scholarly journals Prevalence of Microorganisms and Antibiotic Sensitivity Among Patients with Diabetic Foot Ulcer in Sulaimani City, Iraq

2020 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Aso Nasih Qadir ◽  
Bakhtiar Mohamed Mahmoud ◽  
Taha Othman Mahwi ◽  
Delman Mohammed Raoof Arif Al-Attar ◽  
Safeen Othman Mahmood

Background: Diabetic foot ulcers (DFUs) are responsible for days of costly hospitalization and are the major cause of medical lower limb amputations. Determining the appropriate antimicrobial therapy for DFUs is highly dependent on recognizing the microorganisms that cause them. Many reports have indicated that there has been a remarkable increase in antibiotic resistance. Objectives: The present study examined various cultures of patients with DFUs to detect the prevalence of microorganisms and their antibiotic sensitivity profiles. Methods: This cross-sectional study was carried out on 92 patients with DFUs admitted to Shar Teaching Hospital and Shahid Hemin Teaching Hospital. Wagner Classification was used to assess the severity and location of the DFUs. Patients were asked questions about their practices of foot care and hygiene, and their answers were recorded. Samples required for testing were taken using sterile swabs. Results: A total of 100 microorganisms were isolated from 92 patients with DFUs, 10 of which were polymicrobial and 2 were culture-negative. There was a highly significant association between the isolated gram-negative microorganisms and higher grades of DFU (P<0.001). A highly significant association was also observed between bad patient knowledge of hygiene practices and gram-negative microorganisms (P<0.001). Osteomyelitis was present in 40 (43.4%) patients. Conclusion: Among gram-positive and gram-negative bacteria, Staphylococcus spp. and E. coli were, respectively, the most frequent organisms isolated. The antibiotic imipenem was found to be effective against microorganisms. Tetracycline, erythromycin, and ceftriaxone, however, were highly resistant to antibiotics. To sum up, since different microorganisms are involved and multidrugresistant strains might emerge, clinicians are recommended to take cultures into account before they initiate empirical therapy.

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.


2020 ◽  
Vol 7 (8) ◽  
pp. 2512
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian ◽  
Sudha Selvam

Background: Diabetic foot ulcer is one of the major surgical problem leading to hospital admission. Diabetic foot ulcer patients with uncontrolled diabetes may end up in forefoot amputation. Early aggressive debridement, control of blood sugar and empirical antibiotic therapy would reduce the morbidities in patients with diabetic foot ulcer. Further the knowledge of commonly isolated microbes and their antibiotic sensitivity pattern would be helpful to start empirical therapy. The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents.Methods: This cross-sectional study was conducted in 115 patients admitted with diabetic foot ulcer over a period of 9 months from October 2015 to June 2016 at the department of general surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Tissue scrapping samples were collected and processed as per standard guidelines.Results: 167 organisms were isolated from 115 patients. 52% of culture showed polymicrobial growth. There was increased prevalence of gram-negative organisms 53% compared to gram positive organisms 47%. When comes to individual isolate, Staphylococcus aureus was the most common organism isolated 24.6% followed by Pseudomonas aeruginosa 21%. All gram-positive aerobes were sensitive to vancomycin and gram-negative isolates were sensitive to amikacin, piperacillin-tazobactum, gentamycin and cefotaxime.Conclusions: Staphylococcus aureus and Pseudomonas were the common pathogens isolated. This study recommends use of vancomycin along with piperacillin-tazobactum as an empirical therapy along with adequate blood sugar control and early debridement of devitalized tissues in patients with diabetic foot infections.


2020 ◽  
Vol 16 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Mutasem Ababneh ◽  
Mousab Y. Al Ayed ◽  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.


2020 ◽  
Vol 14 (2) ◽  
pp. 197-205
Author(s):  
Putri Puspitasari

Pendahuluan : Diabetic Foot Ulcer (DFU) merupakan komplikasi jangka panjang yang umum ditemukan pada pasien Diabetes Mellitus (DM). Penurunan kualitas kesehatan, proses penyembuhan yang lambat, ancaman amputasi, serta ancaman kematian berdampak terhadap keadaan psikologis yang buruk bagi penderita DFU. Keadaan emosi yang mungkin timbul pada pasien dengan penyakit kronis seperti DFU adalah perasaan chronic sorrow dan Quality Of Life yang kurang baik. Tujuan dari penelitian ini adalah melihat keadaan chronic sorrow dan quality of life pada pasien dengan DFU serta secara spesifik melihat hubungan antara chronic sorrow dengan quality of life pasien dengan DFU Metode Penelitian: Penelitian ini merupakan jenis penelitian kuantitatif dengan desain analytic correlative dan rancangan penelitian menggunakan pendekatan cross sectional study. Tujuan penelitian ialah untuk menganalisis hubungan antara chronic sorrow dan kualitas hidup pada pasien dengan DFU. Sampel penelitian adalag 46 Responden. Hasil dan kesimpulan: hasil penelitian menunjukan dari 46 responden 29 (63,04 %) mengalami keadaan chronic sorrow dan diantara 46 responden 27 (58,7 %) mengalami keadaan kualitas hidup yang kurang baik. Responden yang mengalami chronic sorrow memiliki kualitas hidup yang kurang baik sebesar 78,13 % dan kualitas hidup yang baik sebesar 21,87 % dengan p= 0,000 lebih kecil dari α= 0,05, yang dapat diartikan bahwa terdapat hubungan bermakna antara keadaan chronic sorrow dan quality of life.


2018 ◽  
Vol 5 (7) ◽  
pp. 2537
Author(s):  
Praveena D. L. ◽  
Shashi M. Uppin ◽  
S. S. Shimikore

Background: Diabetes mellitus-related foot ulceration is very common. Several classification systems for diabetic foot ulcers have been proposed. The present study was intended to assess the role of Wagner wound classification in predicting the outcome of diabetic foot ulcer and also know the grade of Wagner’s classification to which majority of diabetic foot ulcer patients.Methods: This present one year cross sectional study was carried out at the Department of General Surgery. A total of 100 patients with diabetic foot ulcer who presented during the study period were included. The diabetic foot ulcers were graded according to the Wagner’s classification. The relative risk of amputation in different grades of diabetic foot ulcer based on Wagner classification was determined.Results: In this study majority of the patients were males (79%) and the male to female ratio was 3.76:1. The mean age was noted as 55.8±10.45 years. Majority of the patients had duration of ulcer less than one month (88%). Surrounding skin was inflamed in 60% of the patients, necrosis was present in 40% and slough was noted in 98% while 44% of the patients had necrotic tissue. Based on Wagner’s Classification, most of the patients (48%) had Grade II diabetic foot ulcers. With regard to management, in 44% of the patients’ debridement was done and 36% of the patients had disarticulation or amputation in 36%. Of the 48 patients with grade II ulcer, 79% of the patients had healing without amputation. Of the 58 patients with grade I and II diabetic foot ulcers, 82.76% had healing without amputation compared to 17.24% of the patients who needed amputation. Patients with Grade III, IV and V had 3.59 times higher risk of amputation compared to patients with grade I and II. (p<0.001; 95% CI- 1.95 to 6.62).Conclusions: Grading of diabetic foot ulcer based on Wagner’s classification affects and predicts the outcome and the risk of amputation increases with increasing grade. Most of the patients admitted for diabetic foot ulcers in our hospital belonged to Wagner’s grade II (48%).


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mojtaba Anvarinejad ◽  
Gholamreza Pouladfar ◽  
Aziz Japoni ◽  
Shahram Bolandparvaz ◽  
Zeinab Satiary ◽  
...  

Background. Diabetic foot infections (DFIs) are a major public health issue and identification of the microorganisms causing such polymicrobial infections is useful to find out appropriate antibiotic therapy. Meanwhile, many reports have shown antibiotic resistance rising dramatically. In the present study, we sought to determine the prevalence of microorganisms detected on culture in complicated DFIs in hospitalized patients and their antibiotic sensitivity profiles.Methods. A cross-sectional study was conducted for a period of 24 months from 2012 to 2014 in Nemazee Hospital, Shiraz, Iran. The demographic and clinical features of the patients were obtained. Antimicrobial susceptibility testing to different agents was carried out using the disc diffusion method.Results. During this period, 122 aerobic microorganisms were isolated from DFIs. Among Gram-positive and Gram-negative bacteria,Staphylococcusspp. andE. coliwere the most frequent organisms isolated, respectively. Of the isolates, 91% were multidrug while 78% ofS. aureusisolates were methicillin resistant. 53% of Gram-negative bacteria were positive for extended-spectrumβ-lactamase.Conclusion. Given the involvement of different microorganisms and emergence of multidrug resistant strains, clinicians are advised to consider culture before initiation of empirical therapy.


2020 ◽  
Vol 10 (1) ◽  
pp. 91-101
Author(s):  
Cynthia Eka Fayuning Tjomiadi

AbstrakLATAR BELAKANG: Tingginya kejadian ulkus kaki diabetik di dunia terutama di Indonesia membawa pertanyaan besar, apa faktor yang menyebabkan fenomena tersebut. Hasil penelitian terbaru menunjukan adanya peranan persepsi terhadap penyakit dapat memoengaruhi signifikansi kejadian ulkus kaki diabetik.TUJUAN: Penelitian ini bertujuan untuk mendeskripsikan bagaimana persepsi penyakit terhadap ulkuk kaki diabetik di Banjarmasin, Kalimantan Selatan, Indonesia.METODE: Studi deskriptif dengan metode cross-sectional dilakukan di poliklinik kaki diabetik Rumah Sakit Umum Daerah Ulin Banjarmasin. Persepsi penyakit diukur dengan menggunakan Brief Illness Perceptions Questionnaire (BIPQ).HASIL: Domain dari perspsi penyakit telah berhasil dideskripsikan. Ulkus kaki diabetik dianggap sebagai penyakit kronis yang akan memberikan dampak besar terhadap kehidupan sehari-hari dan sulit di identifikasi. Kurangnya pemahaman tentang ulkus kaki diabetik juga ditemukan dari hasil penelitian iniKata Kunci: Ulkus Kaki Diabetik, Persepsi Penyakit Perception of Patient's Disease with Diabetic Foot UlcersIn Banjarmasin, South Kalimantan, IndonesiaAbstractBACKGROUND The urgency of the high incidence of Diabetic Foot Ulcer (DFU) around the world especially in Indonesia bring a big question, what are the factor that causes this phenomenon. Evidence from the recent research showed the role of illness perception and its significance on DFU.OBJECTIVE This study aims to describe what are the illness perceptions of patients with DFU in Banjarmasin, South Borneo, Indonesia.METHODS A descriptive cross-sectional study design was used. The DFU patients who required routine follow up in podiatry outpatient department of Ulin General Hospital in Banjarmasin were recruited. The illness perceptions were measured by using Brief Illness Perceptions Questionnaire (BIPQ).RESULTS The mean of the illness perceptions domain has been described. DFU considered as chronic disease which bring a major impact on daily life, difficult to identify. The lack of understanding on DFU also has been endorsed by the participants in this study. Keywords: Diabetic Foot Ulcer, Perception of Disease


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