Bacterial Profile and Their Antimicrobial Susceptibility Pattern with Assessment of Risk Factors among Diabetic Foot Ulcer Patients in a Tertiary Care Hospital, South India

Abstract

The incidence of diabetes foot ulcer (DFU) in India is influenced by various predisposing factors. A broad range of pathogenic bacteria consisting of Gram-positive, Gram-negative aerobes and anaerobes are associated with diabetic foot infections (DFI). Due to increase in prevalence of multidrug resistant (MDR) organisms it has become very challenging to treat DFU patients. The aim of the study is to determine the spectrum of bacteria and their antimicrobial susceptibility pattern with assessment of risk factors in those patients visiting a tertiary care hospital in Chennai, South India. A cross sectional descriptive study was performed on 344 diabetic patients attending the Department of Surgery. The data were collected using a self-administered questionnaire; the ulcers were physically examined; the microbiological lab investigations were performed in the Central laboratory, Department of Microbiology. Data analysis was done using MS excel and SPSS version 25.0. Among the 344 diabetic patients, 86 (25%) patients had DFU. 74 organisms were isolated from 50 patients (58%) who had DFI. 76% of the infections were monomicrobial and 24% polymicrobial. Among the Gram-negative and Gram-positive organisms, Escherichia coli and Staphylococcus aureus showed a higher degree of MDR. The following variables were associated with DFU: male gender, alcohol/ tobacco use, high HbA1c, patients not on anti-diabetic drugs and insulin (P < 0.05). Finding the predictors associated with DFU is essential to reduce the morbidity. MDR bacteria are often associated with DFI. Hence, this study emphasises the proper selection of antimicrobial agents in the era of multidrug resistance.