[Diabetic foot infection. Bacteriologic analysis of 141 patients]

Diabetes mellitus (DM) is a progressive disease with chronic complications. Feet problems represent one of the most important complications. In a prospective study, we analyzed 298 species of bacteria isolated from 141 patients with community-acquired diabetic foot ulcers. The study was undertaken at a diabetic center and at the Federal University of Ceará, Brazil, from March/2000 to November/2001. The majority of patients had mild to moderate infections and was classified as Wagner's grades I and II. The samples were cultured using selective media. The identification and the susceptibility tests were done by conventional and automated methods. The most frequently occurring pathogens were Enterobacteriaceae (83.7%), Staphylococcus aureus (43.3%) and anaerobic bacteria (17%). Streptococcus pyogenes was recovered from 7.8% of the patients. ESBL producing strains were detected in 6% and methicillin resistant Staphylococcus aureus strains were recovered from 11.6% of the patients. Resistance among bacteria has increased largely, and became common even in community-acquired infections. Improvements in the routine etiologic diagnostics and antibiotic use strategies are required to avoid inadequate treatment and its well known dramatic consequences.