title: Pseudomonas as trespassers in diabetic foot infections: More questions and fewer answers.
abstract: OBJECTIVE
  To assess microbiological isolates from diabetic foot ulcers presented at a tertiary care teaching hospital.
  
  
  METHODS
  The prospective observational study was conducted at department of Orthopaedics, Liaquat National Hospital Karachi, from January 2009 to October 2011, and comprised patients with diabetic foot ulcers (Wagner grading 1-4). Grade 0 and 5 were excluded. Wound swabs or tissue biopsies were taken before the induction of antibiotic prophylaxis according to the standard aseptic protocols. SPSS 16 was used for statistical analysis.
  
  
  RESULTS
  Of the 250 patients in the study, 151(60.4%) were male with an overall mean age of the subjects of 46±8.1 years. Mean duration of diabetes was 14±6.7 years. Based on Wagner's grading, 90(36%) patients had grade 1, 58(23.2%) grade 2, 97(38.8%) grade 3, and 5(2%) grade 4. The most common isolates were polymicrobial in 90(36%) patients and pseudomonas aeruginosa in 87(34.8%). Resistance antibiogram for pseudomonas aeruginosa showed sensitivity against Imipenem, Aztreonam, Ceftazidime, Ciprofloxacin and Gentamicin.
  
  
  CONCLUSIONS
  The isolation of pseudomonas aeruginosa gives an idea about the recent microbial spectra from our region and should prompt the need for multi-centre studies from South Asia to devise treatment guidelines for this part of the world.
authors.affiliation: Liaquat National Hospital, Karachi.
authors.forename: Muhammad Kazim Rahim
authors.initials: MK
authors.lastname: Najjad
authors.affiliation: Liaquat National Hospital, Karachi.
authors.forename: Zaki
authors.initials: Z
authors.lastname: Idrees
authors.affiliation: Liaquat National Hospital, Karachi.
authors.forename: Mehroze
authors.initials: M
authors.lastname: Zamir
authors.affiliation: Liaquat National Hospital, Karachi.
authors.forename: Sana
authors.initials: S
authors.lastname: Zeeshan
authors.affiliation: Liaquat National Hospital, Karachi.
authors.forename: Syed Amir Ali
authors.initials: SA
authors.lastname: Shah
keywords: Diabetic Foot, Infection/microbiology, Gram-negative bacteria.