Title: Multidrug Resistant Organisms in Diabetic Foot Ulcers-Analysis of Risk Factors and Clinical Outcome
Authors: Ragesh Kalikkottu Valappil, Sheena Krishnan, Sarada Devi Karunakaran Lalitha Bai
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.144
Abstract
Background: Diabetes Mellitus is one of the most important health problem in the world. Foot infection is a common sequelae of diabetes, which once established progressively worsens and become more difficult to treat and is associated with substantial morbidity and mortality. Multidrug resistance organism infection is extremely common in hospitalized patients with diabetic foot ulcers.
Aim of Study: To detect multidrug resistant organism among isolates from diabetic foot ulcers, identification of risk factors and clinical outcome.
Materials and Methods: A prospective study conducted in 150 patients admitted in Department of Surgery in a tertiary care center in south India.
Results: In this study 76.6% of patients were infected with multidrug resistant organisms.
Among the risk factors analyzed, ulcer duration more than 2 weeks showed significant association with this infections. 68% of patients showed good response to treatment and 24% underwent amputations.
Keywords: Diabetic Foot Ulcer, Multidrug Resistant Organisms, Foot Ulcers.
References
1. C. Anandi, D. Alaguraja, V. Natarajan: Bacteriology of Diabetic Foot Lesions, Indian Journal of Microbiology, (2004) 22(3): 175-178.
2. Ravisekhar Gadepalli, Benu Dhawan, Vishnubhatla Sreenivas: A Clinico-microbiological Study of Diabetic Foot Ulcers in an Indian Tertiary Care Hospital: Diabetes Care, Volume 29(8), Aug. 2006.
3. David G. Armstrong, Lawrence A. Lavery, Lawrence B. Harkless Validation of a Diabetic Wound Classification System: Diabetes Care, Volume 21, No. 5, May 1998.
4. The Diabetic Foot, Second Edition, edited by Aristidis Veves, John M. Giurini, Frank W. LoGerfo, 2006.
5. David G Amstrong and Lawrence A Lavery: Diabetic foot ulcer, prevention, diagnosis and classification : J American Academy of Family Physician March 15 1998 March 15, 57(6) : p 1325- 1332.
6. R. Sasikala, R Latha et al. Surveillance on multidrug resistant organisms (MDRO) associated with diabetic foot ulcer in Pondicherry. The internet Journal of Microbiology 2008 vol 5 No.1.
7. Seyed Mohd Alavi, Azar D et al. Bacteriologic study of diabetic foot ulcer. Pak J Med Science 2007. Vol 23 No. 5 681-84
8. Ekta Bansal, Ashish Garg, Sanjeev Bhatia, AK Attri, Jagadish Chander, Spectrum of Microbiological Flora in Diabetic Foot Ulcer: Indian Journal of pathology and microbiology-51 (2). April –June 2008.
9. Andrew J. M. Boulton and Miami FL et al: The diabetic foot: Grand overview, epidemiology and pathogenesis, Diabetes/ metabolism research and reviews Diabetes Metab Res Rev 2008; 24(Suppl 1): S3–S6.
10. Mohammad Zubair, Abida Malik, Jamal Ahmad et al: Clinico-bacteriology and risk factors for the diabetic foot infection with multidrug resistant microorganisms in north India Biology and Medicine, Vol 2 (4): 22-34, 2010.
11. E M Shanker, V Mohan et al. :Bacterial aetiology of diabetic foot infection in South India, European Journal of Internal Medicine Vol 16 Issue 8 Dec 2005 Page 567-70.
12. J.Vimalin Hena, Lali Growther et al. Studies on Bacterial infections on diabetic foot ulcer. African Journal of Clinical and Experimental Microbiology, Sept. 2010 ISBN Vol 11(3).
13. P.Ramakant, A.K.Verma, R.Misraetal: Changing microbiological profile of pathogenic bacteria in diabetic foot infections: time for a rethink on which empirical therapy to choose? Diabetologia (2011) 54:58–64.
14. Ozer B, Kalaci A., Semerci E et al: Infections and aerobic bacterial pathogens in diabetic foot: African Journal of Microbiology Research Vol. 4(20), pp. 2153-2160, 18 October, 2010.
15. Shobha K.L , Ramachandra L, Rao G , Majumder S, Rao S P Extended Spectrum Beta-Lactamases (ESBL) In Gram Negative Bacilli at a tertiary Care Hos-pital: Journal of Clinical and Diagnostic Research. 2009 Feb ;(3)1307-1312.
16. Motta R.N., Oliveira M.M., Magalhães P.S.F., Dias A.M. et al Plasmid-Mediated Extended-Spectrum b-lactamase-Produ-cing Strains of Enterobacteriaceae Isolated from Diabetes Foot Infections in a Braz-ilian Diabetic Center, Center of Diabetes and Hypertension: BJID 2003; 7 (April).
17. A Varaiya, J Dogra, M Kulkarni, P Bhalekar et al. Extended spectrum beta lactamase (ESBL) producing Escherichia coli and klebsiella pneumoniae in diabetic foot infection, Indian journal of medical microbiology 2008, Vol: 26, Issue: 3 p : 281-282.
18. Shazi Shakil, Asad U Khan et al. :Infected foot ulcers in male and female diabetic patients: a clinico-bioinformative study: Annals of Clinical Microbiology and Antimicrobials 2010, 9:2.