Clinical presentation and microorganisms sensitivity profile for diabetic foot ulcers: a pilot study
- Author:
Nur Hilda Hanina ABD Wahab
;
Intan Nureslyna Samsudin
;
Syafinaz Amin Nordin
;
Zalinah Ahmad
;
Lailatul Akmar Mat Noor
;
Anand Sobhraj Devnani
- Publication Type:Journal Article
- Keywords:
Diabetic foot ulcer;
microbial culture;
antibiotic sensitivity
- MeSH:
Diabetic Foot;
Foot Ulcer
- From:
The Medical Journal of Malaysia
2015;70(3):182-187
- CountryMalaysia
- Language:English
-
Abstract:
SUMMARY
Introduction: Patients suffering from diabetes mellitus (DM)
frequently present with infected diabetic foot ulcers (DFU).
This study was done to record the anatomical site and the
grade of ulcers according to Wagner’s classification and to
culture the microorganisms from the ulcers and determine
their antibiotic sensitivity.
Materials and methods: Prospective study was conducted
on 77 diabetic patients who were admitted with DFU from
June until December 2011. Patients with end stage renal
failure, those who had previous vascular surgery on the
involved limb, or hyperbaric oxygen or maggot therapy for
the ulcers, or had unrelated skin diseases around the
involved foot were excluded from the study. Specimens for
culture were obtained by a sterile swab stick or tissue
sample was taken from the wound with sterile surgical
instruments.
Results: Wagner’s grade III and IV ulcers were most
common. Majority of the ulcers involved toes (48%). Gram
negative microorganisms were predominantly isolated
(71.1%). Gram positive microorganisms were less frequently
cultured (27.7%). Fungus was cultured from one sample
(1.2%). Gram negative microorganisms were sensitive to
aminoglycosides, cephalosporins or β-lactamase inhibitors.
More than 40% were resistant to ampicillin. Gram positive
microorganisms were sensitive to cloxacillin. MRSA were
sensitive to vancomycin.
Conclusion: Empirical use of antibiotics should be curtailed
to prevent development of drug resistant strains of
microorganisms and MRSA. We suggest use of antiseptic
solutions to clean the ulcers until antibiotic sensitivity
report is available. Results of our altered treatment regimen
we plan to publish in a later study.
- Full text:P020150904412615757411.pdf
