Clinico- microbiological update of diabetic foot infections from tertiary care hospital of northern India

Awanindra Dwivedi, Shalbha Tiwari, D.D.Pratyush, Balram Gupta, S. K Singh

: J Bioengineer & Biomedical Sci

Abstract :

Diabetic foot infection (DFI) is one of the major causes of hospital admission in our region. Profiling of infection characteristics including bacteriological and clinical is essential for effective management of DFI. We performed microbial and clinical analysis of DFI patients visited our hospital. A total of 93 patients underwent clinical, microbiological culture and antibiotic sensitivity investigations. The mean age and duration of diabetes was 53.24 (±10.3) and 6.8 (±6.4) years respectively. Duration of ulcer varied from 5 days to one year. Among 93 cases, 27 were sterile on culture, 40 had mono-and 26 had poly-microbial infections. Altogether 113 bacteria were isolated in which gram negatives were 73% and gram positives were 27%. Monomicrobial infections were more common than polymicrobial. In case of polymicrobial infection, TLC was higher (16435±954 Vs 15643±6486) and hemoglobin level (8.2±2.2 Vs 9.1±1.9) was lower compared to monomicrobial infection whereas HbA1C in both the groups were almost similar (9.8±1.4% Vs 9.7±2.3%). Patients infected with gram negative bacteria had lower Hb and higher TLC than those infected with gram positive. E.coli was the most common isolate followed by S.aureus. DFI patients with culture sterile were clinically found to have evidence of persistent infection showing raised TLC (12203±3215) and low hemoglobin (9.5±1.8). Antibiotic sensitivity was highest for Piperacillin+ Tazobactum. In conclusion, gram negative infections were the commonest and piperacillin+ tazobactum should be the empirical choice of antibiotic for DFI. Molecular diagnosis could better alternative for identification of microorganisms in cases where infection is evident clinically and culture is sterile.

Biography :

Awanindra Dwivedi has completed his M. Sc. in Applied Microbiology from Banaras Hindu University, Varanasi. He is JRF in an ICMR funded research project under Prof. S. K. Singh, Department of Endocrinology & Metabolism, IMS, BHU, Varanasi. He had worked as Summer Research Fellow awarded by Indian Academy of Sciences, Bangalore.