Assessment of major microorganisms involved in diabetic foot infection which delays wound healing

Background: India has the largest diabetic population of 50.8 million that could reach an epidemic proportion by 2030. Diabetic foot infection is one of the dreaded complications of diabetes. Only a few studies that focus on patterns of diabetic foot infection in our region, where diabetic foot care is inadequate. This study evaluated microbial and clinical characteristics of diabetic foot infections that will be helpful in taking appropriate measures for their management. Aim and objectives: This study was undertaken to evaluate the clinical and the microbial characteristic of diabetic foot infection in patients. The ulcers were graded and swab samples were collected under aseptic condition. Materials and methods: In this prospective study conducted during 2016-2017, Totally 100 diabetic foot patients underwent detailed history, clinical examination, and laboratory investigations including parameters of systemic infections. Microbial culture and sensitivity were performed at the time of presentation. Results: Among 100 cases, 27 (43.5%) had mono-microbial infection, 22 (35.5%) had poly-microbial infection, and 13 (21%) had sterile culture. Altogether 82 bacteria were isolated from 49 cases. Among 82 bacterial isolates, 56 (68.3%) were Gram negative while 26 (31.7%) were Gram-positive bacteria. Escherichia coli was the most common pathogen isolated followed by Staphylococcus aureus. Conclusion: Gram-negative bacteria were most prevalent in diabetic foot infection. It is not uncommon to have culture reports negative despite clinical evidence of infection. This study suggests that piperacillin/ tazobactam should be the treatment of choice on an empirical basis prior to a definitive bacteriological study and in cases with negative culture reports.