Kalinga Institute of Medical Sciences, Bhubaneswar.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Worldwide, diabetic foot lesions are a major medical, social and economic problem and are the leading cause of hospitalization for patients with diabetes. The organisms causing the ulcers vary from different geographical regions and initiation of empiric antibiotics depends on the prevalence of the local pathogens and their sensitivity pattern, With this background the present study was carried out to evaluate the bacterial diversity and their culture sensitivity patterns in diabetic foot ulcers.
Medical records of 65 cases of diabetes mellitus with diabetic foot ulcer admitted to hospital during the period from January 2019 to December 2020 were retrieved from the Medical Records Department. Demographic, clinical profile and microbiological profile with antibiotic sensitivity pattern were analyzed.
Out of 65 cases (n=65), 54 (83.07%) were male and 11 (16.92%) were female. Age range of the patients was from 39 years to 80 years with mean age of 59=/-9.65years. The mean duration of diabetes was 9.4=/-5.7 years and 52.4% had diabetes for more than 10 years. Hypertension was present in 84.5% of the cases. Nearly 62.5% had lesions for 3 months before presenting to the hospital. Peripheral neuropathy was present in all the cases. More than 60% cases were surgically treated with debridement. Osteomyelitis was present in 44.5% cases. Out of 65 cases, 64 were culture positive. Pseudomonas aeruginosa was the leading pathogen in 23.3% cases (n=15), Staphylococcus aureus, E.coli, Acinetobacter baumannii and Klebsiella pneumoniae were isolated in 15.38% cases each followed by Burkholderia cepacia which constituted 10% of all cases. Multiple organisms were isolated in 11 cases (16.92%).
Burkholderia cepacia, which was earlier an uncommon infection in Diabetic foot ulcer, was found in significant (10%) number of cases. This may be due to improper waste management and change in environmental conditions.
评估糖尿病足溃疡患者的细菌多样性及其培养药敏模式。
从医院病历档案科调取了 2019 年 1 月至 2020 年 12 月期间收治的 65 例糖尿病足溃疡患者的病历，分析了患者的人口统计学、临床特征和微生物特征及抗生素敏感性模式。
65 例（n=65）患者中，男 54 例（83.07%），女 11 例（16.92%）；年龄 39~80 岁，平均年龄 59±9.65 岁；糖尿病病程 9.4±5.7 年，病程>10 年者占 52.4%；合并高血压者占 84.5%；就诊前溃疡病程 3 个月以内者占 62.5%；所有患者均存在周围神经病变；60%以上患者接受手术清创治疗；44.5%患者合并骨髓炎。65 例患者中，64 例培养阳性，其中 23.3%（n=15）为铜绿假单胞菌，15.38%（n=15）为金黄色葡萄球菌、大肠埃希菌、鲍曼不动杆菌和肺炎克雷伯菌，10%（n=6）为洋葱伯克霍尔德菌。11 例（16.92%）患者为混合感染。
洋葱伯克霍尔德菌是糖尿病足溃疡的一种不常见感染病原体，在本次研究中，其检出率为 10%，可能与不适当的废物管理和环境条件变化有关。
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