BACTERIOLOGICAL PROFILE OF DIABETIC FOOT INFECTIONS

Priyanka Patil, Ravindra Khadse*, Sonal Chavan and Sharmila Raut

ABSTRACT

Diabetes Mellitus (DM), with its increasing prevalence and incidence, is regarded as a serious public health problem worldwide. The 15% of all diabetic patients develop a foot ulcer at some point in their lifetime leading to hospital admissions and cause of non traumatic lower extremity amputations. A total of 150 pus samples from patients having diabetic foot ulcer were processed for 162 bacteria isolation, antimicrobial susceptibility and drug resistance. The mono-microbial infection was 65.3% and poly-microbial 21.3%. Maximum organisms were isolated from Grade 3 and 4 foot wounds. Monomicrobial flora was predominant in Grade 3, while polymicrobial flora in Grade 4. Gram negative bacilli were more prevalent (79.6%) than gram positive cocci (20.4%). In enterobacteriaceae group, Imipenem (74.3%) was the most effective drug. The 42.8% were ESBL producers, 18.6% AmpC producers, 21.4% carbapenemase producer and 15.7% were MBL producer. In Pseudomonas aeruginosa and Acinetobacter species were sensitive to Polymyxin B, Colistin and Imipenem., 22% were ESBL producers, 18.6% AmpC producers and 32.2% MBL producers. All S. aureus isolates were sensitive to Vancomycin and Linezolid. MRSA were 40.9% and MSSA were 59.1%. Introduction of ESBL, MBL or carbapenemase production in Gram negative bacilli and MRSA is a matter of great concern. Since there is an increasing rate of multidrug resistant organisms, there is a need for continuous surveillance to provide the basis of the empirical therapy and to reduce the risk of the complications.

Keywords: Diabetic foot, Diabetic ulcer, multidrug resistance.