Evaluation of various risk factors associated with multidrug-resistant organisms isolated from diabetic foot ulcer patients

Priya Datta; Jagdish Chander; Varsha Gupta; Gursimran Kaur Mohi; Ashok K. Attri

doi:10.4103/JLP.JLP_106_18

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(01): 058-062
DOI: 10.4103/JLP.JLP_106_18

Original Article

Evaluation of various risk factors associated with multidrug-resistant organisms isolated from diabetic foot ulcer patients

Priya Datta

Department of Microbiology, Government Medical College and Hospital, Chandigarh, India

,

Jagdish Chander

Department of Microbiology, Government Medical College and Hospital, Chandigarh, India

,

Varsha Gupta

Department of Microbiology, Government Medical College and Hospital, Chandigarh, India

,

Gursimran Kaur Mohi

Department of Microbiology, Government Medical College and Hospital, Chandigarh, India

,

Ashok K. Attri

Department of Surgery, Government Medical College and Hospital, Chandigarh, India

› Author Affiliations

Abstract

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Abstract

AIMS: Diabetic foot ulcer is a dreaded complication of diabetes. Diabetic foot ulcer patients are often infected with multidrug resistant organism (MDRO) due to chronic course of the wound, inappropriate antibiotics treatment, frequent hospital admission, neuropathy, nephropathy, and peripheral vascular disease.

MATERIALS AND METHODS: This prospective study was conducted in our 750 bedded hospital for a period of 6 months. The present study was undertaken to isolate various MDRO methicillin resistant Staphylococcus aureus; Gram-negative bacteria producing enzymes such as extended spectrum beta-lactamases (ESBL), Amp C, Carbapenamases; Pseudomonas and Acinetobacter species producing metallo-beta-lactamases (MBL). In addition we attempted to identify risk factors for association of diabetic foot ulcer and MDRO.

RESULTS: A total of 149 bacterial isolates were identified. Of the total isolates 73.2% were Gram-negative and remaining 26.8% were Gram-positive bacteria. Among Enterobacteriaceae 59% were ESBL producers and 48% were Amp C producers. In addition, 41.5% of the isolates produced both ESBL and Amp C and 13.4% were carbapenem resistant Enterobacteriaceae. Among 20 Pseudomonas and Acinetobacter isolates, 5 were MBL producers (25%). Furthermore, in the study, 56% of patients with diabetic foot ulcer harbored MDRO. The risk of multidrug-resistant infection is significantly more in patients having diabetes duration >20 years and size of ulcer more than 4 cm².

CONCLUSION: The detection of MDRO in patients of diabetic foot ulcer changes the treatment strategies limits the antimicrobial options and causes higher complications among them.

Key words

Diabetic foot ulcer - multidrug resistant organisms - risk factors

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References

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