DIABETIC FOOT INFECTIONS AND THEIR MANAGEMENT IN A TERTIARY CARE HOSPITAL
Abstract
Background: Diabetic foot is a common complication of diabetes world over. We conducted this studyto determine common microbiological pathogens in Diabetic Foot Infections (DFI) at a tertiary carehospital and their management. Methods: In this observational study deep wound swabs of all admitteddiabetic patients were taken, pathogens isolated, antibiotic used and its response depending on completeresolution of symptoms and biochemical markers were recorded. Data were analysed on SPSS-11.Results: A total of 114 cases were recorded. Sixty-eight (59%) cases had ulcers on forefoot, 28 (25%)mid-foot and 18 (16%) hind-foot. One hundred and four pathogens were isolated from wound swabsafter debridement. Commonest pathogen isolated was Staphylococcus aureus (52, 46%) followed by E.coli (11, 10%), MRSA was found in 10 (9%) cases, streptococcus in 6 (5%) and pseudomonas in 5 (4%)cases. Polymicrobial infection was also seen in a few cases. Surgical intervention included superficialdebridement in 88 (77%) cases, toe amputation/forefoot amputation in 19 (17%) cases, and below/aboveknee (major) amputation in 7 (6%) cases. Commonest antibiotic used was Cefoperazone/Sulbactam in43 (38%) cases, alone or in combination, followed by Ceftraixone 36 (33%) cases. Linezolid was usedfor MRSA. Ninety-four (82%) patients responded to treatment and were recorded as ‘cured’.Conclusion: Diabetic Foot ulcers often present with serious foot infections. Commonest pathogens areStaph. aureus, E. coli, Pseudomonas spp. and MRSA. Treatment was effective withCefoperazone/Sulbactam and Ceftraixone. MRSA was treated successfully with Linezolid.Keywords: Diabetic foot, Diabetic foot infections (DFI), Staph. Aureus, E. coli, MRSA, antibioticsReferences
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