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. 2019 Jan;26(1):107-114.
doi: 10.21315/mjms2019.26.1.10. Epub 2019 Feb 28.

The Significant Association between Polymicrobial Diabetic Foot Infection and Its Severity and Outcomes

Sharifah Aisyah Syed Hitam  1   2 , Siti Asma' Hassan  1   2 , Nurahan Maning  3
Affiliations

The Significant Association between Polymicrobial Diabetic Foot Infection and Its Severity and Outcomes

Sharifah Aisyah Syed Hitam et al. Malays J Med Sci. 2019 Jan.

Abstract

Background: Foot infection is a major complication of diabetes mellitus (DM) and its agents are usually polymicrobial. This study aims to describe the agent and determine the association between polymicrobial infections and the severity of diabetic foot infections (DFI) and their outcomes.

Methods: This retrospective cohort study was conducted during one year and it involved 104 patients. Their records were reviewed and assessed. The causative agents and its sensitivity pattern were noted. The results were presented as descriptive statistic and analysed.

Results: A total of 133 microorganisms were isolated with 1.28 microorganisms per lesion. The microorganism isolated were 62% (n = 83) GN (Gram-negative) and 38% (n = 50) GP (Gram-positive). GN microorganisms include Pseudomonas spp (28%), Proteus spp (11%), Klebsiella spp (8%) and E. coli (4%). Staphylococcus aureus (54%) was predominant among GP, followed by Group B Streptococci (26%) and Enterococcus spp (6%). Thirty patients (28.8%) had polymicrobial infections. The association between the quantity of microorganisms and severity of DFI was significant. Among severe DFI cases, 77.8% with polymicrobial microorganisms underwent amputation compared to 33.3% with monomicrobial infection.

Conclusion: GN microorganisms were predominantly isolated from DFIs and remained sensitive to widely used agents. Polymicrobial infections were associated with DFI severity.

Keywords: diabetes mellitus; diabetic foot infection; microorganisms; polymicrobial infection; severity of infection.

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Conflict of interest statement

Conflict of Interest None.

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