Analysis of pathogens and their susceptibility in patients with diabetic foot syndrome treated surgically
Abstract
Introduction. Diabetes is one of the most common civilization diseases, which has a significant impact on particular individuals but also on society as a whole. Improper metabolism of sugars can lead to a number of complications affecting the whole body. From a surgical point of view treatment of diabetes complications, apart from optimizing the treatment of hyperglycaemia, is limited to the treatment of diabetic foot syndrome. The syndrome develops on a basis of microneuropathy, leading to development of necrotic lesions which are the perfect breeding ground for a number of bacteria. Adequate antibiotic therapy is one of the most important elements of all interdisciplinary therapy in treatment of diabetic foot syndrome.
Material and methods. In the present study, results of obtained swab cultures were evaluated to assess optimal antibiotic treatment, evaluating only the first bred isolate from the patient.
Results. In all 61 patients inflammatory infiltration of skin and soft tissues was observed, most of which accompanied by foot/leg wounds that healed after minor surgical interventions. A single pathogen was isolated in nearly half of the patients. In one patient, eight pathogens were isolated. The most commonly identified pathogens
were Staphylococcus aureus, Enterococcus faecalis, Coagulase-negative staphylococcus (other than S. Cohni, S. Epidermidis, S. Werneri, S. Haemoliticus).
Conclusions. Soft tissue infections in the diabetic foot syndrome are most frequently caused by several types of bacteria, most commonly Staphylococcus aureus. Based on the provided results, it appears that the optimal start of antibiotic therapy would be the use of amoxicillin with clavulanic acid. (Clin Diabetol 2017; 6, 6: 189–194)
Keywords: diabetesdiabetic footdiabetic complicationsdiabetic foot infectionsamputation
References
- Toumi A, Bernard L, Chakroun M. Antibiothérapie des infections du pied diabétique. RevTunInfectiol. 2011; 5: 61–7.
- Sieradzki J, Kblik T. Zespół stpy cukrzycwej, VM Media Sp. z . z o o. : 2008.
- P. Porzycki, D. Dzierżanowska. Chirurgia Noszczyka, Rozd 17: Zakażenia w chirurgii. : 200–234.
- Leiblein M, Marzi I, Sander AL, et al. Necrotizing fasciitis: treatment concepts and clinical results. Eur J Trauma Emerg Surg. 2017 [Epub ahead of print].
- Datsenko BM, Belov SG, Girka EI. Surgical treatment of purulent necrotic complcations in patients with diabetic foot syndrome. Klin Khir. 2001 Aug. ; 8: 10–2.
- Liu Si, He CZ, Cai YT, et al. Evaluation of negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and meta-analysis. Ther Clin Risk Manag. 2017; 13: 533–544.
- Ford-Dunn S. Use of vacuum assisted closure therapy in the palliation of a malignant wound. Palliat Med. 2006; 20(4): 477–478.
- Ha Va, Hartemann-Heurtier A, Gautier F, et al. Pied diabétique. Encycl Med Chir Endocrinologie-Nutrition. 2011; 10: 366–9.
- https://bazalekow.mp.pl/leki/doctor_subst.html?id=89.
- https://bazalekow.mp.pl/leki/doctor_subst.html?id=4063.
- Analiza lekowrażliwości za 2015 rok dla Kliniki Chirurgii Ogólnej i Onkologicznej USK im. WAM–CSW w Łodzi. dr n. med. G. Woch – Pracownia Mikrobiologii ZDL i BK.
- Iiro HJ, Hagberg L, Forsblom E, et al. Microbiological Etiology and Treatment of Complicated Skin and Skin Structure Infections in Diabetic and Nondiabetic Patients in a Population-Based Study Open Forum Infect Dis 4. 2017; 4(2).