Data on bacterial profile and antimicrobial susceptibility pattern ‘critical’ for management of diabetic foot ulcers

A new study has assessed the bacterial profile of people with diabetic foot ulcers and their antimicrobial susceptibility pattern within the setting of a tertiary care hospital.

The research, carried out in Pakistan, involved 200 people over a sixth-month period, with ages ranging from 24 to 92 years (mean age 58.12 years).

The team collected data including type and duration of diabetes, glycaemic control, presence of retinopathy, nephropathy, neuropathy, peripheral vascular disease, ulcer size and outcomes.

The mean HbA1c level was 9.33 per cent, while the mean duration of diabetes was 12.3 years.

Pus or discharges from the ulcer base and debrided necrotic tissue were obtained. Gram staining was performed on the samples which were isolated on chocolate agar and MacConkey agar. Incubation was done for 24 hours at a temperature of 37°C, and isolates were identified using standard bacteriological methods. The Kirby-Bauer testing method was used to assess antibiotic susceptibility.

The team reported the following results: “In total, 96 (66.2%) isolates were gram-negative bacteria, while 49 (33.8%) were gram-positive bacteria. Among the gram-negative bacteria, Pseudomonasspp. was the most reported (15.9%), whereas methicillin-resistant Staphylococcus aureus was the most reported gram-positive bacteria (20.7%).

“Amikacin was found to be the most effective (45%) in treating diabetic foot ulcers, followed by tineam and meropenem being equally effective at a susceptibility of 44%. The highest resistance of the microbes was to the drug trimethoprim (44.5%).”

The team, made up of researchers from Northwest General Hospital and Research Center in Peshawar and Gomal Medical College in Peshawar, concluded: “The pathogens causing diabetic foot ulcers show sensitivity to many of the routinely used medications. However, resistance is being developed to some of the antibiotics such as trimethoprim.

“Therefore, the culture of the specimen to identify the causative agent and adequate knowledge of the susceptibility pattern are critical for the appropriate management of diabetic foot ulcers.”

The study, entitled Microbial Profile and Antimicrobial Susceptibility Pattern in Diabetic Foot Ulcer Patients Attending a Tertiary Care Hospital, can be viewed here.

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