The bacteriology of diabetic foot ulcers in Port Harcourt, Nigeria.
BACKGROUND
Diabetic foot ulcer and/or gangrene is a common cause of morbidity and mortality in Nigeria. The lesions are usually infected and early treatment of the infection will reduce the associated problems. The study was carried out to determine the common bacteriological flora of diabetic foot ulcers in Port Harcourt. The antimicrobial sensitivity pattern of the isolates was determined to enhance possible empirical treatment.


METHODS
Deep wound swabs were collected from 60 consecutive diabetic patients admitted with foot ulcers and/or gangrene into the medical wards of the University of Port Harcourt Teaching Hospital from January 2001 to April 2002. The bacteriological isolation and antimicrobial sensitivity tests of the isolates was carried out by standard microbiological methods.


RESULTS
Aerobes and anaerobes constituted 95.4% and 4.6% of the total bacterial isolates respectively. Staphylococcus aureus was the commonest bacterial isolate; it was cultured from 32 (56.1%) of infected patients and constituted 24.4% of the total isolate. The mean bacterial isolate per patient infected was 2.3. The aerobic isolates showed significant sensitivity to ciprofloxacin (78.4%), pefloxacine (71.2%), ceftazidime (73.6%) and cefuroxime (69.6%). All the anaerobic isolates were sensitive to metronidazole and clindamycin.


CONCLUSIONS
Infections of diabetic foot ulcers are usually polymicrobial. From the in vitro antimicrobial susceptibility pattern of the bacterial isolates, diabetic patients presenting with foot ulcers and/or gangrene could be commenced empirically on a combination of clindamycin or metronidazole and either a fluoroquinolone (ciprofloxacin or pefloxacine) or a second or third generation cephalosporin (e.g. cefuroxime or ceftazidime).
Unachukwu
C N
CN
Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Obunge
O K
OK
Odia
O J
OJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D001432:Bacteriology; D002981:Clindamycin / Q000494:pharmacology / Q000627:therapeutic use; D017719:Diabetic Foot / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology
D024841:Fluoroquinolones; D002981:Clindamycin