[Diabetic foot infections: a preliminary report]

Abstract

Foot infection is a common cause of hospitalization for diabetic patients. Our study aimed to analyze patients' age, sex, the primary sites of infection, presenting features, outcome, bacteriologic studies and their clinical significance in diabetic foot infections. The age of our diabetic patients with foot infections ranged from 43 to 82 years, with a mean of 62.5 years; fifty-two of them were males and twenty-eight were females. The male to female ratio was 1.9:1, but there was no statistically significant difference between the sexes (p greater than 0.05). The commonest age group was the seventh decade of life (47.5%), followed by the sixth decade (32.5%). The commonest primary site of infection was the toes (53.8%), followed by foot area other than toe (25%) and the leg area was the least frequent (21.2%). Cellulitis combined with other foot lesions presented in 78.8% of these patients, foot ulcers in 75% of them, gangrenous change in 68%, necrotizing cellulitis or fasciitis in 16.3%, abscess formation in 12.5% and osteomyelitis in 7.5%. The legs were amputated in 53 patients (66.3%), usually below the knee (in 47.5%). We found that patients with a long history of DM had statistically significantly higher rate of amputation (p less than 0.01) than patients with only a brief history. Bacterial cultures from the infected foot lesions yielded numerous organisms in 58.8% of cases and a single organism in 31.1% of cases. Proteus mirabilis was the commonest organism isolated, followed by E. coli, Pseudomonas aeruginosa. The commonest month of the onset of diabetic foot infection was January, followed by February.