Bacterial characteristics and their antibiotic sensitivity pattern in Sri Lankan diabetic foot ulcers

Abstract

Introduction: The pathology behind the poor healing of diabetic foot ulcers is multifactorial. A major cause for the deterioration of diabetic foot disease is infection. lt needs thorough understanding of the bacteriology of diabetic foot ulcers in order to achieve a good control of infection. The bacteriology would defer from one ethnic community to other due to the variations of antibiotic policies and various genetic and environmental factors. There are no published data in the English literature with regard to the bacteriology of diabetic foot ulcers among Sri Lankan. Material and methodology: A descriptive cross sectional study was performed from 15th of April 2010 to 15th of October 2010. All the patients who admitted with grade 2 to 4 (Meggit Wagner grading) diabetic foot ulcers were included. Swab cultures were taken from a deeper layer of slough/exudates before administration of systemic antibiotics. ldentification of microorganism done by an experienced medical microbiologist and the sensitivity pattern was performed by Kirby Baurer disc diffusion method. Anaerobic cultures were not done due to lack of resources. Results: Fifty three patients with diabetic foot ulcers, age ranging from 33 to 78 years (mean 59, SD ± 12.5) met the inclusion criteria 45 (85%) male and I (15%) females).All swabs were positive for the culture. Single microbial isolates were commoner (n =40,75%) than poly microbial isolates (n =13,25%). The commonest organism was pseudomonas spp (n= 35,66%), followed by coIiform s (n = 16,30% ) an d staphylococcus aurius (n =10, 20%).Most of the pseudomonas spp is sensitive to Amikacine (85%) and most of coliforms and staphyloccus aurius are sensitive to Amikacine (81%) and Fusidic acid (100%) respectively. Conclusion: The most common etiology for the diabetic foot infection among Sri Lankan is pseudomonas spp, and 85% of them are sensitive to Amikacine. Current study revealed the bacteriological characteristic among the Sri Lankan Diabetic foot disease for the first time. Data will be helpful to update guideline in the management of diabetic ulcers. DOI: http://dx.doi.org/10.4038/amj.v5i1.5777 Anuradhapura Medical Journal Vol.5(1) 2011: 7-12