STUDY TO DETERMINE THE BACTERIOLOGICAL ANALYSIS OF DIABETIC FOOT ULCERS

Abstract

Aim: This study was conducted to evaluate the bacterial flora according to the Wagner classification of the diabetic foot disease. Determine aerobic bacterial pathogens and their drug sensitivity model from their ESBL (Extended Spectrum Beta-Lactamase) production for isolation. Methods: A prospective study was conducted among diabetic patients with diabetic foot infection in a tertiary care hospital in the orthopedic department. All recorded cases were classified according to the Wagner classification and socio-demographic data were recorded. Ulcer samples were collected and processed for pathogen isolation and identification according to standard CLSI (Clinical and Laboratory Standards Institute) guidelines. The isolates were sensitized to antibiotics and ESBL production was demonstrated according to standard guidelines. Place and Duration: In the Orthopedic Department, Al Qassimi Hospital Sharjah, United Arab Emirates (UAE). for one-year duration from March 2019 to March 2020. Results: The study included 370 cases in which Wagner's grade 3 ulcers predominated. The majority was male, the common age group was 46-55 years, and the mean age was 55.3 ± 1.4 years. The most common disease was peripheral arterial disease and the second common problem was peripheral neuropathy, both were significantly associated with the development of diabetic foot ulcers. Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa were the most common isolates. Vancomycin, clindamycin and linezolid shows maximumsusceptibility against MRSA. Meropenems and piperacillin-tazobactamshowed maximum susceptibility against gram-negative strains. The frequency of ESBL producers in the study was 16.24%. Conclusions: Diabetic foot infections are very serious problem in diabetic patients and require appropriate treatment. The outcome of an infection depends on the classification of the ulcer according to the Wagner classification as well as the nature of the infection, whether it is due to single organismormulti-organism. Our study highlights and recommends that propermulticenter studies are required to evaluate the proper antibiotic therapy for diabetic foot ulcers and to apply appropriate antibiotic treatment to reduce the incidence and growth of multi-drug resistant microbes.