Antimicrobial Resistance Patterns in Diabetic Foot Infections, an Epidemiological Study in Northeastern Italy

Area of Science:

• Microbiology
• Infectious Diseases
• Epidemiology

Background:

• Diabetic foot infections (DFIs) are a significant complication of diabetes mellitus.
• Bacterial infections are a primary cause of morbidity and mortality in DFIs.
• Understanding the etiological agents and their antimicrobial resistance patterns is crucial for effective treatment.

Purpose of the Study:

• To conduct a retrospective epidemiological assessment of bacterial pathogens isolated from out-patients with DFIs.
• To identify the predominant bacterial species and their antibiotic resistance profiles.
• To highlight key pathogens and emerging resistance trends in DFIs.

Main Methods:

• Retrospective analysis of bacterial isolates from out-patients with DFIs over one year.
• Identification of bacterial species using standard microbiological techniques.
• Antimicrobial susceptibility testing to determine resistance patterns, including Methicillin-Resistant Staphylococcus aureus (MRSA) and Extended-Spectrum Beta-Lactamase (ESBL) producing organisms.

Main Results:

• Staphylococcus aureus (33.5%) and Pseudomonas aeruginosa (11.9%) were the most common pathogens.
• Methicillin-Resistant Staphylococcus aureus (MRSA) was isolated in 27.1% of patients, with 14.06% exhibiting resistance to three antimicrobial classes.
• Pseudomonas aeruginosa showed high resistance to fluoroquinolones (57.3%) and significant co-resistance to piperacillin (17.6%) and carbapenems (23.5%).
• Other significant pathogens included MRSA, ESBL-producing E. coli and Morganella morganii, and VRE (Vancomycin-Resistant Enterococcus faecium).

Conclusions:

• Staphylococcus aureus and Pseudomonas aeruginosa are key pathogens in diabetic foot infections.
• High rates of MRSA and multi-drug resistant Pseudomonas aeruginosa necessitate careful antibiotic selection.
• Continuous surveillance of bacterial epidemiology and resistance patterns is essential for managing DFIs effectively.