Frequency of Different Complication Associated with Diabetic Foot and its Bacteriology

Authors

  • Irfan Ahmad Nishtar Hospital, Multan, Pakistan
  • Abdul Manan Nishtar Hospital, Multan, Pakistan
  • Muhammad Usman Nishtar Hospital, Multan, Pakistan
  • Tania Mahar Nishtar Hospital, Multan, Pakistan
  • Muhammad Waseem Abbas Nishtar Hospital, Multan, Pakistan

DOI:

https://doi.org/10.61581/mjsp.v2i2.67

Keywords:

Bacteriological, Diabetic foot, Pakistan, Comlications

Abstract

Objective: To assesses the frequency of postoperative complication, microbial isolates of patients with diabetic foot infections and their antibiotic susceptibility pattern.

Methodology:  This cross sectional study was carried out on 150 diabetic patients with infected diabetic foot. Patients were admitted for surgical intervention. Major variables of study were post-operative complications includes wound infection, stump dehiscence, septicemia and gas gangrene. micro-organisms isolated, type of antibiotic. SPSS version 23 was used for data analysis.

Results: Majority of the patients between 40-50 years. Most of the patients 69.3% were males. The mean hospital stay was 14.41±2.92 days. Majority of the patients, 79.3% were >7 days of hospital stay. Wound infection was the most common post-operative complication i.e. 48.7%. The most common organism culture, 39.3%, was vulgaris. While, frequently used antibiotics was ciprofloxacin i.e. 62.7%. Debridement & non-stick dressingwas the most common surgical management of diabetic foot i.e. 36.0%.

Conclusion: Wound infection and gas gangrene are the main post operative complications of diabetic foot, Valgaris and Staphylococcus aureus were main responsible micro-organisms. Among antibiotics therapy Amikacin and vancomycine can cover gram positive and gram negative more effectively.

Downloads

Download data is not yet available.

References

1. Lynar SA, Robinson CH, Boutlis CS, Commons RJ. Risk factors for mortality in patients with diabetic foot infections: a prospective cohort study. Intern Med J. 2019 Jul;49(7):867-873. doi: 10.1111/imj.14184.

2. Chen SY, Giurini JM, Karchmer AW. Invasive Systemic Infection After Hospital Treatment for Diabetic Foot Ulcer: Risk of Occurrence and Effect on Survival. Clin Infect Dis. 2017;64 (3):326-334.

3. Nelson A, Wright-Hughes A, Backhouse MR, et al. CODIFI (Concordance in Diabetic Foot Ulcer Infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England. BMJ Open. 2018;8 (1):e019437.

4. Snyder RJ, Frykberg RG, Rogers LC, Applewhite AJ, Bell D, Bohn G. The management of diabetic foot ulcers through optimal off-loading: building consensus guidelines and practical recommendations to improve outcomes. J Am Podiatr Med Assoc. 2014;104(6):555-67.

5. Rao N, Lipsky BA. Optimising antimicrobial therapy in diabetic foot infections. Drugs 2007; 67:195–214.

6. Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of Diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27:1047–1053.

7. Citron DM, Goldstein EJC, Merriam CV, Lipsky BA, Abramson MA. Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. J Clin Microbiol 2007; 45:2819–2828.

8. Hwang YG, Lee JW, Park KH, Han SH. Allogeneic keratinocyte for intractable chronic diabetic foot ulcers: A prospective observational study. Int Wound J. 2019;16(2):486-491. doi: 10.1111/iwj.13061.

9. Lebowitz D, Gariani K, Kressmann B, Dach EV, Huttner B, Bartolone P, Lê N, Mohamad M, Lipsky BA, Uçkay I. Are antibiotic-resistant pathogens more common in subsequent episodes of diabetic foot infection? Int J Infect Dis. 2017 Jun;59:61-64. doi: 10.1016/j.ijid.2017.04.012.

10. Pouget C, Dunyach-Remy C, Pantel A, Schuldiner S, Sotto A, Lavigne JP. Biofilms in Diabetic Foot Ulcers: Significance and Clinical Relevance. Microorganisms. 2020 Oct 14;8(10):1580. doi: 10.3390/microorganisms8101580.

11. Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJM. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care 2001; 24:84–88.

12. 0 Sopata M, Ciupin´ ska M, G"owacka A, Muszyn´ ski Z, Tomaszewska E, Piotrowicz K. Microbial flora in pre-treated pacjento’wParata antyspetycznym Octenisept and hydrocolloid dressings. Wound Granuflex 2006; 3:59–65.

13. Rao N, Lipsky BA. Optimising antimicrobial therapy in diabetic foot infections. Drugs 2007; 67:195–214.

14. Raja NS. Microbiology of diabetic foot infections in a teaching hospital in Malaysia: a retrospective study of 194 cases. J Microbiol Immunol Infect 2007; 40:39–44.

15. Wright-Pascoe R, Roye-Green K, Bodonaik N. The medical management of diabetes mellitus with particular reference to the lower extremity: the Jamaican experience. West Indian Med J 2001; 50 (Suppl 1): 46–49.

16. Loan CA, Legout L, Assal M, Rohner P, Hoffmeyer P, Bernard L. Severe Streptococcus agalactiae infection of the diabetic foot: a deleterious role of Streptococcus agalactiae? Presse Med 2005; 34:491–494.

17. Bansal E, Garg A, Bhatia S, Attri A, Chander J. Spectrum of microbial flora in diabetic foot ulcers. Indian J Pathol Microbiol 2008; 51:204–208.

18. Shankar EM, Mohan V, Premalatha G, Srinivasan RS, Usha AR. Bacterial etiology of diabetic foot infections in South India. Eur J Intern Med 2005; 16:567–570.

19. Gadepalli R, Dhawan B, Sreenivas V, Kapil A, Ammini AC, Chaudhry R. A clinico-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital. Diabetes Care 2006; 29:1727–1732.

20. Joseph WS, Lipsky BA. Medical therapy of diabetic foot infections. J Am Podiatr Med Assoc 2010; 100:395–400.

21. Shakil S, Khan AU. Infected foot ulcers in male and female diabetic patients: a clinico-bioinformative study. Ann Clin Microbiol Antimicrob 2010; 9:2.

Downloads

Published

13-10-2021

How to Cite

Frequency of Different Complication Associated with Diabetic Foot and its Bacteriology. (2021). Medical Journal of South Punjab, 2(2). https://doi.org/10.61581/mjsp.v2i2.67