Biology and Medicine

Abstract

Clinico-bacteriology and risk factors for the diabetic foot infection with multidrug resistant microorganisms in north India

Mohammad Zubair, Abida Malik, Jamal Ahmad

This study was carried out in diabetic patients with foot ulcer, to determine the bacterial profile of infected ulcer, antibiotic resistance of the isolates and to find out the potential risk factors for infection with multidrug resistance. Gram-negative bacilli were screened for extended spectrum β lactamase (ESBL) production and Staphylococcus aureus were screened for methicillin resistance. In the 60 diabetic foot patients, 37(61.6%) were males and 23(38%) were females. 49(81.6%) had T2DM, whereas only 11(18.3%) patients had T1DM. The presence of sensory neuropathy was observed in 66.6% patients. Bacterial infection was found in 86.6% DFU cases, 40% cases had mixed bacterial infection while 48.5% cases had monomicrobial infections. 23.3% DFU patients had infection by multidrug resistant (MDR) organisms. ESBL producer was found in 45.3% gram-negative isolates. 33 % gram-negative strains were positive for blaCTX-M gene followed by blaSHV (20%) and blaTEM (6.6%) Poor glycemic control in 63.3% patients, duration of infection > 1month (43.3%) and ulcer size > 4cm2 (78.1%) was independently associated with risk of MDR organism infection