scholarly journals Antimicrobial Susceptibility Patterns ofPseudomonas aeruginosafrom Diabetes Patients with Foot Ulcers

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Tamil Selvi Sivanmaliappan ◽  
Murugan Sevanan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Susceptibility Patterns ◽  
Diabetes Patients

Pseudomonas aeruginosais an invasive organism that frequently causes severe tissue damage in diabetic foot ulcers. A major problem inP. aeruginosainfection may be that this pathogen exhibits a high degree of resistance to a broad spectrum of antibiotics. The study aimed to isolate and determine the antimicrobial susceptibility patterns of theP. aeruginosapopulation from diabetes patients with foot ulcers attending tertiary care hospitals in and around Coimbatore and their antimicrobial susceptibility pattern. The study was carried out at the Department of Microbiology, Dr. N.G.P. Arts and Science College, Coimbatore, for a period of one year (June 2006 to April 2007). The present study comprised 270 pus specimens collected from diabetic patients with foot ulcers. All pus samples were subjected to gram staining; bacterial culture and subsequently the antibiotic sensitivity to 15 different antibiotics for the confirmedP. aeruginosawere performed as per the standard procedures. Eighteen strains (14.28%) ofP. aeruginosafrom 270 diabetic foot ulcers were detected. Almost all the strains exhibited a varying degree of resistance to the antibiotics tested. Multidrug resistance for about 8 to 11 antibiotics was observed among the 55.5% of the isolates. Disk diffusion results show 100% resistance to ampicillin, cefoperazone, erythromycin, norfloxacin, and only cefotaxime, ciprofloxacin exhibited greater activity againstPseudomonas aeruginosa.

Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

2018 ◽  
Vol 17 (3) ◽  
pp. 161-168 ◽  
Author(s):  
Mousab Yousef Al Ayed ◽  
Mutasem Ababneh ◽  
Asirvatham Alwin Robert ◽  
Aus Alzaid ◽  
Rania Ahmed Ahmed ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Saudi Arabia ◽  
Diabetic Foot ◽  
Antibiotic Sensitivity ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Gram Positive ◽  
Gram Negative ◽  
Klebsiella Spp

We sought to define the type and antibiotic sensitivity response of pathogens isolated from diabetic foot ulcers based on ulcer location and Wagner classification. This retrospective analysis was done among 126 patients between 40 and 70 years of age at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia, using the swab culture method for microbiological assessment. Data on demographic variables, ulcer sites (location), and depth of ulcer (Wagner classification) were also collected. A total of 134 pathogens were isolated from 126 patients. The most common gram-negative pathogen identified was Pseudomonas aeruginosa (15.6%), followed by Klebsiella spp (6.7%). The most common gram-positive pathogen was Staphylococcus aureus (35%), followed by Streptococcus (8.9%). The most widely accepted antibiotic to which the gram-negative bacteria were sensitive was gentamycin (20.1%), followed by ciprofloxacin (19%). The most routinely used antibiotic in the treatment of the gram-positive bacteria was erythromycin (16%), with trimethoprim-sulfamethoxazole (14.1%) being the next most effective. In conclusion, Pseudomonas aeruginosa, Klebsiella spp, Staphylococcus aureus, and Streptococcus were the most common causes of diabetic foot infections. However, the frequency of encountered pathogens and respective sensitivity to antibiotic therapy may be influenced by the location site and severity of the ulceration.

scholarly journals A study on clinical grading and bacteriological profile of diabetic foot ulcers in tertiary care centre

2020 ◽  
Vol 7 (7) ◽  
pp. 2342 ◽  
Author(s):  
Mohammed Hamza ◽  
Thomas K. Thomas
Keyword(s):  
Treatment Outcome ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Tertiary Care Centre ◽  
Wagner’S Grade

Background: Diabetes is one of the commonest diseases worldwide and diabetic foot ulcer and its complications are associated with significant morbidity and even amputation. Early detection of colonizing agent of these ulcers help in reduced morbidity and hospital stay. We targeted this subgroup of patients to study Wagner’s grade, identify the bacterial agent and its antibiotic sensitivity and ankle-brachial pressure index (ABPI) assessment to detect PAD, for the best treatment outcome of diabetic foot ulcers.Methods: The present study was conducted in the Department of Surgery of SGMCRF, Venjaramoodu on 210 patients with diabetic foot ulcers between November 2017 and May 2019. Wagner’s grading of ulcer, culture and antibiotic sensitivity of microbe were done as well as ABPI was measured. Outcome of ulcers was compared to ABPI and ABPI was compared to time of healing.Results: Out of 210 patients 122 were males and 88 females, 62.9% had neuropathy and 66.7% had vasculopathy. Most patients presented with Wagner’s grade-II ulcers.  Most common microbe isolated was pseudomonas aeruginosa which was most sensitive to piperacillin and tazobactam combination. Majority of lesions 62.9% had ABPI in range of 0.5-0.89.Conclusions: Wagner’s grading and presence of neuropathy are predictors of major amputation. Piperacillin and tazobactam should be empirical choice of antibiotic. ABPI was inversely related to time of healing and has got significant association with treatment outcome.

scholarly journals Frequency of Most Prevalent Bacteria in Wound of Diabetic Foot Ulcers and their Antimicrobial Susceptibility to Antibiotics

2021 ◽  
Vol 15 (9) ◽  
pp. 2223-2225
Author(s):  
Ashfaq Nasir ◽  
Muhammad Najam Iqbal ◽  
Ghulam Hassan ◽  
Muhammad Arshad Abbas ◽  
Hafiz Jawad Abdul Raheem ◽  
...  
Keyword(s):  
Emergency Department ◽  
Antimicrobial Susceptibility ◽  
Diabetic Foot ◽  
Antibiotic Susceptibility ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional

Background: Most of the diabetic patients present as diabetic foot in surgical outdoor and emergency department. Diabetic Foot infections are common and take long duration to be treated. Both Gram positive and Gram negative aerobic bacteria are involved in diabetic foot infection. Aim: To determine the frequency of most prevalent bacteria in wound of diabetic foot ulcers and to determine the antimicrobial susceptibility of isolated bacteria from diabetic foot ulcers so that an empirical antibiotics can be started before the report of culture and sensitivity. Methods: This cross sectional study was conducted in surgical unit 1 of Bahawal Victoria Hospital (BVH) Bahawalpur from 01-08-2020 to 31-07-2021. This study was conducted on 145 patients with diabetic foot ulcer from outdoor and emergency department of BVH. Data about patient’s demography, duration of diabetes, duration of DFUs, type of pathogen and its antibiotic susceptibility was entered on a proforma. Pus sample was obtained from wound under aseptic measures. Culture sensitivity to assess presence of type of pathogen and its antibiotic susceptibility of all the samples was done from the pathology department of the hospital. Results: The mean age of patients was 52.02±10.14 years. There were 77(53.1%) males and 68(46.9%) females. The foot ulcer’s mean duration was 3.81±1.43 months. There were 15(10.3%) patients with St. aureus, 12(8.3%) with E.coli, 12(8.3%) with Proteus mirabilis, 15(10.3%) with P. aeruginosa, 12(8.3%) with Enterobacter spp., 9(6.2%) with Morganella spp., 19(13.1%) with P. vulgaris, 18(12.4%) with P. Mirabilis, 16(11%) with K. pneumonia and 17(11.75) with Morganella pathogen in this study. There were 74(51%) patients sensitive to Amikacin, 73(50.3%) sensitive to Amoxicillin, 66(45.5%) sensitive to Aztreonam, 74(51%) sensitive to Ceftriaxone, 75(51.7%) sensitive to Cefuroxime and 68(49.6%) sensitive to Cephazolin. Conclusion: The most frequent organisms in DFUs, regardless of age, gender and comorbidity, were P. vulgaris, St. aureus and P. aeruginosa. The most sensitive antibiotic in these ulcers was Piperacillin and Meropenem and the most resistant was Cephazolin. Keywords: Diabetic Foot Ulcers, Antimicrobial Susceptibility, St. aureus, P. vulgaris, P. aeruginosa, Piperacillin

scholarly journals Clinical profiles of diabetic foot ulcer patients undergoing major limb amputation at a tertiary care center in North-eastern Tanzania

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Shabhay ◽  
Pius Horumpende ◽  
Zarina Shabhay ◽  
Andrew Mganga ◽  
Jeff Van Baal ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Foot ◽  
Care Center ◽  
Tertiary Care ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Random Blood Glucose ◽  
North Eastern ◽  
The Mean

Abstract Background Diabetic foot ulcers complications are the major cause of non-traumatic major limb amputation. We aimed at assessing the clinical profiles of diabetic foot ulcer patients undergoing major limb amputation in the Surgical Department at Kilimanjaro Christian Medical Centre (KCMC), a tertiary care hospital in North-eastern Tanzania. Methods A cross—sectional hospital-based study was conducted from September 2018 through March 2019. Demographic data were obtained from structured questionnaires. Diabetic foot ulcers were graded according to the Meggitt-Wagner classification system. Hemoglobin and random blood glucose levels data were retrieved from patients’ files. Results A total of 60 patients were recruited in the study. More than half (31/60; 51.67%) were amputated. Thirty-five (58.33%) were males. Fifty-nine (98.33%) had type II diabetes. Nearly two-thirds (34/60; 56.67%) had duration of diabetes for more than 5 years. The mean age was 60.06 ± 11.33 years (range 30–87). The mean haemoglobin level was 10.20 ± 2.73 g/dl and 9.84 ± 2.69 g/dl among amputees. Nearly two thirds (42/60; 70.00%) had a haemoglobin level below 12 g/dl, with more than a half (23/42; 54.76%) undergoing major limb amputation. Two thirds (23/31; 74.19%) of all patients who underwent major limb amputation had mean hemoglobin level below 12 g/dl. The mean Random Blood Glucose (MRBG) was 13.18 ± 6.17 mmol/L and 14.16 ± 6.10 mmol/L for amputees. Almost two thirds of the study population i.e., 42/60(70.00%) had poor glycemic control with random blood glucose level above 10.0 mmol/L. More than half 23/42 (54.76%) of the patients with poor glycemic control underwent some form of major limb amputation; which is nearly two thirds (23/31; 74.19%) of the total amputees. Twenty-eight (46.67%) had Meggitt-Wagner classification grade 3, of which nearly two thirds (17:60.71%) underwent major limb amputation. Conclusion In this study, the cohort of patients suffering from diabetic foot ulcers treated in a tertiary care center in north-eastern Tanzania, the likelihood of amputation significantly correlated with the initial grade of the Meggit-Wagner ulcer classification. High blood glucose levels and anaemia seem to be also important risk factors but correlation did not reveal statistical significance.

scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

Blind Comparative study between Silver nanoparticles dressings and Standard Moist Wound Dressings (SMWD) in management of diabetic foot ulcers

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amr Abdelaal ◽  
Mostafa Soliman ◽  
Hany Rafik ◽  
Mohamed Emam ◽  
Mohamed Mahmoud Mohamed Elsadek
Keyword(s):  
Silver Nanoparticles ◽  
Diabetic Foot ◽  
Wound Dressing ◽  
Treatment Modalities ◽  
Controlled Study ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Group A ◽  
Group B

Abstract Background Diabetic foot ulcers (DFUs) are the main cause of hospitalization in diabetic patients and they are considered a major worldwide health problem. Thus, there is a need to evaluate various treatment modalities. In this study we will assess the clinical efficacy of Silver nanoparticles dressing vs Standard Moist Wound Dressing (SMWD) in management of diabetic foot ulcers. Objective To compare wound outcome, limb salvage, healing time of diabetes related foot ulcers and cost effectiveness in terms of duration of hospital stay between Silver nanotechnology dressings and Standard moist wound therapy (SMWT) in management of diabetic foot ulcers. Patients and Methods This is a prospective randomized controlled study involving 34 patients with active diabetic foot ulcers, in a high volume tertiary referral vascular center. They were divided into 2 groups: 17 patients (group A) were prescribed SMWD and the other 17 patients (group B) received Silver nanoparticles wound dressing. Results Our study correlates with the study conducted by K.Suhas et al. which had observed that Silver nanoparticles wound dressing was safe and effective treatment for complex diabetic foot wounds and could lead to higher proportion of healed wounds and faster healing rates. At the end of the study, group B promised a better outcome as compared to group A. Conclusion The role of Silver nanoparticles wound dressing in healing of diabetic foot ulcers has been proposed as a novel method of manipulating the chronic wound environment in a way that it reduces bacterial burden and chronic interstitial wound fluid, increases vascularity and cytokine expression and to an extent mechanically exploiting the viscoelasticity of peri wound tissues.

scholarly journals Predictors of intra-hospital mortality in patients with diabetic foot ulcers in Nigeria: data from the MEDFUN Study.

2020 ◽  
Author(s):  
Olufunmilayo O Adeleye ◽  
Ejiofor T Ugwu ◽  
Ibrahim D Gezawa ◽  
Innocent Okpe ◽  
Ignatius Ezeani ◽  
...  
Keyword(s):  
Renal Impairment ◽  
Hospital Mortality ◽  
Cardiac Failure ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Diabetic Foot Ulcers ◽  
Grade 3

Abstract Background: Diabetic foot ulcers (DFU) are associated with high morbidity and mortality globally. Mortality in patients hospitalized for DFU in Nigeria is unacceptably high. This study was undertaken to determine factors that predict mortality in patients hospitalized for DFU in Nigeria.Methods:The current study was part of Multi-centre Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN), an observational study conducted in six tertiary healthcare institutions across the 6 geopolitical zones of Nigeria. Consecutive type 1 or 2 diabetic patients hospitalized for DFU who consented to participate were recruited and subjected to relevant clinical, biochemical and radiological assessments and multidisciplinary care until discharge or death. Data for type 1 diabetes mellitus (DM) patients were expunged from current mortality analysis due to their small number.Results: Three hundred and twenty three type 2 DM subjects with mean age and mean duration of DM of 57.2 11.4 years and 8.7± 5.8 years respectively participated in this study. The median duration of ulcers was 39 days with a range of 28 to 54 days and majority (79.9%) presented with advanced ulcers of at least Wagner grade 3. Mortality of 21.4% was recorded in the study, with the highest mortality observed among subjects with Wagner grade 5. Variables significantly associated with mortality with their respective p values were DM duration more than 120 months (p 0.005), ulcer duration > one month (p 0.020), ulcer severity of Wagner grade 3 and above (p 0.001), peripheral arterial disease (p 0.005), proteinuria (p <0.001), positive blood cultures (p<0.001), low HDL (p <0.001), shock at presentation (p<0.001), cardiac failure (p 0.027),and renal impairment (p <0.001). On Multivariate regression analysis, presence of bacteraemia (OR 5.053; 95% CI 2.572-9.428) and renal impairment (OR 2.838; 95% CI 1.349 – 5.971) were significantly predictive of mortality independent of other variables.Conclusions: This study showed high intra-hospital mortality among patients with DFU, with majority of deaths occurring among those with advanced ulcers, bacteremia, cardiac failure and renal impairment. Prompt attention to these factors might be helpful in improving survival from DFU in Nigeria.

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