Abstract

CLINICO-MICROBIOLOGICAL PROFILE OF DIABETIC FOOT ULCER: A HOSPITAL BASED STUDY

Dr. Atul Chandra Baro and Dr. Rituparna Bhowmick*

ABSTRACT

Aim: Diabetic foot ulcer is the commonest presentation of diabetic foot and of all amputations in diabetic patients 85% are preceded by foot ulceration. The present study was carried out to determine the factors associated with the depth of Diabetic foot ulcer amongst the patients admitted in the General surgery ward in JMCH. The study also aimed at determining the bacteriological profile of the ulcers and their anti-microbial sensitivity Methods: A prospective study was carried out from June 2020 to May 2021 in the General surgery department of Jorhat medical college and hospital.52 patients were recruited in the College study and their demographic and clinical data was collected. Subsequently the tissue specimen from the ulcer site was also collected and it was used to determine the bacteriological profile and drug sensitivity. Results: The mean age of the population was 53.6 yrs(SD±12.4) and Males (34) outnumbered females (18).There is a significant association of Depth of Ulcer with the duration of diabetes amongst the patients. Majority of the ulcers were infected with Gram negative bacteria(63%) followed Gram positive(21%), Polymicrobial(10%) & Sterile(6%). The bacterial groups identified were Enterobacteriaceae(44%), Staph Aureus(19%), Pseudomonas(15%), Acinetobacterbaumanni(13%) & Enterococcus (9%). Amongst the total Staph Aureusisolated(10),90% were Methicillin resistant(MRSA). High degree of antibiotic resistance was observed amongst the bacterial isolates. Conclusion: The study shows the association of Diabetic foot ulcers with duration of Diabetes, which implies that long term follow up and treatment adherence of Diabetic patients is needed. Based on the findings of the present study, clinically infected DFU should be treated with antibiotic regimen and proper wound care. Use of a broad spectrum antibiotic Linezolid with meropenam/pip tazobactum/ cefepime along with metronidazole pending culture results and antibiotic susceptibility data is advised. Anti-microbials is to be used in a judicious manner,in order to counter the menance of Anti-Microbial Resistance.

Keywords: Diabetic foot ulcer (DFU), Lower extremity amputation (LEA), Methicillin resistant staphylococcus aureus(MRSA).