DIABETIC FOOT INFECTIONS AND THEIR MANAGEMENT IN A TERTIARY CARE HOSPITAL
Abstract
Background: Diabetic foot is a common complication of diabetes world over. We conducted this studyto determine common microbiological pathogens in Diabetic Foot Infections (DFI) at a tertiary care
hospital and their management. Methods: In this observational study deep wound swabs of all admitted
diabetic patients were taken, pathogens isolated, antibiotic used and its response depending on complete
resolution of symptoms and biochemical markers were recorded. Data were analysed on SPSS-11.
Results: A total of 114 cases were recorded. Sixty-eight (59%) cases had ulcers on forefoot, 28 (25%)
mid-foot and 18 (16%) hind-foot. One hundred and four pathogens were isolated from wound swabs
after debridement. Commonest pathogen isolated was Staphylococcus aureus (52, 46%) followed by E.
coli (11, 10%), MRSA was found in 10 (9%) cases, streptococcus in 6 (5%) and pseudomonas in 5 (4%)
cases. Polymicrobial infection was also seen in a few cases. Surgical intervention included superficial
debridement in 88 (77%) cases, toe amputation/forefoot amputation in 19 (17%) cases, and below/above
knee (major) amputation in 7 (6%) cases. Commonest antibiotic used was Cefoperazone/Sulbactam in
43 (38%) cases, alone or in combination, followed by Ceftraixone 36 (33%) cases. Linezolid was used
for MRSA. Ninety-four (82%) patients responded to treatment and were recorded as '˜cured'.
Conclusion: Diabetic Foot ulcers often present with serious foot infections. Commonest pathogens are
Staph. aureus, E. coli, Pseudomonas spp. and MRSA. Treatment was effective with
Cefoperazone/Sulbactam and Ceftraixone. MRSA was treated successfully with Linezolid.
Keywords: Diabetic foot, Diabetic foot infections (DFI), Staph. Aureus, E. coli, MRSA, antibiotics
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