Bacteriology of diabetic foot.
OBJECTIVE
To study the relative frequency of bacterial isolates cultured from diabetic foot infections and assess their comparative in vitro susceptibility to the commonly used antibacterial agents.


METHODS
This is a retrospective study with a review of the bacteriology results of specimens taken from 111 consecutive patients with diabetic foot infections at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, during the period January 1997 to June 1999. The specimens were cultured using optimal aerobic and anaerobic microbiologic techniques. Antimicrobial susceptibility testing to different agents, was carried out using the disc diffusion method.


RESULTS
Staphylococcus aureus was the commonest isolate being recovered from 28% of cases, including methicillin resistant staphylococcus aureus in 9 of 30 (30%) patient wounds. The other organisms isolated were Pseudomonas aeruginosa (22%) and Proteus mirabilis (18%), anaerobic gram-negative organisms (11%) mainly Bacteroides fragilis. The antimicrobial susceptibility testing, showed that vancomycin was the most effective against gram-positive and and imipenem was the most effective against gram-negative organisms.


CONCLUSIONS
Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis and Bacteroides fragilis were the most common causes of diabetic foot infections. These wounds require use of combined antimicrobial therapy for initial patient management prior to susceptibility results.
El-Tahawy
A T
AT
Department of Microbiology, King Abdulaziz University Hospital, PO Box 6615, Jeddah 21452, Kingdom of Saudi Arabia.
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*; D001442:Bacteroides Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D001441:Bacteroides fragilis; D017719:Diabetic Foot / Q000150:complications*; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011159:Population Surveillance; D011512:Proteus Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D011513:Proteus mirabilis; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D014946:Wound Infection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*