Endocrine Abstracts

Background: According to western literature aerobic Gram-positive cocci are the predominant microorganisms that are isolated from diabetic foot ulcers. In contrast, whatever limited data is available from India Gram-negative aerobic bacteria were most frequently isolated.

Aims and objectives: To know the clinical and microbiological profile of patients with infected diabetic foot ulcers.

Patients and methods: A descriptive cross-sectional study conducted between January 2009 to May 2010. Patients with diabetic foot-ulcers with clinical signs and symptoms of infection admitted in our inpatient words. Soft tissue cultures (n=62) from deep portion of ulcer and bone specimens (n=35) in patients with suspected osteomyelitis were taken for both aerobic and anaerobic cultures. Antibiotic susceptibility was done according to standard protocol.

Results: Total 157 organisms were isolated from 117 specimens (1.34 organisms/specimen). In majority aerobic (78.3%) and gram-negative organisms (66.2%) dominated. Bone culture was positive in (80%) and was predominantly mono-microbial, soft tissue culture and pus cultures were positive in 76.2 and 75.9% respectively. Specimens showing maximum number of organisms in descending order are soft tissue, pus and bone. Duration of ulcer was most important predictor of osteomyelitis (P=0.002, odds ratio 1.19). Twelve (20%) required amputation at various sites.

Summary and conclusion: Pus and tissue cultures were predominantly poly-microbial. Most common bacterial specimen was E. coli. Proper culture and antibiotic susceptibility helps in formulating empirical treatment protocol.