Aamir Azizul Hasan, Nasir Ahmed, Jadoon Mohammad Zahid, Mehmood Khalid, Ali Sobia Sabir
Department of Diabetes, Endocrinology and Metabolic Diseases, Postgraduate Medical Institute, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2011 Jan-Mar;23(1):58-62.
Diabetic foot is a common complication of diabetes world over. We conducted this study to determine common microbiological pathogens in Diabetic Foot Infections (DFI) at a tertiary care hospital and their management.
In this observational study deep wound swabs of all admitted diabetic patients were taken, pathogens isolated, antibiotic used and its response depending on complete resolution of symptoms and biochemical markers were recorded. Data were analysed on SPSS-11.
A total of 114 cases were recorded. Sixty-eight (59%) cases had ulcers on forefoot, 28 (25%) mid-foot and 18 (16%) hind-foot. One hundred and four pathogens were isolated from wound swabs after debridement. Commonest pathogen isolated was Staphylococcus aureus (52, 46%) followed by E. coli (11, 10%), MRSA was found in 10 (9%) cases, streptococcus in 6 (5%) and pseudomonas in 5 (4%) cases. Polymicrobial infection was also seen in a few cases. Surgical intervention included superficial debridement in 88 (77%) cases, toe amputation/forefoot amputation in 19 (17%) cases, and below/above knee (major) amputation in 7 (6%) cases. Commonest antibiotic used was Cefoperazone/Sulbactam in 43 (38%) cases, alone or in combination, followed by Ceftraixone 36 (33%) cases. Linezolid was used for MRSA. Ninety-four (82%) patients responded to treatment and- were recorded as 'cured'.
Diabetic Foot ulcers often present with serious foot infections. Commonest pathogens are Staph. aureus, E. coli, Pseudomonas spp. and MRSA. Treatment was effective with Cefoperazone/Sulbactam and Ceftraixone. MRSA was treated successfully with Linezolid.
糖尿病足是全球糖尿病常见的并发症。我们开展这项研究以确定一家三级护理医院中糖尿病足感染（DFI）的常见微生物病原体及其治疗方法。
在这项观察性研究中，采集了所有入院糖尿病患者的深部伤口拭子，分离出病原体，记录使用的抗生素及其根据症状完全缓解和生化指标的反应。数据在SPSS - 11上进行分析。
共记录了114例病例。68例（59%）患者前足有溃疡，28例（25%）中足有溃疡，18例（16%）后足有溃疡。清创后从伤口拭子中分离出104种病原体。分离出的最常见病原体是金黄色葡萄球菌（52株，46%），其次是大肠杆菌（11株，10%），10例（9%）患者检出耐甲氧西林金黄色葡萄球菌（MRSA），6例（5%）为链球菌，5例（4%）为假单胞菌。少数病例还存在混合感染。手术干预包括88例（77%）进行浅表清创，19例（17%）进行趾截肢/前足截肢，7例（6%）进行膝下/膝上（大）截肢。最常用的抗生素是头孢哌酮/舒巴坦，43例（38%）单独或联合使用，其次是头孢曲松36例（33%）。利奈唑胺用于治疗MRSA。94例（82%）患者对治疗有反应并被记录为“治愈”。
糖尿病足溃疡常伴有严重的足部感染。最常见的病原体是金黄色葡萄球菌、大肠杆菌、假单胞菌属和MRSA。头孢哌酮/舒巴坦和头孢曲松治疗有效。利奈唑胺成功治疗了MRSA。
