A Prospective Study on Bacterial Isolation from Diabetic Foot Ulcer in Department of Surgery

  • Kapil Sharda Assistant Professor, Department of Surgery, Geetanjali Medical College and Hospital, Udaipur.
  • Prakash Choudhary Assistant Professor, Department of Surgery, Geetanjali Medical College and Hospital, Udaipur.
Keywords: Diabetes mellitus, MRSA, MSSA, Klebsiella pneumoniae


Background: There are various wound classification systems to assess the severity of diabetic foot ulcer and involve different factors specifically depth, site, presence of neuropathy, ischemia etc. Wagner’s system classification is the most widely used in grading of diabetic foot ulcers.

Methods: The case study was carried out in the Department of Surgery, Geetanjali Medical College and Hospital, Udaipur.

Results: 173 cases were enrolled in study and grade-3 Wagner’s ulcers were predominant. Males were predominant. Peripheral arterial disease was more common than peripheral neuropathy and both were found significantly associated with development of ulcers. Methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae were most common isolates. MRSA exhibited maximum sensitivity to vancomycin, clindamycin and linezolid. Gram negative isolates exhibited maximum sensitivity to meropenems, piperacillin-tazobactam.

Conclusions: This study conclude that prospective multicenter studies are required to assess the appropriate antibiotic regimen in diabetic foot ulcers and proper management of antibiotics must be started to decrease the incidence and development of MDR organisms.


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1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabet Res Clinic Pract. 2011;94(3):311-21.
2. Tharkar S, Devarajan A, Kumpatla S, Viswanathan V. The socioeconomics of diabetes from a developing country: a population based cost of illness study. diabetes research and clinical practice. 2010;89(3):334-40.
3. Cervantes-García E, Salazar-Schettino PM. Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico. Diabet foot and Ankle. 2017;8(1):1367210.
4. Lipsky BA. Evidence-based antibiotic therapy of diabetic foot infections. FEMS Immunology and Medical Microbiology 1999; 26: 267-27.
5. Khan MH. Pathogenesis of diabetic foot ulcer. Diab Endocr J 2006; 34(suppl 1): 11.
6. Dang CN, Prasad YD, Boulton A.J., Jude EB. Methicillin resistant Staphylococcus aureus in the diabetic foot clinic: a worsening problem. Diabet Med 2003; 20: 159-161.
7. Lipsky BA, Berendt AR, Decry JM, Embil WS, Joseph AW, Karechmer et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2004; 39: 885-910.
8. Lipsky BA, Pecoraro SA, Larson M, Hanley E, Ahroni JH. Outpatient management of uncomplicated lower extremity infections in diabetic patients, Arch Intern Med 1990; 150: 790-797.
9. Lipsky BA, Pecoraro RE, Wheat JL. The diabetic foot: soft tissue and bone infection. Infect Dis Clin North Am 1990; 4(3): 409-432.
10. Lipsky BA, Berendt AR. Principles and practice of antibiotic therapy of diabetic foot infections. Diabetes Metab Res Rev 2000; 16(suppl 1): S42-S46.
11. Wagner FW. The dysvascular foot: a system of diagnosis and treatment. Foot Ankle. 1981;2:64- 122.
12. Jeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. 2003;361:1545-51.
13. Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classification system: the contribution of depth, infection and vascular disease to the risk of amputation. Diabet Care. 1998;21:855-9.
14. Shea JD. Pressure sores: classification and management. Clin Orthop. 1975;112:89-100.
15. Mayfield JA, Reiber GE, Nelson RG, Greene T. A foot risk classification system to predict diabetic amputation in Pima Indians. Diabet Care. 1996;19:704-9.
16. Yonem A, Cakir B, Guler S, Azal OO, Corakei A. Effects of granulocyte-colony Stimulating factor in the treatment of diabetic foot infection. Diabetes Obes Metab. 2001;3(5):332-7.
17. Gershater MA, LoÈndahl M, Nyberg P, Larsson J, ThoÈrne J, Eneroth M, et al. Complexity of factors related to outcome of neuropathic and neuroischaemic/ischaemic diabetic foot ulcers: a cohort study. Diabetologia. 2009;52(3):398-407.
18. Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetes. Diabet Care. 2006;29(6):1288-93.
19. Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Armstrong DG, Harkless LB, et al. The effects of ulcer size and site, patient's age, sex and type and duration of diabetes on the outcome of diabetic foot ulcers. Diabet Med. 2001;18(2):133-8.
20. Baba M, Davis WA, Norman PE, Davis TME. Temporal changes in the prevalence and associates of foot ulceration in type 2 diabetes: the Fremantle Diabetes Study. J Diabetes Complications. 2015;29(3):356-361.
21. Viswanathan V, Jasmine JJ, Snehalatha C, Ramachandran A. Prevalence of pathogens in diabetic foot infection in South Indian type 2 diabetic patients. J Assoc Physicians India. 2002;50:1013-16.
22. Chincholikar DA, Pal RB. Study of fungal and bacteriological infections of the diabetic foot. Indian J Pathol Microbiol. 2002;45:15-22.
How to Cite
Sharda K, Choudhary P. A Prospective Study on Bacterial Isolation from Diabetic Foot Ulcer in Department of Surgery. IABCR [Internet]. 30Sep.2018 [cited 18Oct.2018];4(3):62-4. Available from: https://iabcr.org/index.php/iabcr/article/view/405