Prognostic significance of non-enteric blood culture in diabetic foot disease

The diabetic foot is a group of syndromes in which ischemia, neuropathy and infection leads to tissue breakdown resulting in morbidity and possible lower extremity amputation. The diagnosis is based on clinical criteria investigations. It is imperative that such patients are managed by a team of Physician, Surgeon, Social care worker, Physiotherapist and a Podiatrist. In this study we included 100 diabetic foot patients in the age group of 30 to 80 years. The study was done for a period of one year. 47% of our patients had Meggit Wagner grade 3 and 10% had grade 5. 27% of the patients had renal failure and 30% had anemia. These patients were subjected to non-enteric culture of blood under sterile precautions. 80% of our patients showed positive culture. The organisms commonly isolated were Staphylococcus aureus, beta haemolytic Streptococcus and Klebsiella pneumoniae. Less commonly isolated were Citrobacter species, Proteus mirabilis and anaerobes. 40% of patients with positive culture went on to have lower extremity amputation. Thus we concluded that non enteric culture in diabetic foot disease has prognostic significance and the spectrum of infection in diabetic foot disease is polymicrobial in nature and at par with the literature.