Bacteriological study of diabetic foot infection in Egypt

Foot infections are one of the major complications of diabetes mellitus and are a significant risk factor for lower extremity amputation. Providing effective antimicrobial therapy is an important component in treating these infections. This study assesses the microbial isolates of patients with diabetic foot infections and their antibiotic susceptibility pattern. Patients and methods A prospective study of 75 patients with diabetic foot infections admitted to Al-Azhar university hospitals was undertaken. Bacteriological specimens were obtained and processed using standard hospital procedure for microbiological culture and sensitivity testing. Results Overall, 40 (54%) patients had subcutaneous infections, 22 (29%) had infected superficial ulcers, seven (9%) had infected deep ulcers involving muscle tissue, and six (8%) patients had osteomyelitis. A total of 99 pathogens were isolated. Forty percent of patients had polymicrobial infection, 39 (52%) had single organism infections, and six (8%) had no growth. Gram-negative bacteria (67%) were more commonly isolated compared with Gram-positive bacteria (30%). The three most frequently found Grampositive organisms were Staphylococcus aureus (10.2%), Streptococcus pyogenes (7.1%) and methicillin-resistant S. aureus (7.1%), and the most common Gram-negative organisms were Pseudomonas aeruginosa (19.4%), Klebsiella pneumoniae (15.3%), and Acinetobacter spp. (10.2%). Vancomycin was found to be the most effective against Gram-positive bacteria, whereas imipenem and amikacin were most effective against Gram-negative bacteria on antibiotic testing. Conclusion Forty percent of diabetic foot infections were polymicrobial. S. aureus and P. aeruginosa were the most common Gram-positive and Gram-negative organisms, respectively. This study helps us to choose empirical antibiotics for patients with diabetic foot infections