title: Common pathogens isolated in diabetic foot infection in Bir Hospital.
abstract: OBJECTIVE
  Foot ulcers are a frequent complication of patients suffering with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admission . Secondary infection of these ulcers is by far the leading cause of amputation of feet and legs and the polymicrobial nature of diabetic foot infection has been well documented in the literature. The present study sought to reveal the bacterial etiology of diabetic foot ulcer in patients presenting to Bir Hospital.
  
  
  METHODS
  A 1 year retrospective study was carried out to analyse the bacterial isolates of all patients admitted with diabetic foot infection presented with Wagner grade 2 -5 ulcers. Bacteriological diagnosis and antibiotic sensitivity profiles were carried out and analysed using standard procedures.
  
  
  RESULTS
  Diabetic polyneuropathy was found to be common in (51.1%) and gram positive bacteria were isolated more often than gram-negative ones in the patients screened. The most frequent bacterial isolate were Staphylococcus aureus (38.4%), Pseudomonas aeruginosa (17.5%), and Proteus (14%). Imipenem was the most effective agent against gram-negative organisms. Vancomycin was found to be most effective against gram-positive organisms.
  
  
  CONCLUSIONS
  Staph aureus and Pseudomonas aeruginosa were the most common causes of diabetic foot infections in Bir Hospital. Theses wounds require use of combined antimicrobial therapy for initial management, repeated dressing and wound debridements were done.
authors.affiliation: General Surgery Unit III, Bir Hospital NAMS, Mahaboudha Kathmandu, Nepal. names@healthnet.org.np
authors.forename: V K
authors.initials: VK
authors.lastname: Sharma
authors.forename: P B
authors.initials: PB
authors.lastname: Khadka
authors.forename: A
authors.initials: A
authors.lastname: Joshi
authors.forename: R
authors.initials: R
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D017719:Diabetic Foot / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D018579:Patient Selection; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014946:Wound Infection / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D015378:Imipenem; D000583:Amikacin