[Diabetic foot microbiology through biopsy cultures]. / Microbiología del pie diabético determinada por estudio de biopsia.

OBJECTIVE: To determine the microbiology of diabetic foot wounds, through biopsy cultures. MATERIALS AND METHODS: Patients with diabetic foot and clinical data of infection were recruited consecutively. Cultures were processed for aerobic organisms after mortar homogenization. For cases with multiple isolates, only the two predominant organisms were identified. The bacterial identification was carried out by biochemical procedures. The sensitivity to antibiotics was made by the disk diffusion method. RESULTS: A total of 91 biopsies were studied, 47 from men (52%). There were 102 isolates, 68 being Gram-negative bacilli (67%), with predominance of Escherichia coli (21%). A total of 28 Gram-positive cocci were isolated (28%) and 6 yeasts (6%). Of the 68 Gram-negative bacilli, 24 were resistant to ciprofloxacin (35%). A total of 55 Enterobacteriaceae were isolated, of which 4 (7%) produced extended-spectrum beta-lactamases. There were 8 Staphylococcus aureus isolates, 3 of which (38%) were resistant to methicillin. CONCLUSIONS: In comparison with reports from industrialized countries, we found a higher proportion of Gram-negative and resistant organisms.

[Methicillin-resistant Staphylococcus aureus at a general hospital: epidemiological overview between 2000-2007]. / Staphylococcus aureus resistente a meticilina en un hospital general: panorama epidemiológico del 2000 al 2007.

INTRODUCTION: The high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients is a significant problem due to its associated morbidity and mortality. It is important to know the recent MRSA epidemiology at a General Hospital. OBJECTIVES: To determine the MRSA epidemiology at a Mexican general hospital from 2000 to 2007, in order to know if there is a significant trend in its proportion. MATERIAL AND METHODS: Prevalence survey. The resistance to oxacillin was identified by the Kirby-Bauer's method. The specimens were classified by type and year of isolation. Trend statistics were used for analysis. RESULTS: S. aureus was identified in 1,008 samples, being 301 resistant to oxacillin (30%, 95% Confidence Interval [CI], 25 to 35%). The proportion of MRSA went from 37% (95% CI, 29 to 44%) to 49% (95% CI, 40 to 58%) in the period of study (chi2 for trends = 6.676, p < 0.01). Specimens with the highest proportion of MRSA were blood and sterile liquids with 32% (95% CI, 26 to 39%), secretions with 29% (95% CI, 24 to 33%), and catheters with 21% (95% CI, 16 to 26%). CONCLUSIONS: The proportion of MRSA has increased significantly. This leads to higher costs and morbi-mortality for the hospitalized patients. We require stricter policies to prevent transmission and to control the use of antibiotics.