Commonly associated aerobic microbial pathogens and their antibiotic susceptibility profile in diabetic foot ulcers in tertiary care centre in Western Maharashtra

Indian J Med Microbiol. 2024 Mar-Apr:48:100538. doi: 10.1016/j.ijmmb.2024.100538. Epub 2024 Feb 16.

Abstract

Purpose: Diabetes mellitus (DM-II) is a metabolic disorder either due to reduced insulin production or reduced insulin sensitivity. Diabetic foot ulcer (DFU) is one of the most devastating complications of DM-II. This study was performed to assess commonly isolated micro-organisms and their anti-microbial sensitivity pattern in diabetic foot ulcers in a tertiary care centre in Western Maharashtra.

Methods: Adult patients with a known case of DM-II with foot lesions, suspected to be a Diabetic Foot Infections (DFIs) at the tertiary care hospital from Aug 2022 to Sept 2022 were included in the study. After obtaining informed written consent, pus sample was collected with sterile swab from lesion's base and submitted to Microbiology Laboratory for aerobic culture and sensitivity.

Results: Out of 56 enrolled patients, 47 (83.9%) patients tested positive for bacteriological growth and there was 'no growth' in 9 (16.07%) patients at the end of 48 h of aerobic incubation. There was male preponderance and patients were in age group of 35-85 years. The most commonly isolated micro-organisms were P. aeruginosa (17.8%), followed by S. aureus (14.2%), K. pneumonia and P. mirabilis (12.5% each). The resistance markers observed was ESBL producer, AmpC producer, MBL producer, Methicillin resistance and Inducible Clindamycin Resistance (ICR).

Conclusion: Due to the injudicious use of antibiotics, antibiotic resistance has been increased in all types of soft tissue infections. The empirical formula for the treatment of DFIs should be decided for given geographical reasons according to antimicrobial susceptibility profile from particular geographical area or health care institute.

Keywords: Antimicrobial resistance; Diabetic foot infections; Diabetic foot ulcers.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Bacteria, Aerobic / drug effects
  • Bacteria, Aerobic / isolation & purification
  • Diabetic Foot* / drug therapy
  • Diabetic Foot* / microbiology
  • Female
  • Humans
  • India
  • Klebsiella pneumoniae / drug effects
  • Male
  • Microbial Sensitivity Tests*
  • Middle Aged
  • Pseudomonas aeruginosa / drug effects
  • Staphylococcus aureus / drug effects
  • Tertiary Care Centers*

Substances

  • Anti-Bacterial Agents