Prevalence and resistance profile to antibiotics of diabetic foot infections isolated microorganisms
DOI:
https://doi.org/10.29059/cienciauat.v9i1.628Keywords:
diabetic foot, infections, drug-resistance.Abstract
Diabetes mellitus (DM) is a chronic disease that affects a considerable portion of the population and type 2 diabetes represents a serious current public health problem in Mexico. Diabetic foot is a severe consequence of diabetes for its prevalence, the frequency of resulting infections, and the high social and economic costs. In this study we examined 382 isolated families of infections in 284 patients to determine their identity by biochemical tests and their drug resistance profile. Of the 382 isolates, 186 samples (48.6 %) were positive Gram bacteria; 182 samples (47.6 %) were negative Gram bacteria; and 14 (3.6 %) were Candida sp. In 158 of the 284 samples (55.6.%) only one type of bacteria was identified; in 113 samples (39.7 %) a mixed culture was found, with 7 samples containing both bacteria and yeast and 13 samples resulting negative. The most prevalent pathogens were Staphylococcus aureus and Pseudomonas aeruginosa. In S. aureus isolates, 63.9 % was resistant to MRSA; 4.1 % was resistant to vancomicyn; and 18.6 % was resistant to imepenem. P. aeruginosa was the most prevalent Gram negative isolated and also the one with the most drug resistance. Drug-resistance analysis showed that the majority of S. aureus were MRSA and in P. aeruginosa, families resistant to all tested antimicrobials prevailed.
References
Abdulrazak, A., Bitar, Z. I., Al-Shamali, A. A., and Mobasher, L. A. (2005). Bacteriological study of diabetic foot infections. Journal of Diabetes Complications. 19(3): 138-141.
Aguilar-Salinas, C. A., Vázquez-Chávez, C., Gamboa-Marrufo, R., García-Soto, N., Ríos-González, J. J., and Holguín, R. (2001). Prevalence of obesity, diabetes, hypertension and tobacco consumption in an urban adult mexican population. Archives Medical Research. 32(1): 446-453.
Bansal, E., Garg, A., Bhatia, S, Attri, A. K., and Chander, J. (2008). Spectrum of microbial flora in diabetic foot ulcers. Indian Journal of Pathology and Microbiology. 51(2): 204-208.
Bonomo, R. A. and Szabo, D. (2006). Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. Clinical Infectious Diseases. 43(1): 49–56.
Chincholikar, D. A. and Pal, R. B. (2002). Study of fungal and bacterial infections of the diabetic foot. Indian Journal of Pathology and Microbiology. 45(1): 15-22.
Citron, D. M., Goldstein, E. J., Merriam, C. V., Lipsky, B. A., and Abramson, M. A. (2007). Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. Journal of Clinical Microbiology. 45(9): 2819-2828.
Esposito, S., Leone, S., Noviello, S., Fiore, M., Ianniello, F., Felaco, F. M., Romagnoli, F., and Sarli, E. (2008). Complications foot infections in diabetes (DFIs) in the out-patient setting: an Italian multicentre observational survey. Diabetic Medicine. 25: 979–984.
Gadepalli, R., Dhawan, B., Sreenivas, V., Kapil, A., Ammini, A. C., and Chaudhry, R. (2006). A clinical-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital. Diabetes Care. 29(8): 1727-32.
Gardner, S. E. and Frantz, R. A. (2008). Wound bioburden and infection related complications in Diabetic foot ulcers. Biological Research for Nursing. 10(1): 44-53.
Grayson, M. L. (1995). Diabetic foot infections. Antimicrobial therapy. Infectious Disease Clinics of North America. 9(1): 143-161.
Hartemann-Heurtier, A., Robert, J., Jacqueminet, S., Ha, Van G., Golmard, J. L., Jarlier, V., and Grimaldi, A. (2004). Diabetic foot ulcer and multidrug-resistant organisms: risk factors and impact. Diabetic Medicine. 21: 710–715.
Islam, S., Cawich, S. O., Budhooram, S., Harnarayan, P., Mahabir, V., Ramsewak, S., and Naraynsingh, V. (2013). Microbial profile of diabetic foot infections in Trinidad and Tobago. Primary Care in Diabetes. 7(4):303-308.
Khanolkar, M. P., Bain, S. C. and Stephens, J. W. (2008). The diabetic foot. QJM. 101(9): 685-695.
Korzon-Burakowska, A. and Dziemidok, P. (2011). Diabetic foot - the need for comprehensive multidisciplinary approach. Annals of Agriculture and Environ Medicine. 18(2): 314.
Kuri, M. P., Vargas, C. M., Zárate, H. M. y Juárez, V. P. (2001). La Diabetes en México. Dirección General de Epidemiología, Secretaría de salud.
Lerman-Garber, I. and Rull-Rodrigo, J. A. (2001). Epidemiology of diabetes in Mexico and associated coronary risk factors. The Israel Medical Associaction Journal. 3(5): 369-373.
Lipsky, B. A., Berendt, A. R., Deery, H. G., Embil, J. M., Joseph, W. S., Karchmer, A. W., LeFrock, J. L., Lew, D. P., Mader, J. T., Norden, C., and Tan, J. S. (2004). Diagnosis and treatment of diabetic foot infections. Plastic and Reconstructive Surgery. 7(1): 212S-238S.
Martínez-Gómez, D. A, Ramírez-Almagro, C., Campillo-Soto, A., Morales-Cuenca, G., Pagán-Ortiz, J. y Aguayo-Albasini, J. L. (2009). Infecciones del pie diabético. Prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermedades Infecciosas y Microbiología Clínica. 27(6): 317–321.
National Committee for Clinical Laboratory Standards (2002) Performance Standards for Antimicrobial Susceptibility Testing: Twelfth Informational Standard. M100-S12, vol. 22, no. 1. Villanova, PA, National Committee for Clinical Laboratory Standards.
Omar, N. S., El-Nahas, M. R., and Gray, J. (2008). Novel antibiotics for the management of diabetic foot infections. International Journal of Antimicrobial Agents. 31(5): 411-419.
Raja, N. S. (2007). Microbiology of diabetic foot infections in a teaching hospital in Malaysia: a retrospective study of 194 cases. Journal of Microbiology and Immunology of Infections. 40(1): 39-44.
Ramakant, P., Verma, A. K., Misra, R., Prasad, K. N., Chand, G., Mishra, A., Agarwal, G., Agarwal, A., and Mishra, S. K. (2011). Changing microbiological profile of pathogenic bacteria in diabetic foot infections: time for a rethink on which empirical therapy to choose? Diabetologia. 54(1):58-64.
Rao, N. and Lipsky, B. A. (2007). Optimizing antimicrobial therapy in diabetic foot infections. Drugs. 67(2):195-214.
Ricco, J. B., Thanh Phong, L., Schneider, F., Illuminati, G., Belmonte, R., Valagier, A., Régnault, and De La Mothe G. (2013). The diabetic foot: a review. Journal Cardiovascular Surgery. 54(6):755-762.
Richard, J. L., Sotto, A., and Lavigne, J. P. (2011). New insights in diabetic foot infection. World Journal of Diabetes. 15:2(2):24-32.
Rooh-Ul-Muqim, Ahmedn M., and Griffin, S. (2003). Evaluation and management of diabetic foot according to Wagner’s classification. A study of 100 cases. Journal of Ayub Medical Collage Abbottabad. 15(3): 39-42.
Sagray, B. A., Malhotra, S., and Steinberg, J. S. (2014). Current therapies for diabetic foot infections and osteomyelitis. Clinics in Podiatric Medicine and Surgery. 31(1): 57-70.
Secretaría de Salud (2001). Estadística de egresos hospitalarios de la Secretaría de Salud 2000. Salud Pública Mexicana. 43: 494-510.
Shankar, E. M., Mohan, V., Premalatha, G., Srinivasan, R. S., and Usha, A. R. (2005). Bacterial etiology of diabetic foot infections in South India. European Journal of Internal Medicine. 16(8):567-570.
Tascini, C., Piaggesi, A., Tagliaferri, E., Iacopi, E., Fondelli, S., Tedeschi, A., Rizzo, L., Leonildi, A., and Menichetti, F. (2011). Microbiology at first visit of moderate-to-severe diabetic foot infection with antimicrobial activity and a survey of quinolone monotherapy. Diabetes research and clinical practice. 94(1): 133-139.
Tentolouris, N., Petrikkos, G., Vallianou, N., Zachos, C., Daikos, G. L., Tsapogas, P., Markou, G. and Katsilambros, N. (2006). Prevalence of methicillin-resistant Staphylococcus aureus in infected and uninfected diabetic foot ulcers. Clinical Microbiology and Infectious Diseases. 12(1): 178–196.
Varaiya, A. Y., Dogra, J. D., Kulkarni, M. H., and Bhalekar, P. N. (2009). Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in diabetic foot infections. Indian Journal of Pathology and Microbiology. 51(3):370-372.
Wild, S., Roglic, G., Green, A., Sicree, R., and King, H. (2004).Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 27(1): 1047-1053.
