Bacterial and clinical profile of diabetic foot patients

Background and Objective: Diabetic foot ulceration is a multifactorial process involving various intrinsic complications of diabetes mellitus which cause injury to the foot at risk. The diabetic foot ulcer infections are polymicrobial in nature. Failure to recognize and control of the infectious process may have devastating consequences of limb amputation, sepsis, and mortality. Hence, the study was undertaken to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques and the antimicrobial sensitivity pattern of the isolates. Materials and Methods: A total of 100 patients with diabetic foot ulcer of Wagner′s grade I and above were included in the study. Pus and tissue biopsy were collected for bacteriological study. The specimen was processed in the microbiology laboratory for Gram stain, aerobic culture, and anaerobic culture. The organisms isolated were identified by standard procedures and antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. Results: A total of 187 organisms were isolated, with an average of 1.87 organisms per specimen. Pseudomonas sp, 36 (21.9%), was the most common aerobic organisms isolated followed by Klebsiella sp, 32 (19.4%). Anaerobic organisms isolated were 22 (11.77%). The predominant anaerobic organisms isolated were Peptostreptococcus sp, 10 (45.5%). All the aerobic Gram-negative organisms were sensitive to imipenem (100%). Gram-positive organism was 100% sensitive to vancomycin. Methicillin resistant staphylococcus aureus (MRSA) was seen in 66.7%. All the anaerobes were sensitive to metronidazole, clindamycin, cefoxitin, and penicillin G. Conclusion: Pseudomonas was the most common organism isolated in our study. MRSA was seen in 66.7% of the isolate.