Hitam Sharifah Aisyah Syed, Hassan Siti Asma', Maning Nurahan
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Hospital USM, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Malays J Med Sci. 2019 Jan;26(1):107-114. doi: 10.21315/mjms2019.26.1.10. Epub 2019 Feb 28.
Foot infection is a major complication of diabetes mellitus (DM) and its agents are usually polymicrobial. This study aims to describe the agent and determine the association between polymicrobial infections and the severity of diabetic foot infections (DFI) and their outcomes.
This retrospective cohort study was conducted during one year and it involved 104 patients. Their records were reviewed and assessed. The causative agents and its sensitivity pattern were noted. The results were presented as descriptive statistic and analysed.
A total of 133 microorganisms were isolated with 1.28 microorganisms per lesion. The microorganism isolated were 62% ( = 83) GN (Gram-negative) and 38% ( = 50) GP (Gram-positive). GN microorganisms include spp (28%), spp (11%), spp (8%) and (4%). (54%) was predominant among GP, followed by Group B (26%) and spp (6%). Thirty patients (28.8%) had polymicrobial infections. The association between the quantity of microorganisms and severity of DFI was significant. Among severe DFI cases, 77.8% with polymicrobial microorganisms underwent amputation compared to 33.3% with monomicrobial infection.
GN microorganisms were predominantly isolated from DFIs and remained sensitive to widely used agents. Polymicrobial infections were associated with DFI severity.
足部感染是糖尿病的主要并发症，其病原体通常为多种微生物。本研究旨在描述病原体，并确定多种微生物感染与糖尿病足感染（DFI）严重程度及其预后之间的关联。
本回顾性队列研究为期一年，涉及104例患者。对他们的记录进行了审查和评估。记录了病原体及其敏感性模式。结果以描述性统计呈现并进行分析。
共分离出133种微生物，每个病灶分离出1.28种微生物。分离出的微生物中，62%（=83）为革兰氏阴性（GN）菌，38%（=50）为革兰氏阳性（GP）菌。GN菌包括大肠埃希菌（28%）、肺炎克雷伯菌（11%）、阴沟肠杆菌（8%）和铜绿假单胞菌（4%）。金黄色葡萄球菌（54%）在GP菌中占主导地位，其次是B组链球菌（26%）和肠球菌属（6%）。30例患者（28.8%）发生了多种微生物感染。微生物数量与DFI严重程度之间的关联具有显著性。在严重DFI病例中，77.8%的多种微生物感染患者接受了截肢，而单一微生物感染患者的这一比例为33.3%。
GN菌主要从DFI中分离出来，并且对广泛使用的药物仍敏感。多种微生物感染与DFI严重程度相关。
