title: Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers.
abstract: BACKGROUND
  In the present study, we sought to identify the bacterial organisms associated with diabetic foot infections (DFIs) and their antibiotic sensitivity profiles.
  
  
  METHODS
  We retrospectively reviewed the records of wound cultures collected from diabetic patients with foot infections between May 2005 and July 2010.
  
  
  RESULTS
  We identified a total of 298 culture specimens (165 [55%] wound swab, 108 [36%] tissue samples, and 25 [9%] bone samples) from 107 patients (74 [69%] males and 33 [31%] females, mean age 62 ± 13 yr) with a DFI. Among all cultures 83.5% (223/267) were monomicrobial and 16.4% (44/267) were polymicrobial. Gram-negative bacterial isolates (n = 191; 61.3%) significantly outnumbered Gram-positive isolates (n = 121; 38.7%). The most frequently isolated bacteria were Pseudomonas species (29.8%), Staphylococcus aureus (16.7%), Enterococcus species (11.5%), Escherichia coli (7.1%), and Enterobacter species (7.1%), respectively. While 13.2% of the Gram-negative isolates were inducible beta-lactamase positive, 44.2% of Staphylococcus aureus isolates were methicillin resistant.
  
  
  CONCLUSIONS
  Our results support the recent view that Gram-negative organisms, depending on the geographical location, may predominate in DFIs.
authors.affiliation: Gata Haydarpasa Training Hospital, Istanbul, Turkey. vedatturhan@yahoo.com.
authors.forename: Vedat
authors.initials: V
authors.lastname: Turhan
authors.forename: Mesut
authors.initials: M
authors.lastname: Mutluoglu
authors.forename: Ali
authors.initials: A
authors.lastname: Acar
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hatipoğlu
authors.forename: Yalçın
authors.initials: Y
authors.lastname: Önem
authors.forename: Gunalp
authors.initials: G
authors.lastname: Uzun
authors.forename: Hakan
authors.initials: H
authors.lastname: Ay
authors.forename: Oral
authors.initials: O
authors.lastname: Öncül
authors.forename: Levent
authors.initials: L
authors.lastname: Görenek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017719:Diabetic Foot / Q000382:microbiology*; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D014456:Ulcer / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents