey c Department of Orthopaedics and Travmatology, Mersin University, Faculty of Medicine, Zeytinli Bahc ¸e caddesi, 33079 Mersin, Turkey Accepted 21 August 2006 Available online 2 October 2006 KEYWORDS Diabetic foot ulcer; Multidrug resistant microorganism Summary Aim: To investigate the risk factors for infection of the diabetic foot with multi- drug resistant microorganisms. Methods: Amongst 102 diabetic patients with evidence of soft tissue infection of the foot who presented to our health center over a three year period, we investigated risk factors that might be predictive of multi-antibiotic resistance of the infecting organism. Results: Of 102 patients with a diabetic foot wound, bacteria were cultured from 73, yielding a total of 104 isolates. The number of multidrug resistant isolates was 42 from 36 cases and the number of isolates other than multidrug resistant ones was 62 from 37 cases. Previous anti- biotic therapy (p Z 0.002) and its duration (p Z 0.0001), frequency of hospitalization for the same wound (p Z 0.000), duration of hospital stay (p Z 0.000) and osteomyelitis (p Z 0.001) were significant risk factors for infections with multidrug resistant microorganisms. Conclusion: In conclusion, an appropriate antibiotic should be initiated promptly, wound perfu- sion should be effective, duration of hospital stay should be as short as possible and optimum hygiene should be provided during wound care to prevent infections of diabetic foot wound with multidrug resistant microorganisms. ª 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved. Introduction About 15% of all people with diabetes mellitus have a foot ulcer during their lifetime. There are many routes for the development of a diabetic foot ulcer. In general, they * Corresponding author. Tel.: þ90 324 337 4300/1121; fax: þ90 324 337 4305. E-mail address: kandemirege@hotmail.com (O ¨ . Kandemir). 0163-4453/$30 ª 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2006.08.013 www.elsevierhealth.com/journals/jinf Journal of Infection (2007) 54, 439e445