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Bacteriological study of diabetic foot ulcers

P Prabhakar, A B Rao, J Hira

    Tropical and Geographical Medicine
    |September 1, 1981
    PubMed
    Summary

    Diabetic foot infections often involve mixed bacteria, with anaerobes more common in gangrenous ulcers. Optimal antibiotic therapy for severe cases combines gentamycin, ampicillin, and metronidazole with surgery.

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    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Diabetic Foot Care

    Background:

    • Diabetic foot ulcers are a common complication of diabetes mellitus.
    • Bacterial infections significantly impact ulcer progression and treatment outcomes.
    • Understanding causative pathogens and their antibiotic susceptibility is crucial for effective management.

    Purpose of the Study:

    • To identify the bacterial spectrum in diabetic foot infections (gangrenous and non-gangrenous).
    • To determine antimicrobial susceptibility patterns of isolated pathogens.
    • To guide optimal antibiotic therapy selection for these patients.

    Main Methods:

    • Bacteriological analysis of 61 patients with diabetic foot ulcers.
    • Isolation and identification of aerobic and anaerobic bacteria.
    • Antimicrobial susceptibility testing using standard antibiotic panels.

    Main Results:

    • Gangrenous ulcers frequently presented with mixed infections (Enterococci, Proteus, Pseudomonas, Klebsiella).
    • Non-gangrenous ulcers often showed single organisms like Staph. pyogenes and beta-hemolytic Streptococcus.
    • Anaerobic bacteria were more prevalent in gangrenous lesions.
    • Gram-positive bacteria were sensitive to co-trimoxazole, cephaloridine, ampicillin, and penicillin.
    • Gram-negative bacteria were sensitive to gentamycin, chloramphenicol, co-trimoxazole, and streptomycin.
    • Anaerobes showed sensitivity to chloramphenicol, clindamycin, and metronidazole.

    Conclusions:

    • Specific bacterial patterns exist for gangrenous versus non-gangrenous diabetic foot ulcers.
    • Tailored antibiotic selection based on susceptibility data is essential.
    • For severe gangrenous infections with systemic involvement, a combination of gentamycin, ampicillin, and metronidazole, alongside surgical intervention, is recommended.

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