Jain Sudhir K, Barman Rashmisnata
Department of Surgery, Jorhat Medical College and Hospital, Jorhat, Assam, India.
Department of Microbiology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India.
Indian J Endocrinol Metab. 2017 Sep-Oct;21(5):688-694. doi: 10.4103/ijem.IJEM_546_16.
This study was carried out to determine the bacteriological profile of infected diabetic foot ulcers (DFUs) and the antibiotic resistance pattern from the isolates. An attempt was made to suggest an empiric antibiotic regimen to treat such patients.
Tissue samples were collected from 150 patients between February 2015 and January 2016 with DFUs under aseptic precautions and they were processed as per the Clinical and Laboratory Standards Institute guidelines.
A total of 185 bacterial isolates were obtained from 150 persons with diabetic and with foot ulcers. The age group of these persons ranged from 35 to 80 years and the maximum number of persons with DFUs was in the age group of 60-65 years. Among the isolates, Gram-negative bacilli were isolated in 112/185 (61%) and Gram-positive cocci in 73/185 (39%) cases. The most common isolate was spp. 46 (25%), followed by (20%) and spp. (15%). The antibiotic sensitivity profile of the bacteria was also studied. Among the isolates, 59/112 (53%) of the Gram-negative bacilli were extended spectrum beta-lactamase producers, 19/46 (41%) were methicillin-resistant , and 5/27 (19%) were vancomycin-resistant .
This study showed a preponderance of multidrug-resistant strains among the isolates from the DFUs. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining the drugs for the empirical treatment of diabetic ulcers. Thus, indiscriminate use of antibiotics and chances of subsequent development of antibiotic resistance can also be reduced.
本研究旨在确定感染性糖尿病足溃疡(DFU)的细菌学特征以及分离菌株的抗生素耐药模式。尝试提出一种经验性抗生素治疗方案以治疗此类患者。
在2015年2月至2016年1月期间,在无菌预防措施下从150例患有DFU的患者中采集组织样本,并按照临床和实验室标准协会指南进行处理。
从150例患有糖尿病足溃疡的患者中共获得185株细菌分离株。这些患者的年龄范围为35至80岁,其中患有DFU的人数最多的年龄组为60 - 65岁。在分离株中,革兰氏阴性杆菌分离出112/185(61%),革兰氏阳性球菌分离出73/185(39%)。最常见的分离株是 spp. 46株(25%),其次是 (20%)和 spp. (15%)。还研究了细菌的抗生素敏感性特征。在分离株中,59/112(53%)的革兰氏阴性杆菌是超广谱β-内酰胺酶产生菌,19/46(41%)是耐甲氧西林 ,5/27(19%)是耐万古霉素 。
本研究表明,DFU分离株中多药耐药菌株占优势。了解分离株的抗生素敏感性模式将有助于确定糖尿病溃疡经验性治疗的药物。因此,还可以减少抗生素的滥用以及随后出现抗生素耐药性的可能性。