1.The Significant Association between Polymicrobial Diabetic Foot Infection and Its Severity and Outcomes
Sharifah Aisyah Syed Hitam ; Siti Asma& ; rsquo ; Hassan ; Nurahan Maning
Malaysian Journal of Medical Sciences 2019;26(1):107-114
Background: Foot infection is a major complication of diabetes mellitus (DM) and
its agents are usually polymicrobial. This study aims to describe the agent and determine the
association between polymicrobial infections and the severity of diabetic foot infections (DFI) and
their outcomes.
Methods: This retrospective cohort study was conducted during one year and it involved
104 patients. Their records were reviewed and assessed. The causative agents and its sensitivity
pattern were noted. The results were presented as descriptive statistic and analysed.
Results: A total of 133 microorganisms were isolated with 1.28 microorganisms per lesion.
The microorganism isolated were 62% (n = 83) GN (Gram-negative) and 38% (n = 50) GP (Grampositive).
GN microorganisms include Pseudomonas spp (28%), Proteus spp (11%), Klebsiella spp
(8%) and E. coli (4%). Staphylococcus aureus (54%) was predominant among GP, followed by
Group B Streptococci (26%) and Enterococcus spp (6%). Thirty patients (28.8%) had polymicrobial
infections. The association between the quantity of microorganisms and severity of DFI was
significant. Among severe DFI cases, 77.8% with polymicrobial microorganisms underwent
amputation compared to 33.3% with monomicrobial infection.
Conclusion: GN microorganisms were predominantly isolated from DFIs and remained
sensitive to widely used agents. Polymicrobial infections were associated with DFI severity.