CLINICO-BACTERIOLOGICAL PROFILE IN DIABETICS ADMITTED FOR FOOT ULCERS: OBSERVATIONS FROM A TERTIARY CARE HOSPITAL

Abstract

Aim: To study the clinical profile with co-morbidities of patients admitted with Diabetic foot ulcer (DFU) infection. Also, to study the microbiological flora causing the infection, along with antibiotic susceptibility pattern of the pathogens isolated from these ulcers. Material and method: A prospective study was carried out on 95 diabetic patients with foot ulcers for a period of 11⁄2 years. The demographic details of the patients with Diabetic foot ulcer (DFU) along with Wagner’s grade and treatment profile were also collected. The tissue sample were collected and processed as per standard microbiological procedure and antibiotic susceptibility testing was done as per Clinical & Laboratory Standards Institute (CLSI). The data was analyzed by percentage and correlated. Results: A total of 95 patients were included in the study with 83 males. The majority of patients with DFU were below the age of 40 years. Around 36.48% patients developed DFU following 6-10 years of diagnosed as Diabetes mellitus. Hypertension (26.88%) and neuropathy (20%) were the most common co-morbidity and complications among these patients. A total of 92 pathogens isolated from these patients, with Gram negative pathogens being predominant. The most common pathogens isolated were Pseudomonas aeruginosa (30%), followed by Escherichia coli(28.8%) and Staphylococcus aureus (72.5%) among Gram negative and Gram positive pathogens, respectively. Minimal resistance was noted for high end antimicrobials like Beta lactamBeta lactamase inhibitors & carbapenems. But, for empirical therapy, fluoroquinoles and aminoglycosides may be considered as alternative for cephalosporins. Conclusion: Diabetic foot ulcer infection is mainly seen in individuals with > 5 years of diabetes and complications especially peripheral neuropathy and nephropathy. Gram negative bacteria, coliforms are predominant pathogens isolated. Flouroquinolones and aminoglycoside group of antimicrobials can be considered for empirical therapy provided antibiogram is monitored on regular basis.