Diabetic foot ulcers; common isolated pathogens and in vitro antimicrobial activity

ABSTRACT

To determine common pathogens isolated in diabetic foot ulcers and in vitro antimicrobial activity. Muhammad Medical College Hospital, Mirpurkhas and Liaquat University of Medical and Health Sciences Jamshoro. 1st November 2007 to 30th June 2008. Pus samples for bacterial culture were collected from 60 patients admitted with diabetic foot infections. Anti-microbial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommended by the National Committee for Clinical Laboratory Standards. Microbroth dilution test was arranged for susceptibility of anaerobic organisms to metronidazole and amoxicillin/clavulanate. A vancomycin screen agar [6 micro g/ml] was used to detect vancomycin intermediate isolates of Staphylococci. Clinical grading and bacteriological study of 60 patients revealed, 44 [73.33%] patients had gram-negative organisms, and Pseudomonas aeruginosa was the most common. While 16 [26.66%] patients had gram-positive organisms and Staphylococci was the most common organism. Infection with anaerobes was observed in one patient [1.66%]. Both gram-positive and -negative organisms were seen in 8 [13.33%]. Pseudomonas aeruginosa and S.aureus exhibited a high frequency of resistance to the antibiotics tested. All the isolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin. Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis and Proteus were the most common causes of diabetic foot infections in this study. And the rate of antibiotic resistance was 66.66% among the isolates. All the isolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin