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. 2018 Apr-Jun;49(2):401-406.
doi: 10.1016/j.bjm.2017.09.003. Epub 2017 Nov 1.

Epidemiology of diabetic foot infections in a reference tertiary hospital in India

Sanjith Saseedharan  1 , Manisa Sahu  2 , Roonam Chaddha  3 , Edwin Pathrose  3 , Arun Bal  4 , Pallavi Bhalekar  4 , Priyadharshini Sekar  5 , Padma Krishnan  5
Affiliations

Epidemiology of diabetic foot infections in a reference tertiary hospital in India

Sanjith Saseedharan et al. Braz J Microbiol. 2018 Apr-Jun.

Abstract

Introduction: The present study attempts to examine the microbial profile and antibiotic susceptibility of diabetic foot infections in the intensive care unit of a tertiary referral centre for diabetic foot. As part of the study, we also attempted to find the prevalence of blaNDM-like gene among carbapenem-resistant gram negative infections.

Methodology: A prospective study of 261 patients with diabetic foot infections was performed during the period between January 2014 and June 2014.

Results: A total of 289 isolates were obtained from 178 tissue samples from 261 patients, 156 (59.7%) males and 105 (40.2%) females, with a mean age of 58 years (-15 years), having diabetic foot infection. No growth was seen in thirty eight (17.6%) tissue samples. Out of the total samples, 44.3% were monomicrobial and 55.7% were polymicrobial. Gram negative pathogens were predominant (58.5%). Seven of the total isolates were fungal; 0.7% showed pure fungal growth and 1.7% were mixed, grown along with some bacteria. The most frequently isolated bacteria were Staphylococcus aureus (26.9%), followed by Pseudomonas aeruginosa (20.9%). Of the 58.5% gram negative pathogens, 16.5% were Enterobacteriaceae resistant to carbapenems. Among these isolates, 4 (25%) were positive for blaNDM-like gene. Among the rest, 18.6% were carbapenem-resistant Pseudomonas, among which 4 (36.3%) were blaNDM. Among the Staphylococci, 23.7% were methicillin-resistant Staphylococcus aureus.

Conclusions: Our results support the recent view that gram negative organisms, depending on the geographical location, may be predominant in DFIs. There is an increase in multidrug-resistant pathogens, especially carbapenem resistance and this is creeping rapidly. We need to be more judicious while using empiric antibiotics.

Keywords: Diabetic foot infection; MRSA; blaNDM.

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Figures

Fig. 1
Fig. 1
Susceptibility pattern of Staphylococcus aureus.
Fig. 2
Fig. 2
Susceptibility pattern of E. coli.
Fig. 3
Fig. 3
Susceptibility pattern of Klebsiella pneumoniae.
Fig. 4
Fig. 4
Susceptibility pattern of P. aeruginosa.
See this image and copyright information in PMC

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