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Prospective, Randomized, and Controlled Study of a Human Umbilical Cord Mesenchymal Stem Cell Injection for Treating Diabetic Foot Ulcers
Published on: March 3, 2023
Evaluation of various risk factors associated with multidrug-resistant organisms isolated from diabetic foot ulcer
Priya Datta1, Jagdish Chander1, Varsha Gupta1
1Department of Microbiology, Government Medical College and Hospital, Chandigarh, India.
Aims:
Diabetic foot ulcer is a dreaded complication of diabetes. Diabetic foot ulcer patients are often infected with multidrug resistant organism (MDRO) due to chronic course of the wound, inappropriate antibiotics treatment, frequent hospital admission, neuropathy, nephropathy, and peripheral vascular disease.
Materials And Methods:
This prospective study was conducted in our 750 bedded hospital for a period of 6 months. The present study was undertaken to isolate various MDRO methicillin resistant Staphylococcus aureus; Gram-negative bacteria producing enzymes such as extended spectrum beta-lactamases (ESBL), Amp C, Carbapenamases; Pseudomonas and Acinetobacter species producing metallo-beta-lactamases (MBL). In addition we attempted to identify risk factors for association of diabetic foot ulcer and MDRO.
Results:
A total of 149 bacterial isolates were identified. Of the total isolates 73.2% were Gram-negative and remaining 26.8% were Gram-positive bacteria. Among Enterobacteriaceae 59% were ESBL producers and 48% were Amp C producers. In addition, 41.5% of the isolates produced both ESBL and Amp C and 13.4% were carbapenem resistant Enterobacteriaceae. Among 20 Pseudomonas and Acinetobacter isolates, 5 were MBL producers (25%). Furthermore, in the study, 56% of patients with diabetic foot ulcer harbored MDRO. The risk of multidrug-resistant infection is significantly more in patients having diabetes duration >20 years and size of ulcer more than 4 cm2.
Conclusion:
The detection of MDRO in patients of diabetic foot ulcer changes the treatment strategies limits the antimicrobial options and causes higher complications among them.
Insights
Diabetic foot ulcers frequently harbor multidrug-resistant organisms (MDRO). Longer diabetes duration and larger ulcer size increase the risk of these infections, necessitating updated treatment strategies.
Area of Science:
- Microbiology
- Infectious Diseases
- Diabetology
Background:
- Diabetic foot ulcers are a severe diabetes complication often associated with multidrug-resistant organisms (MDRO).
- Factors contributing to MDRO infections include chronic wounds, inadequate antibiotic use, and comorbidities like neuropathy and peripheral vascular disease.
Purpose of the Study:
- To isolate and identify multidrug-resistant organisms (MDRO) in diabetic foot ulcer infections.
- To determine the prevalence of specific MDROs, including methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase (ESBL), Amp C, carbapenemase-producing Gram-negative bacteria, and metallo-beta-lactamase (MBL) producers.
- To identify risk factors associated with MDRO in diabetic foot ulcer patients.
Main Methods:
- A prospective study was conducted over six months in a 750-bedded hospital.
- Bacterial isolates from diabetic foot ulcer patients were identified.
- Risk factors for MDRO association were analyzed.
Main Results:
- 149 bacterial isolates were identified; 73.2% were Gram-negative and 26.8% were Gram-positive.
- Among Gram-negative bacteria, 59% were ESBL producers, 48% were Amp C producers, and 13.4% were carbapenem-resistant Enterobacteriaceae. 25% of Pseudomonas and Acinetobacter isolates were MBL producers.
- 56% of patients with diabetic foot ulcers harbored MDRO. Diabetes duration exceeding 20 years and ulcer size >4 cm² were significant risk factors.
Conclusions:
- The presence of MDRO in diabetic foot ulcers significantly impacts treatment decisions and limits antimicrobial choices.
- MDRO infections in diabetic foot ulcer patients can lead to increased complications.
- Early detection and appropriate management of MDRO are crucial for improving patient outcomes.
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