Copari-Vargas Eligio, Copari-Vargas Luisa Elena, Copari-Vargas Tania Libertad, Domínguez-Valdez Luis Fernando, Copari-Jimenez Eligio, Urquizo-Ayala Juan Guillermo
Endocrinology, Diabetes and Metabolism, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, MEX.
Internal Medicine, Hospital de Clínicas, La Paz, BOL.
Cureus. 2025 Apr 22;17(4):e82809. doi: 10.7759/cureus.82809. eCollection 2025 Apr.
Introduction Diabetic foot ulcer (DFU), is a common complication of uncontrolled diabetes, that frequently progresses to diabetic foot infection (DFI), contributing to morbidity, economic burden, and lower limb amputations. This study characterizes the bacteriological profile and antibiotic susceptibility patterns in DFIs patients. Methods A retrospective study was conducted from January 2014 and December 2018. All patients records with microbiologically confirmed DFIs. Demographic data, clinical history, ulcer classification, and microbiological findings were reviewed. Bacterial isolates were identified, and antibiotic susceptibility testing was performed. Results Of a total of 56 patients diagnosed with DFIs at a secondary care hospital in Bolivia, the medical records of 42 individuals were reviewed, of which 28 patients met the inclusion criteria for analysis. Among these, 89.2% (n=25) had polymicrobial infections. was the most frequently isolated pathogen, representing 38.4% (n=10) of cases, followed by and . Among Gram-negative isolates, exhibited complete resistance to both ampicillin and cephalosporins, highlighting its multidrug-resistant (MDR) profile. The most frequently administered antibiotics were metronidazole, ceftriaxone, and ciprofloxacin. Resistance to quinolones and β-lactam antibiotics was particularly pronounced across several isolates. Conclusions DFUs with associated infections (DFIs) in this study were predominantly polymicrobial and showed a high prevalence of MDR pathogens. These findings underscore the importance of early and accurate microbiological assessment to prevent infection progression and optimize antibiotic selection in patients with DFUs. Targeted antimicrobial therapy is essential to reduce the risk of treatment failure and amputation. Continued surveillance of resistance patterns is critical to inform empirical treatment strategies in similar healthcare settings.
引言 糖尿病足溃疡(DFU)是糖尿病控制不佳的常见并发症,常进展为糖尿病足感染(DFI),会导致发病、经济负担以及下肢截肢。本研究对DFI患者的细菌学特征和抗生素敏感性模式进行了描述。方法 进行了一项回顾性研究,时间跨度为2014年1月至2018年12月。纳入所有微生物学确诊为DFI的患者记录。对人口统计学数据、临床病史、溃疡分类和微生物学检查结果进行了回顾。鉴定细菌分离株,并进行抗生素敏感性测试。结果 在玻利维亚一家二级护理医院诊断为DFI的56例患者中,对42例患者的病历进行了回顾,其中28例患者符合分析纳入标准。在这些患者中,89.2%(n = 25)患有多微生物感染。 是最常分离出的病原体,占病例的38.4%(n = 10),其次是 和 。在革兰氏阴性分离株中, 对氨苄西林和头孢菌素均表现出完全耐药,凸显了其多重耐药(MDR)特征。最常使用的抗生素是甲硝唑、头孢曲松和环丙沙星。几种分离株对喹诺酮类和β-内酰胺类抗生素的耐药性尤为明显。结论 本研究中伴有感染的DFU(DFI)主要为多微生物感染,且多重耐药病原体的患病率较高。这些发现强调了早期准确的微生物学评估对于预防感染进展和优化DFU患者抗生素选择的重要性。针对性抗菌治疗对于降低治疗失败和截肢风险至关重要。持续监测耐药模式对于为类似医疗环境中的经验性治疗策略提供依据至关重要。