International Surgery Journal | February 2021 | Vol 8 | Issue 2 Page 704
International Surgery Journal
Shah P et al. Int Surg J. 2021 Feb;8(2):704-709
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Case Series
Bacteriological profile of diabetic foot
Priti Shah
1
, Mridula Eswarawaka
1
*, Dinesh Anne
1
, Sai Charan Reddy M.
1
,
Pranjal Shah
2
, Neha Srivastava
1
INTRODUCTION
Foot wounds are an increasingly common problem in
people with diabetes and now constitute the most
frequent diabetes-related cause of hospitalization.
1
People
with diabetes have about a 12-25% chance of developing
a foot ulcer in their lifetime, thus contributing to a major
public health issue.
2,3
Rate of amputation of a limb is
estimated to be forty times greater in infected non-healing
ulcer in diabetics than the patients in trauma.
4,5
Amputation is even more likely when DFI and foot
ischemia coexist.
6
The pathophysiology of foot infections in persons with
diabetes is quite complex, but their prevalence and
severity are largely a consequence of host-related
disturbances (immunopathy, neuropathy and
arteriopathy) and secondarily pathogen-related factors
(virulence, antibiotic-resistance and microbial load).
7,8
Because many different organisms, alone or in
combination, can cause a DFI, selecting the most
appropriate antibiotic therapy requires defining the
specific causative pathogens.
8-10
Clinicians should avoid
antibiotic therapy that is unnecessary, overly broad-
spectrum or excessively prolonged, as it may cause drug-
ABSTRACT
Foot infections in patients with diabetes mellitus are a major cause of morbidity, can lead to gangrene and ultimately
amputation of the limb. Aim of the study was to determine the type of microorganisms isolated from the Diabetic foot
ulcer and antibiotic resistance pattern. We have included 50 patients having diabetic foot ulcers of Wagner's grade 1
or above in our study. Debrided tissue, pus, or swabs from the base of the ulcers were subjected to aerobic and
anaerobic culture. The organisms were identified, and further antibiotic sensitivity was conducted. Seventy-two
aerobic and 13 anaerobic organisms were isolated. Among the aerobic and anaerobic bacteria isolated, most
predominant organisms were S. aureus and Bacteroides spp.; respectively. Of the S. aureus, 77.8% were methicillin
resistant, while 42.1% of gram-negative Enterobacteriaceae were extended spectrum beta-lactamase (ESBL) positive.
Klebsiella spp. was the highest ESBL producer. Acinetobacter spp. was the highest MBL producer. Most sensitive
drugs for S. aureus were linezolid, vancomycin and amikacin. Gram-negative bacteria were mostly sensitive to
piperacillin-tazobactam and amikacin. Pseudomonas spp. were usually sensitive to meropenem, piperacillin -
tazobactam. Acinetobacter spp. was sensitive to colistin, tigecycline. As diabetic ulcers are often infected by
multidrug-resistant bacteria, a knowledge of the common bacterial pathogens implicated as well as their sensitivity
pattern helps the clinician to choose the proper antibiotic for a timely treatment.
Keywords: Diabetic foot infection, Amoxicillin-clavulanic acid, Cefotaxime, Ceftriaxone, Ceftriaxone-sulbactam,
Amikacin, Gentamycin, Linezolid, Azithromycin, Piperacillin-tazobactam
1
Department of General Surgery, DPU Vidyapeeth, Pune, Maharashtra, India
2
Department of General Surgery, SKNMC, Pune, Maharashtra, India
Received: 27 October 2020
Revised: 29 December 2020
Accepted: 05 January 2021
*Correspondence:
Dr. Mridula Eswarawaka,
E-mail: mridulaeswar@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20210389