title: Aerobic bacterial profile and antibiotic resistance in patients with diabetic foot infections.
abstract: BACKGROUND
  This study aimed to determine the frequencies of bacterial isolates cultured from diabetic foot infections and assess their resistance and susceptibility to commonly used antibiotics.
  
  
  METHODS
  This prospective study included 41 patients with diabetic foot lesions. Bacteria were isolated from foot lesions, and their antibiotic susceptibility pattern was determined using the Kirby-Bauer disk diffusion method and/or broth method [minimum inhibitory concentration (MIC)].
  
  
  RESULTS
  The most common location of ulceration was the toe (54%), followed by the plantar surface (27%) and dorsal portion (19%). A total of 89 bacterial isolates were obtained from 30 patients. The infections were predominantly due to Gram-positive bacteria and polymicrobial bacteremia. The most commonly isolated Gram-positive bacteria were Staphylococcus aureus, followed by Staphylococcus saprophyticus, Staphylococcus epidermidis, Streptococcus agalactiae, and Streptococcus pneumoniae. The most commonly isolated Gram-negative bacteria were Proteus spp. and Enterobacterspp., followed by Escherichia coli, Pseudomonasspp., and Citrobacterspp. Nine cases of methicillin-resistant Staphylococcus aureus (MRSA) had cefoxitin resistance, and among these MRSA isolates, 3 were resistant to vancomycin with the MIC technique. The antibiotic imipenem was the most effective against both Gram-positive and Gram-negative bacteria, and gentamicin was effective against Gram-negative bacteria.
  
  
  CONCLUSIONS
  The present study confirmed the high prevalence of multidrug-resistant pathogens in diabetic foot ulcers. It is necessary to evaluate the different microorganisms infecting the wound and to know the antibiotic susceptibility patterns of the isolates from the infected wound. This knowledge is crucial for planning treatment with the appropriate antibiotics, reducing resistance patterns, and minimizing healthcare costs.
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Michele Cezimbra
authors.initials: MC
authors.lastname: Perim
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Joelma da Costa
authors.initials: Jda C
authors.lastname: Borges
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Stela Regina Costa
authors.initials: SR
authors.lastname: Celeste
authors.affiliation: Setor de Cirurgia Vascular, Hospital Geral de Palmas, Palmas, Tocantins, Brazil.
authors.forename: Ederson de Freitas
authors.initials: Ede F
authors.lastname: Orsolin
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Rafael Rocha
authors.initials: RR
authors.lastname: Mendes
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Gabriella Oliveira
authors.initials: GO
authors.lastname: Mendes
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Roumayne Lopes
authors.initials: RL
authors.lastname: Ferreira
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Solange Cristina
authors.initials: SC
authors.lastname: Carreiro
authors.affiliation: Universidade Federal do Tocantins, Palmas, Tocantins, Brazil.
authors.forename: Maria Cristina da Silva
authors.initials: MC
authors.lastname: Pranchevicius
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017719:Diabetic Foot / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects*; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents