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The Significant Association between Polymicrobial Diabetic Foot Infection and Its Severity and Outcomes

Sharifah Aisyah Syed Hitam1,2, Siti Asma' Hassan1,2, Nurahan Maning3

  • 1Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

The Malaysian Journal of Medical Sciences : MJMS
|March 28, 2019
PubMed
Abstract

Insights

Diabetic foot infections (DFI) are often caused by multiple types of bacteria. Polymicrobial infections are linked to more severe DFI and higher amputation rates, with Gram-negative bacteria being common agents.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Diabetology

Background:

  • Diabetic foot infections (DFI) represent a significant complication of diabetes mellitus (DM).
  • These infections are frequently polymicrobial, involving multiple causative agents.
  • Understanding the specific agents and their patterns is crucial for effective management.

Purpose of the Study:

  • To identify the microbial agents responsible for DFI.
  • To determine the association between polymicrobial infections and DFI severity.
  • To evaluate the impact of infection type on DFI outcomes.

Main Methods:

  • A retrospective cohort study involving 104 patients with DFI.
  • Review of patient records to identify causative microorganisms and their sensitivity patterns.
  • Descriptive statistical analysis of isolated agents and infection characteristics.

Main Results:

  • A total of 133 microorganisms were isolated, with an average of 1.28 per lesion.
  • Gram-negative (GN) bacteria constituted 62% of isolates, with Pseudomonas spp. being most common.
  • Staphylococcus aureus (54%) predominated among Gram-positive (GP) isolates.
  • Polymicrobial infections were present in 28.8% of patients.
  • A significant association was found between microbial load and DFI severity.
  • Severe DFI cases with polymicrobial infections had higher amputation rates (77.8%) compared to monomicrobial infections (33.3%).

Conclusions:

  • Gram-negative microorganisms were predominantly isolated from DFI and showed sensitivity to common antimicrobial agents.
  • Polymicrobial infections are significantly associated with increased DFI severity.
  • These findings highlight the importance of identifying polymicrobial infections in diabetic patients to guide treatment and improve outcomes.
Keywords:
diabetes mellitusdiabetic foot infectionmicroorganismspolymicrobial infectionseverity of infection

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