[Infections in the diabetic. Comparative study of infections in the foot and other locations].
Given the high morbi-mortality of foot infections among the diabetics and the poor knowledge of their predictive, clinical and evolutive factors, we have retrospectively studied a group of patients with these characteristics, comparing them with infections among diabetics affecting other locations. We studied 66 infections among diabetics: 34 patients with diabetic's foot and 32 with infections at other locations: 20 pyelonephritis and 12 pneumonias. Medical records were obtained in all cases and all patients underwent a complete physical exploration in order to assess their risk factors. We observed as a significant predictive factor of diabetic's foot, diabetes type I, with an evolution longer than 10 years, neuropathy, vasculopathy or retinopathy. From the clinical point of view and compared with the other infections, these patients showed longer hospitalization, greater initial clinical severity, glucemias higher than 200 mgr/l., anemia and high GSR. Ethiologically, the infection of diabetic's foot was polymicrobian in 42.3% of all cases, being S. aureus the microorganism more frequently isolated. On the contrary, in infections at other locations, monomicrobian flora was more frequent, being E. coli the most frequent in pyelonephritis and S. pneumoniae in pneumonias. The evolution was satisfactory in all cases, with a close medical and surgical combined treatment and the appropriate use of antibiotic combinations, mainly clindamicine + tobramicine in the diabetic's foot and cefuroxime in the other locations.
Gómez
J
J
Servicio de Medicina Interna, Hospital Virgen de Arrixaca.
Baños
V
V
López
F
F
Sempere
M
M
Madrid
J
J
Tebar
F J
FJ
Canteras
M
M
Valdés
M
M
D001424:Bacterial Infections / Q000150:complications*; D048909:Diabetes Complications; D005260:Female; D052776:Female Urogenital Diseases / Q000150:complications; D005534:Foot Diseases / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D008297:Male; D052801:Male Urogenital Diseases; D008875:Middle Aged; D012189:Retrospective Studies