Endocrine and Diabetology Service, Yaoundé Central Hospital, Yaoundé, Cameroon.
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Pan Afr Med J. 2022 May 18;42:52. doi: 10.11604/pamj.2022.42.52.31042. eCollection 2022.
bacterial profile of diabetic foot infections and the antibiotic susceptibility are essential in the prescription of empirical antibiotics before the results of cultures of deep wound samples are available. The aim of this study was to determine the microbiological profile and antibiotic susceptibility of bacteria isolated from infected diabetic foot ulcers in patients attending the Yaoundé Central Hospital, Cameroon.
we retrospectively analyzed the records of patients hospitalized between 2008 and 2013 for diabetic foot infections. The main outcomes were the bacteriological profile and susceptibility patterns of isolates from positive culture of deep wound sample before antibiotherapy, carried out in the national reference laboratory. Eligible clinical records of patients were retrieved from the hospitalization registry.
a total of 101 patient records were analyzed. The mean age of patients was 57.1 ± 9.1 years. There were more males (64.4%), mostly with type 2 diabetes (99%), with a median duration of 9 years (IQR: 4 - 14 years). Their median blood sugar on admission was 246 mg/dL. Five percent of patients died and 23% had a major amputation. Two hundred and twenty-five (225) germs were isolated, with an average of 2.25 germs per patient. Gram-negative bacteria were more frequent (75.2%). These were mainly Morganella morganii (13.8%), Klebsiella pneumonia (12%), Escherichia coli (11.6%), Proteus spp. (10.7%), and Pseudomonas aeruginosa (8.9%). Gram-positive bacteria (24.8%) were mainly Staphylococcus aureus (9.3%), Streptococcus spp. (7.6%), and Enterococcus spp. (7.1%). Gram-negative bacteria showed a high resistance to amoxicillin-clavulanic acid (78%), fluoroquinolones (55%), and gentamycin (50%). They were susceptible to imipenem (95%), amikacin (88%), and show moderate susceptibility to third generation cephalosporins (62%). Gram-positive bacteria were susceptible to vancomycine (94%), and moderately susceptible to pristinamycine (82%) and fusidic acid (67%).
Gram-negative bacteria were more frequently associated with diabetic foot infections, and were frequently resistant to the usually prescribed antibiotics, but remain susceptible to imipenem and amikacin. Our findings should be considered when prescribing empirical anti-biotherapy for diabetic foot infections in our setting.
在获得深部伤口样本培养结果之前，糖尿病足感染的细菌谱和抗生素敏感性对于经验性抗生素的处方至关重要。本研究旨在确定喀麦隆雅温得中心医院就诊的糖尿病足溃疡感染患者分离的细菌的微生物谱和抗生素敏感性。
我们回顾性分析了 2008 年至 2013 年期间因糖尿病足感染住院的患者记录。主要结局是在国家参考实验室进行的深部伤口样本阳性培养前抗生素治疗中分离出的细菌的细菌学特征和药敏模式。从住院登记处检索符合条件的临床记录。
共分析了 101 份患者记录。患者的平均年龄为 57.1 ± 9.1 岁。男性居多（64.4%），主要为 2 型糖尿病（99%），中位病程为 9 年（IQR：4-14 年）。入院时的中位血糖为 246mg/dL。5%的患者死亡，23%的患者进行了大截肢。共分离出 225 株细菌，平均每位患者 2.25 株。革兰氏阴性菌更为常见（75.2%）。主要为摩根摩根菌（13.8%）、肺炎克雷伯菌（12%）、大肠杆菌（11.6%）、变形杆菌属（10.7%）和铜绿假单胞菌（8.9%）。革兰氏阳性菌（24.8%）主要为金黄色葡萄球菌（9.3%）、链球菌属（7.6%）和肠球菌属（7.1%）。革兰氏阴性菌对阿莫西林克拉维酸（78%）、氟喹诺酮类（55%）和庆大霉素（50%）的耐药率较高。它们对亚胺培南（95%）、阿米卡星（88%）敏感，对第三代头孢菌素（62%）中度敏感。革兰氏阳性菌对万古霉素（94%）敏感，对青霉素（82%）和夫西地酸（67%）中度敏感。
革兰氏阴性菌与糖尿病足感染的关系更为密切，且常对常用抗生素耐药，但对亚胺培南和阿米卡星仍保持敏感。在我们的环境中，为糖尿病足感染开具经验性抗生素治疗时，应考虑到我们的发现。
