A Clinical study of prevalence of bacteria isolated from type 2 diabetic foot ulcers and its antibiotic susceptibility

Background and Objectives: The annual incidence of diabetic foot ulcer in diabetic patients is known to be about 2% to 5% and the lifetime risk ranges from 15% to 20%. The main objective of this studyis to determine the most prevalent pathogens involved in diabetic foot ulcers and its antibiotic susceptibility. The predominant organism related to the different Wagner grades were also assessed as part of this study. Methods: The present study was a hospital-based descriptive study conducted on patients admitted with diabetic foot in the department of General Surgery at Government Medical College, Kozhikode, Kerala during the period from August 2019 to July 2020. Tissue or swab culture was taken from the ulcer and the antibiotic sensitivity was tested by Kirby-Bauer Disk Diffusion Susceptibility Test. Results: At the time of presentation more than 50% of ulcers were of Wagner’s grade II and III. The predominant organism isolated from diabetic foot infections were Klebsiella (32.98%) followed by Pseudomonas (24.47%). Multi-drug resistance was seen in 12 out of 62 samples that yielded Klebsiella, 2 out of 46 samples that yielded Pseudomonas, 4 out of 22 samples that yielded E. Coli and MRSA was seen in 8 out of 22 samples that yielded Staph. Aureus. Discussion and Conclusions: The predominant organisms isolated were Klebsiella and Pseudomonas species and were mostly sensitive to Piperacillin/Tazobactam, Meropenem, Ciprofloxacin and Amikacin. Hence it is advisable to start patients on empirical therapy with these drugs for better outcome. Proper assessment of ulcer and targeted antibiotics against these organisms can aid in early healing and avoidance of diabetic foot related complications.