Characteristics and Microbiological Profile of Patients with Diabetic Foot Infections in Kuantan, Pahang
https://doi.org/10.5704/MOJ.2203.003
- Author:
Kow RY
1
;
Low CL
2
;
Ayeop MAS
1
;
Che-Ahmad A
1
;
Awang MS
1
Author Information
1. Department of Orthopaedics, Traumatology and Rehabilitation, International Islamic University Malaysia, Kuantan, Malaysia
2. Department of Radiology, Sultan Ahmad Shah Medical Centre @IIUM, Kuantan, Malaysia
- Publication Type:Journal Article
- Keywords:
diabetic foot infection, diabetic ulcer, antibiotic, microbiology, Malaysia
- From:Malaysian Orthopaedic Journal
2022;16(No.1):11-17
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The number of people suffering from diabetic
foot infection (DFI) has increased precipitously over the
years in Malaysia, owing to increased population,
urbanisation, the surge of number of people with obesity and
physical inactivity. As one of the most dreaded
complications of diabetes mellitus, DFI is associated with
high morbidity and mortality. We aim to study the
microbiological profile of patients with DFI at a university
hospital in Kuantan, Pahang.
Materials and methods: This retrospective study was
carried out at at Sultan Ahmad Shah Medical Centre @IIUM
(SASMEC @IIUM) from 1 January 2018 to 30 April 2019.
Patients’ demographic data, types of infection and surgical
intervention, and the microbiological profile were obtained
from the medical records.
Results: A total of 142 causative pathogens were cultured
from 130 tissue samples, with an average of 1.09 pathogens
per lesion. Majority of the pathogens were gram-negative
pathogens (52.8%). Staphylococcus sp. was the most
common pathogen isolated (22.5%). This was followed by
Streptococcus sp. (10.6%), Pseudomonas sp. (9.2%),
Morganella sp. (5.6%), Klebsiella sp. (4.9%), Enterobacter
sp. (4.9%), and others. Among the 142 pathogens, there were
9 multidrug-resistant strains observed. Most of the
antibiotics were effective against the gram-positive
pathogens except benzylpenicillin, tetracyclin, fusidic acid
and ciprofloxacin. Meanwhile, cefotaxime, amoxicillin and
ampicillin-sulbactam were also not suitable against gramnegative pathogens. Oxacillin and sulfamethoxazole/
trimethoprim can be used as empirical antibiotics against
gram-positive pathogens, while vancomycin should be
reserved for patients with septic shock or suspected multidrug resistant strain infection. Piperacillin/tazobactam and
ceftazidime can be used as empirical antibiotics against
gram-negative pathogens.
Conclusion: Early initiation of empirical antibiotic(s) is
paramount to stymie the infection from getting worse while
waiting for the identification of causative pathogens in the
management of DFI. This study provides a guide for treating
physicians to initiate the most appropriate empirical
antibiotic in DFI.
- Full text:16.2022my1220.pdf
