Endocrine Abstracts

JOINT572

Introduction: Foot infections in diabetic patients represent a critical turning point in the progression of the disease, significantly contributing to the development of diabetic foot disease. These infections are often characterised by a multitude of bacterial strains, which are frequently multi-resistant. Recognising the bacterial flora responsible for foot infection is crucial to ensure the effectiveness of antibiotic treatment. The aim of our study is to determine the microbial flora present in these lesions.

Materials and Methods: A retrospective descriptive analysis was carried out over a period of 2 years on a sample of 102 patients hospitalised for diabetic foot in the Endocrinology-Diabetology Department of Oran University Hospital. Based on the clinical manifestations seen, various sampling techniques were employed, including swab sampling, needle aspiration, tissue biopsies and curettage of the lesion.

Result: The results showed that 48 patients (47%) had overt foot infection, with an average age of 61 years. The average length of hospitalisation was 51 days. Bacteriological samples were positive in 43 cases (89.6%). Of these, gram-negative bacilli were found in 31 cases (72.1%), dominated by proteus mirabilis and vulgaris (11 cases) and Escherichia coli (7cases). There were four cases each of Serratia marcescens and Enterobacter, three cases each of Klebsiella pneumoniae and oxytoca, and two cases of Pseudomonas. Regarding Gram-positive cocci, 12 cases were identified, including Streptococcus species (8 cases) and Staphylococcus aureus (4 cases). The patients received targeted antibiotic therapy based on the antibiogram results, along with additional treatment to cover anaerobic pathogens. Osteitis was diagnosed in 34 patients, representing 71% of the cases. Complications led to minor amputations in 15 patients (31.3% of cases) and major amputations in 7 patients (14.6% of cases). The remaining patients experienced a positive clinical outcome.

Conclusion: A comprehensive understanding of the microbiology of diabetic foot infection is essential. It plays a key role in guiding the selection of targeted antibiotic therapy and contributes to optimizing the overall management of this condition.