Singh Amit Kumar, Yeola Meenakshi, Singh Namrata, Damke Smita
Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India.
Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (Meghe), Wardha, Maharashtra, India.
J Family Med Prim Care. 2020 Aug 25;9(8):4216-4222. doi: 10.4103/jfmpc.jfmpc_700_20. eCollection 2020 Aug.
This study was carried out on patients with diabetic foot ulcer (DFU) to assess the clinical characteristics, spectrum of microbial flora, antibiotic sensitivity, and devise an empiric antimicrobial therapy.
Clinical data and tissue samples were collected from 105 diabetic foot ulcer patients between December 2018 and November 2019. The collected samples were processed as per Clinical and Laboratory Standards Institute guidelines and clinical and microbiological data was analyzed.
In this study of 105 patients, DFU was most common in males in 5 and 6 decade of life. Majority of patients had poor glycemic control and neuropathy. Of 110 bacterial isolates obtained from 97 samples, 73.7% were Gram-negative bacteria, and 27.3% were Gram-positive. Most of samples (48.6%) showed growth of single bacteria, growth of two bacteria and polymicrobial growth was seen in 28.6% and 15.2% of tissue samples respectively of which. was predominant isolate (27.3%) sensitive to imipenem (90%), amikacin (86.6%), gentamicin (83.3%), and cefotaxime (80%) followed by (19.1%) sensitive to amikacin and gentamicin (100%), and ofloxacin (90%). and were highly resistant to ampicillin and amoxicillin-clavulanic acid.
This study showed DFU are common in 5 and 6 decades of life. Gram-negative bacteria are predominant infective organism. Most of both Gram-negative and Gram-positive bacteria are resistant to variable degrees to commonly used antibiotics and sensitive to aminoglycosides. Amikacin and gentamicin can be used as empiric antibiotics for treatment of DFU infections.
本研究针对糖尿病足溃疡（DFU）患者开展，以评估其临床特征、微生物菌群谱、抗生素敏感性，并制定经验性抗菌治疗方案。
收集2018年12月至2019年11月期间105例糖尿病足溃疡患者的临床资料和组织样本。所收集样本按照临床和实验室标准协会指南进行处理，并对临床和微生物学数据进行分析。
在这项对105例患者的研究中，DFU在50至60岁男性中最为常见。大多数患者血糖控制不佳且患有神经病变。从97份样本中分离出110株细菌，其中73.7%为革兰氏阴性菌，27.3%为革兰氏阳性菌。大多数样本（48.6%）显示单一细菌生长，28.6%和15.2%的组织样本分别出现两种细菌生长和多微生物生长，其中 是主要分离株（27.3%），对亚胺培南（90%）、阿米卡星（86.6%）、庆大霉素（83.3%）和头孢噻肟（80%）敏感，其次是 （19.1%），对阿米卡星和庆大霉素（100%）以及氧氟沙星（90%）敏感。 和 对氨苄西林和阿莫西林 - 克拉维酸高度耐药。
本研究表明DFU在50至60岁人群中较为常见。革兰氏阴性菌是主要感染病原体。大多数革兰氏阴性菌和革兰氏阳性菌对常用抗生素有不同程度耐药，对氨基糖苷类敏感。阿米卡星和庆大霉素可作为治疗DFU感染的经验性抗生素。
