Bacteriological profiles of diabetic ulcers in cases of major limb amputation: insights from Solomon Islands.

IF 1.5 4区医学 Q3 DERMATOLOGY

Journal of wound care Pub Date : 2025-07-01 DOI:10.12968/jowc.2025.0201

Maguire E Anuszewski, Dylan M Bush, Adrian Garcia Hernandez, Hugo Bugoro, Rooney Jagilly, Micky Olangi, Thomas H Fitzpatrick, Michael Buin, Stallone Kohia, Mark Love, Alexandra L Martiniuk

{"title":"Bacteriological profiles of diabetic ulcers in cases of major limb amputation: insights from Solomon Islands.","authors":"Maguire E Anuszewski, Dylan M Bush, Adrian Garcia Hernandez, Hugo Bugoro, Rooney Jagilly, Micky Olangi, Thomas H Fitzpatrick, Michael Buin, Stallone Kohia, Mark Love, Alexandra L Martiniuk","doi":"10.12968/jowc.2025.0201","DOIUrl":null,"url":null,"abstract":"Objective: Solomon Islands, a Western Pacific nation, faces a growing burden of type II diabetes amid chronic healthcare shortages. Surgeons report increased incidence of diabetic amputations; however, data on infection rates and pathology remain scarce. This study describes the microbiology of diabetic ulcers in cases of major limb amputation.Method: Demographic, microbiological and outcome data were extracted from records of patients with diabetes who underwent major limb amputation from 2018-2023 in Solomon Islands.Results: Among 356 adults who underwent major limb amputation, microbiological data were available for 113 (32%). Pus and tissue cultures identified 20 bacterial species-predominantly Pseudomonas aeruginosa (n=27; 24%), mixed enteric organisms (n=25; 23%) and Klebsiella pneumoniae (n=18; 16%). Meticillin-resistant Staphylococcus aureus was identified in one patient. Antibiotic resistance was observed in 62 (55%) cultures, with the highest resistance rates against: ampicillin (31 cases); amoxicillin (31 cases); gentamicin (21 cases); and trimethoprim/sulfamethoxazole (21 cases). Escherichia coli, Klebsiella pneumoniae and Enterococcus spp. were significantly associated with resistance.Conclusion: The bacterial diversity and high resistance rates identified in this study are concerning given limited access to next-generation antibiotics in Solomon Islands. Further research is needed to evaluate infection management, resistance drivers and clinical outcomes of antibiotic-resistant infections in Solomon Islands.","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup7","pages":"S13-S22"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of wound care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12968/jowc.2025.0201","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Solomon Islands, a Western Pacific nation, faces a growing burden of type II diabetes amid chronic healthcare shortages. Surgeons report increased incidence of diabetic amputations; however, data on infection rates and pathology remain scarce. This study describes the microbiology of diabetic ulcers in cases of major limb amputation.

Method: Demographic, microbiological and outcome data were extracted from records of patients with diabetes who underwent major limb amputation from 2018-2023 in Solomon Islands.

Results: Among 356 adults who underwent major limb amputation, microbiological data were available for 113 (32%). Pus and tissue cultures identified 20 bacterial species-predominantly Pseudomonas aeruginosa (n=27; 24%), mixed enteric organisms (n=25; 23%) and Klebsiella pneumoniae (n=18; 16%). Meticillin-resistant Staphylococcus aureus was identified in one patient. Antibiotic resistance was observed in 62 (55%) cultures, with the highest resistance rates against: ampicillin (31 cases); amoxicillin (31 cases); gentamicin (21 cases); and trimethoprim/sulfamethoxazole (21 cases). Escherichia coli, Klebsiella pneumoniae and Enterococcus spp. were significantly associated with resistance.

Conclusion: The bacterial diversity and high resistance rates identified in this study are concerning given limited access to next-generation antibiotics in Solomon Islands. Further research is needed to evaluate infection management, resistance drivers and clinical outcomes of antibiotic-resistant infections in Solomon Islands.

查看原文本刊更多论文

主要肢体截肢病例中糖尿病溃疡的细菌学概况：来自所罗门群岛的见解。

目的：所罗门群岛是一个西太平洋国家，在长期医疗短缺的情况下，面临着日益严重的II型糖尿病负担。外科医生报告糖尿病截肢的发生率增加；然而，关于感染率和病理的数据仍然很少。本研究描述了主要肢体截肢病例中糖尿病溃疡的微生物学。方法：从所罗门群岛2018-2023年接受主要肢体截肢的糖尿病患者的记录中提取人口统计学、微生物学和结局数据。结果：在356例接受主要肢体截肢的成年人中，113例（32%）有微生物学数据。脓液和组织培养鉴定出20种细菌，主要是铜绿假单胞菌(n=27；24%)，混合肠道生物(n=25；23%)和肺炎克雷伯菌(n=18；16%)。1例患者发现耐甲氧西林金黄色葡萄球菌。62例（55%）培养物观察到抗生素耐药，其中对氨苄西林的耐药率最高（31例）；阿莫西林（31例）；庆大霉素21例；甲氧苄啶/磺胺甲恶唑21例。大肠杆菌、肺炎克雷伯菌和肠球菌与耐药显著相关。结论：本研究发现的细菌多样性和高耐药率与所罗门群岛下一代抗生素的有限获取有关。需要进一步研究来评估所罗门群岛抗生素耐药感染的感染管理、耐药驱动因素和临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.