The microbiology of diabetic foot infections in patients recently treated with antibiotic therapy: a prospective study from India
Abstract Aim Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously...
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| Veröffentlicht in: | Journal of diabetes and its complications 2017-02, Vol.31 (2), p.407-412 |
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| creator | Rastogi, A Sukumar, S Hajela, A Mukherjee, S Dutta, P Bhadada, S K Bhansali, A |
| description | Abstract Aim Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. Research design and methods 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes. Appropriate tissue samples i.e. purulent drainage, soft-tissue and/ or bone were obtained for aerobic/anaerobic cultures and antimicrobial sensitivities. 71 patients with missing prior antibiotic data were excluded. Results 313 tissue samples obtained from 222 patients isolated 317 causative organisms. Most of the culture results from tissue specimens were mono-microbial (93.2%) compared to 37% in our previous cohort of 60 patients. Pseudomonas aeruginosa was the most common organism isolated on culture of bone (26.9%) or soft tissue (23.2%) specimen, respectively. Only 23% and 64% of P. aeruginosa isolates and 5.6% and 44% of Acinetobacter sp. were sensitive to quinolones and cephalosporins, respectively. Conclusions Clinically infected DFU recently treated with antibiotics have predominant monomicrobial and multi drug-resistant infection. Quinolones as an empirical antibiotic choice may not be appropriate in this setting. |
| doi_str_mv | 10.1016/j.jdiacomp.2016.11.001 |
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The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. Research design and methods 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes. Appropriate tissue samples i.e. purulent drainage, soft-tissue and/ or bone were obtained for aerobic/anaerobic cultures and antimicrobial sensitivities. 71 patients with missing prior antibiotic data were excluded. Results 313 tissue samples obtained from 222 patients isolated 317 causative organisms. Most of the culture results from tissue specimens were mono-microbial (93.2%) compared to 37% in our previous cohort of 60 patients. Pseudomonas aeruginosa was the most common organism isolated on culture of bone (26.9%) or soft tissue (23.2%) specimen, respectively. Only 23% and 64% of P. aeruginosa isolates and 5.6% and 44% of Acinetobacter sp. were sensitive to quinolones and cephalosporins, respectively. Conclusions Clinically infected DFU recently treated with antibiotics have predominant monomicrobial and multi drug-resistant infection. Quinolones as an empirical antibiotic choice may not be appropriate in this setting.</description><identifier>ISSN: 1056-8727</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2016.11.001</identifier><identifier>PMID: 27894749</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject><![CDATA[Acinetobacter ; Acinetobacter - drug effects ; Acinetobacter - growth & development ; Acinetobacter - isolation & purification ; Aged ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antibiotic ; Antibiotics ; Classification ; Clinical medicine ; Cohort Studies ; Diabetes ; Diabetic Foot - microbiology ; Diabetic foot infections ; Diabetic foot ulcer ; Drug Resistance, Multiple, Bacterial ; Endocrinology & Metabolism ; Female ; Follow-Up Studies ; Foot diseases ; Gram-Negative Bacteria - drug effects ; Gram-Negative Bacteria - growth & development ; Gram-Negative Bacteria - isolation & purification ; Gram-Positive Bacteria - drug effects ; Gram-Positive Bacteria - growth & development ; Gram-Positive Bacteria - isolation & purification ; Humans ; India ; Infections ; Infectious diseases ; Male ; Microbial Sensitivity Tests ; Microbiology ; Middle Aged ; Multi drug-resistant infections ; Prospective Studies ; Pseudomonas aeruginosa ; Pseudomonas aeruginosa - drug effects ; Pseudomonas aeruginosa - growth & development ; Pseudomonas aeruginosa - isolation & purification ; Quinolones - pharmacology ; Surgeons ; Ulcers ; Wound Infection - complications ; Wound Infection - microbiology]]></subject><ispartof>Journal of diabetes and its complications, 2017-02, Vol.31 (2), p.407-412</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 01, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-ddf65aca5b55f7accd77a229743f60bda8b1d05513153c8151130da6f63fa5743</citedby><cites>FETCH-LOGICAL-c484t-ddf65aca5b55f7accd77a229743f60bda8b1d05513153c8151130da6f63fa5743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1867916753?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000,64390,64392,64394,72474</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27894749$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rastogi, A</creatorcontrib><creatorcontrib>Sukumar, S</creatorcontrib><creatorcontrib>Hajela, A</creatorcontrib><creatorcontrib>Mukherjee, S</creatorcontrib><creatorcontrib>Dutta, P</creatorcontrib><creatorcontrib>Bhadada, S K</creatorcontrib><creatorcontrib>Bhansali, A</creatorcontrib><title>The microbiology of diabetic foot infections in patients recently treated with antibiotic therapy: a prospective study from India</title><title>Journal of diabetes and its complications</title><addtitle>J Diabetes Complications</addtitle><description>Abstract Aim Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. Research design and methods 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes. Appropriate tissue samples i.e. purulent drainage, soft-tissue and/ or bone were obtained for aerobic/anaerobic cultures and antimicrobial sensitivities. 71 patients with missing prior antibiotic data were excluded. Results 313 tissue samples obtained from 222 patients isolated 317 causative organisms. Most of the culture results from tissue specimens were mono-microbial (93.2%) compared to 37% in our previous cohort of 60 patients. Pseudomonas aeruginosa was the most common organism isolated on culture of bone (26.9%) or soft tissue (23.2%) specimen, respectively. Only 23% and 64% of P. aeruginosa isolates and 5.6% and 44% of Acinetobacter sp. were sensitive to quinolones and cephalosporins, respectively. Conclusions Clinically infected DFU recently treated with antibiotics have predominant monomicrobial and multi drug-resistant infection. Quinolones as an empirical antibiotic choice may not be appropriate in this setting.</description><subject>Acinetobacter</subject><subject>Acinetobacter - drug effects</subject><subject>Acinetobacter - growth & development</subject><subject>Acinetobacter - isolation & purification</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotic</subject><subject>Antibiotics</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>Cohort Studies</subject><subject>Diabetes</subject><subject>Diabetic Foot - microbiology</subject><subject>Diabetic foot infections</subject><subject>Diabetic foot ulcer</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>Endocrinology & Metabolism</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Foot diseases</subject><subject>Gram-Negative Bacteria - drug effects</subject><subject>Gram-Negative Bacteria - growth & development</subject><subject>Gram-Negative Bacteria - isolation & purification</subject><subject>Gram-Positive Bacteria - drug effects</subject><subject>Gram-Positive Bacteria - growth & development</subject><subject>Gram-Positive Bacteria - isolation & purification</subject><subject>Humans</subject><subject>India</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Microbial Sensitivity Tests</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Multi drug-resistant infections</subject><subject>Prospective Studies</subject><subject>Pseudomonas aeruginosa</subject><subject>Pseudomonas aeruginosa - drug effects</subject><subject>Pseudomonas aeruginosa - growth & development</subject><subject>Pseudomonas aeruginosa - isolation & purification</subject><subject>Quinolones - pharmacology</subject><subject>Surgeons</subject><subject>Ulcers</subject><subject>Wound Infection - complications</subject><subject>Wound Infection - microbiology</subject><issn>1056-8727</issn><issn>1873-460X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkktv1TAQhSMEoqXwFypLbNgk2En8CAtEVfGoVIkFRWJnOX5wHZI42L5FWfafd8JtQeoGVh5L3xx7zpmiOCW4Ipiw10M1GK90mJaqhntFSIUxeVQcE8GbsmX422OoMWWl4DU_Kp6lNGCMGaXkaXFUc9G1vO2Oi5urnUWT1zH0Pozh-4qCQ6Dc2-w1ciFk5GdndfZhTlCiRWVv55xQtBrOcUU5WpWtQb983iE1Zw9KW3Pe2aiW9Q1SaIkhLZvItUUp782KXAwTupjhpefFE6fGZF_cnSfF1w_vr84_lZefP16cn12WuhVtLo1xjCqtaE-p40prw7mq6463jWO4N0r0xGAYryG00YJQQhpsFHOscYoCdVK8OujCZ37ubcpy8knbcVSzDfskwbha1EJ04j_QFhzmYDygLx-gQ9jHGQYBivGOME4boNiBAp9TitbJJfpJxVUSLLc85SDv85RbnpIQiX_Ln97J7_vJmj9t9wEC8O4AWLDu2tsok4Z8tDUeAsrSBP_vN94-kNCjn71W4w-72vR3HplqieWXbau2pSKswQLTtrkFx27LIA</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Rastogi, A</creator><creator>Sukumar, S</creator><creator>Hajela, A</creator><creator>Mukherjee, S</creator><creator>Dutta, P</creator><creator>Bhadada, S K</creator><creator>Bhansali, A</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QL</scope><scope>7T5</scope><scope>C1K</scope><scope>H94</scope></search><sort><creationdate>20170201</creationdate><title>The microbiology of diabetic foot infections in patients recently treated with antibiotic therapy: a prospective study from India</title><author>Rastogi, A ; Sukumar, S ; Hajela, A ; Mukherjee, S ; Dutta, P ; Bhadada, S K ; Bhansali, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-ddf65aca5b55f7accd77a229743f60bda8b1d05513153c8151130da6f63fa5743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acinetobacter</topic><topic>Acinetobacter - drug effects</topic><topic>Acinetobacter - growth & development</topic><topic>Acinetobacter - isolation & purification</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotic</topic><topic>Antibiotics</topic><topic>Classification</topic><topic>Clinical medicine</topic><topic>Cohort Studies</topic><topic>Diabetes</topic><topic>Diabetic Foot - microbiology</topic><topic>Diabetic foot infections</topic><topic>Diabetic foot ulcer</topic><topic>Drug Resistance, Multiple, Bacterial</topic><topic>Endocrinology & Metabolism</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Foot diseases</topic><topic>Gram-Negative Bacteria - drug effects</topic><topic>Gram-Negative Bacteria - growth & development</topic><topic>Gram-Negative Bacteria - isolation & purification</topic><topic>Gram-Positive Bacteria - drug effects</topic><topic>Gram-Positive Bacteria - growth & development</topic><topic>Gram-Positive Bacteria - isolation & purification</topic><topic>Humans</topic><topic>India</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Microbial Sensitivity Tests</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Multi drug-resistant infections</topic><topic>Prospective Studies</topic><topic>Pseudomonas aeruginosa</topic><topic>Pseudomonas aeruginosa - drug effects</topic><topic>Pseudomonas aeruginosa - growth & development</topic><topic>Pseudomonas aeruginosa - isolation & purification</topic><topic>Quinolones - pharmacology</topic><topic>Surgeons</topic><topic>Ulcers</topic><topic>Wound Infection - complications</topic><topic>Wound Infection - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rastogi, A</creatorcontrib><creatorcontrib>Sukumar, S</creatorcontrib><creatorcontrib>Hajela, A</creatorcontrib><creatorcontrib>Mukherjee, S</creatorcontrib><creatorcontrib>Dutta, P</creatorcontrib><creatorcontrib>Bhadada, S K</creatorcontrib><creatorcontrib>Bhansali, A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Immunology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Journal of diabetes and its complications</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rastogi, A</au><au>Sukumar, S</au><au>Hajela, A</au><au>Mukherjee, S</au><au>Dutta, P</au><au>Bhadada, S K</au><au>Bhansali, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The microbiology of diabetic foot infections in patients recently treated with antibiotic therapy: a prospective study from India</atitle><jtitle>Journal of diabetes and its complications</jtitle><addtitle>J Diabetes Complications</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>31</volume><issue>2</issue><spage>407</spage><epage>412</epage><pages>407-412</pages><issn>1056-8727</issn><eissn>1873-460X</eissn><abstract>Abstract Aim Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. Research design and methods 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes. Appropriate tissue samples i.e. purulent drainage, soft-tissue and/ or bone were obtained for aerobic/anaerobic cultures and antimicrobial sensitivities. 71 patients with missing prior antibiotic data were excluded. Results 313 tissue samples obtained from 222 patients isolated 317 causative organisms. Most of the culture results from tissue specimens were mono-microbial (93.2%) compared to 37% in our previous cohort of 60 patients. Pseudomonas aeruginosa was the most common organism isolated on culture of bone (26.9%) or soft tissue (23.2%) specimen, respectively. Only 23% and 64% of P. aeruginosa isolates and 5.6% and 44% of Acinetobacter sp. were sensitive to quinolones and cephalosporins, respectively. Conclusions Clinically infected DFU recently treated with antibiotics have predominant monomicrobial and multi drug-resistant infection. Quinolones as an empirical antibiotic choice may not be appropriate in this setting.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27894749</pmid><doi>10.1016/j.jdiacomp.2016.11.001</doi><tpages>6</tpages></addata></record> |
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| subjects | Acinetobacter Acinetobacter - drug effects Acinetobacter - growth & development Acinetobacter - isolation & purification Aged Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Antibiotic Antibiotics Classification Clinical medicine Cohort Studies Diabetes Diabetic Foot - microbiology Diabetic foot infections Diabetic foot ulcer Drug Resistance, Multiple, Bacterial Endocrinology & Metabolism Female Follow-Up Studies Foot diseases Gram-Negative Bacteria - drug effects Gram-Negative Bacteria - growth & development Gram-Negative Bacteria - isolation & purification Gram-Positive Bacteria - drug effects Gram-Positive Bacteria - growth & development Gram-Positive Bacteria - isolation & purification Humans India Infections Infectious diseases Male Microbial Sensitivity Tests Microbiology Middle Aged Multi drug-resistant infections Prospective Studies Pseudomonas aeruginosa Pseudomonas aeruginosa - drug effects Pseudomonas aeruginosa - growth & development Pseudomonas aeruginosa - isolation & purification Quinolones - pharmacology Surgeons Ulcers Wound Infection - complications Wound Infection - microbiology |
| title | The microbiology of diabetic foot infections in patients recently treated with antibiotic therapy: a prospective study from India |
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