title: [The bacterial microflora of diabetic foot infection and factors determining its spectrum in Ouagadougou (Burkina Faso)].
abstract: The aim of the study was to describe the bacterial microflora of diabetic foot infection and to identify the factors which determine the bacterial spectrum in order to increase empiric antibiotic prescription in Ouagadougou. The study was a cross-sectional one, carried from July 1st, 2011 to June 30, 2012 in the departments of internal medicine and general and digestive surgery in Yalgado Ouédraogo teaching hospital. Samples for bacteriological tests consisted of aspiration of pus through the healthy skin, curettage and swab of the base of the ulceration or tissue biopsy from foot lesions. The bacteria's sensitivity to antibiotics has been tested by the qualitative method (Kirby-Bauer). The frequency of diabetic foot infection was 14.45% and the monthly incidence 5.33. The mean age of patients was 56 years and the sex ratio 1.37. Foot ulcerations were chronic in 33 (51.56%), necrotic in 51 (79.69%) and associated with osteitis in 40 (62.5%) patients. Infection was grade 3 in 70.3% cases. Thirty-nine patients had received antibiotics before hospital admission. Among the 71 samples, 62 (87.32%) cultures were positive: 53 (85.48%) monomicrobial and 9 (14.52%) bimicrobial. Aerobic Gram-positive cocci (76%) were the most frequent from ulcerations: Staphylococcus aureus (32.39%), Streptococcus sp (18.30%). Negative coagulase staphylococci have been found in 23.94% cases. Aerobic gram-negative bacilli have been isolated from 24% ulcerations. No factor was associated with the type of bacteria. Gram-positive pathogen cocci showed a high sensitivity to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum beta lactamase Enterobacteriaceae (ESBL) have been isolated. A better design is necessary to a clarification of bacterial flora in diabetic foot infections. Prevention of bacterial resistance is also needed.
authors.affiliation: Unité de formation et de recherche en sciences de la santé, Université de Ouagadougou, BP 7021, Ouagadougou, Burkina Faso. oumgui@yahoo.fr.|Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso. oumgui@yahoo.fr.
authors.forename: O
authors.initials: O
authors.lastname: Guira
authors.affiliation: Unité de formation et de recherche en sciences de la santé, Université de Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.|Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: H
authors.initials: H
authors.lastname: Tiéno
authors.affiliation: Unité de formation et de recherche en sciences de la santé, Université de Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.|Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.|Service de chirurgie générale et digestive, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: S
authors.initials: S
authors.lastname: Traoré
authors.affiliation: Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: I
authors.initials: I
authors.lastname: Diallo
authors.affiliation: Unité de formation et de recherche en sciences de la santé, Université de Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.|Service de chirurgie générale et digestive, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: E
authors.initials: E
authors.lastname: Ouangré
authors.affiliation: Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: Y
authors.initials: Y
authors.lastname: Sagna
authors.affiliation: Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: J
authors.initials: J
authors.lastname: Zabsonré
authors.affiliation: Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: D
authors.initials: D
authors.lastname: Yanogo
authors.affiliation: Unité de formation et de recherche en sciences de la santé, Université de Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.
authors.forename: S S
authors.initials: SS
authors.lastname: Traoré
authors.affiliation: Unité de formation et de recherche en sciences de la santé, Université de Ouagadougou, BP 7021, Ouagadougou, Burkina Faso.|Service de médecine interne, Centre hospitalier universitaire Yalgado Ouédraogo, BP 7022, Ouagadougou, Burkina Faso.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Drabo
mesh_terms: D002050:Burkina Faso / Q000453:epidemiology; D003430:Cross-Sectional Studies; D017719:Diabetic Foot / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D004756:Enterobacteriaceae Infections / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D010000:Osteitis / Q000382:microbiology; D011552:Pseudomonas Infections / Q000453:epidemiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology; D014946:Wound Infection / Q000453:epidemiology / Q000382:microbiology
keywords: Antibiotics; Bacteriology; Burkina Faso; Diabetic foot infection; Sub-Saharan Africa