Abstract

The aim of the study was to investigate the causative pathogens, profile of antimicrobial susceptibility of them and the extent of tissue lesions in diabetic foot infections. This is a prospective study in which infected diabetic foot presenting with Wagner grade 1 to 5 ulcers were investigated. 78 consecutive diabetic patients who were seen in the orthopaedic clinic were cultured during ordinary visits. Bacteriological diagnosis and antimicrobial susceptibility profiles were carried out and analyzed using standard procedures. Diabetic polyneuropathy was found to be a common finding (74.4%). 15 (19.2%) cultures revealed polymicrobial involvement. The most frequent organisms isolated were Enterobacteriaceae (36.5%),Pseudomonas aeruginosa (18.9%), Enterococcus spp. (14.9%), and Staphylococcus aureus (10.8%). While imipenem, meropenem, amikacin, piperacillin/tazobactam were found out to be the most effective agents against Gram-negative organisms, vancomycin, teicoplanin, chloramphenicol were the most effective agents against Gram-positives. The aetiologies of most of the ulcers were neuropathic and 81.6% of them were deep. Our study also revealed that Gram-negative bacteria were the most common pathogens in infected diabetic feet. The diabetic foot ulcer is the most important cause of non-traumatic foot amputations so it is important to know the causative pathogens of these ulcers, profile of antimicrobial susceptibility of them for their treatment.

Key words: Diabetes mellitus, foot ulcers, infection, pathogen.