Unachukwu C N, Obunge O K, Odia O J
Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Niger J Med. 2005 Apr-Jun;14(2):173-6. doi: 10.4314/njm.v14i2.37176.
Diabetic foot ulcer and/or gangrene is a common cause of morbidity and mortality in Nigeria. The lesions are usually infected and early treatment of the infection will reduce the associated problems. The study was carried out to determine the common bacteriological flora of diabetic foot ulcers in Port Harcourt. The antimicrobial sensitivity pattern of the isolates was determined to enhance possible empirical treatment.
Deep wound swabs were collected from 60 consecutive diabetic patients admitted with foot ulcers and/or gangrene into the medical wards of the University of Port Harcourt Teaching Hospital from January 2001 to April 2002. The bacteriological isolation and antimicrobial sensitivity tests of the isolates was carried out by standard microbiological methods.
Aerobes and anaerobes constituted 95.4% and 4.6% of the total bacterial isolates respectively. Staphylococcus aureus was the commonest bacterial isolate; it was cultured from 32 (56.1%) of infected patients and constituted 24.4% of the total isolate. The mean bacterial isolate per patient infected was 2.3. The aerobic isolates showed significant sensitivity to ciprofloxacin (78.4%), pefloxacine (71.2%), ceftazidime (73.6%) and cefuroxime (69.6%). All the anaerobic isolates were sensitive to metronidazole and clindamycin.
Infections of diabetic foot ulcers are usually polymicrobial. From the in vitro antimicrobial susceptibility pattern of the bacterial isolates, diabetic patients presenting with foot ulcers and/or gangrene could be commenced empirically on a combination of clindamycin or metronidazole and either a fluoroquinolone (ciprofloxacin or pefloxacine) or a second or third generation cephalosporin (e.g. cefuroxime or ceftazidime).
糖尿病足溃疡和/或坏疽是尼日利亚发病和死亡的常见原因。这些病变通常会感染，早期治疗感染将减少相关问题。本研究旨在确定哈科特港糖尿病足溃疡的常见细菌菌群。确定分离株的抗菌敏感性模式以加强可能的经验性治疗。
2001年1月至2002年4月，从哈科特港大学教学医院内科病房连续收治的60例患有足溃疡和/或坏疽的糖尿病患者中采集深部伤口拭子。通过标准微生物学方法对分离株进行细菌分离和抗菌敏感性试验。
需氧菌和厌氧菌分别占总细菌分离株的95.4%和4.6%。金黄色葡萄球菌是最常见的细菌分离株；从32例（56.1%）感染患者中培养出该菌，占总分离株的24.4%。每位感染患者的平均细菌分离株数为2.3。需氧菌分离株对环丙沙星（78.4%）、培氟沙星（71.2%）、头孢他啶（73.6%）和头孢呋辛（69.6%）表现出显著敏感性。所有厌氧菌分离株对甲硝唑和克林霉素敏感。
糖尿病足溃疡感染通常是多微生物感染。根据细菌分离株的体外抗菌药敏模式，对于出现足溃疡和/或坏疽的糖尿病患者，可经验性地开始使用克林霉素或甲硝唑与氟喹诺酮类药物（环丙沙星或培氟沙星）或第二代或第三代头孢菌素（如头孢呋辛或头孢他啶）联合治疗。
