ANTIMICROBIAL SUSCEPTIBILITY OF THE MICROORGANISMS ISOLATED FROM DIABETIC FOOT INFECTION - OBSERVED IN TERTIARY CARE HOSPITAL

Talukder MRH*, Alam MNA, Anwar R., Alam H., Ullah M. E. and Haque A. A.

ABSTRACT

Background: Diabetic foot infections (DFIs) are major public health problems and knowledge of microbes causing infections are helpful to determine proper antibiotic therapy. Aims: The aim was to investigate the antimicrobial susceptibility pattern of microbes in DFIs. Methods: An observational study was conducted for a period of 6 months in the Department of Surgery and Microbiology BIRDEM General Hospital. During this period, 108 patients having DFIs admitted in the general surgery wards were tracked from the hospital data management system. Samples (pus/wound swabs) were examined as Gram‑stained smear and cultured aerobically on blood agar and MacConkey agar media. Antimicrobial susceptibility test was performed by disc diffusion techniques according to Clinical and Laboratory Standards Institute guidelines. Results: Of the 108 specimens of the diabetic foot, culture showed monomicrobial growth in 50% (54/108) and polymicrobial growth in 37 %( 40/108). Prevalence of Gram-negative organisms (80.1%, 109/136) was found to be more than Gram‑positive organisms (18.4%, 25/136). Klebsiella species was the most frequent pathogen (26.4% 36/136). Colistin, nitelmycin, piparcillin and tazobactum were the most active against gram-negative microorganisms while gentamicin and vancomycin were the most active agents against gram-positive microorganisms. Conclusion: Prevalence showed Gram‑negative bacteria was more than Gram-positive bacteria in diabetic foot ulcers. The data may help develop and update local clinical guidelines regarding antibiotic therapy for diabetic foot infections. Lack of detection facilities for anaerobic bacteria is a limitation of this study.

Keywords: Antimicrobial susceptibility, Diabetic foot infection (DFI).