Diabetologie und Stoffwechsel 2017; 12(S 01): S1-S84
DOI: 10.1055/s-0037-1601771
Poster: *Poster + Kurzpräsentation
Komplikationen
Georg Thieme Verlag KG Stuttgart · New York

Microbial profile of diabetic foot infections: A retrospective analysis

D Bogdanou
1   Goethe-University Hospital Frankfurt am Main, Department of Internal Medicine 1, Division of Endocrinology&Diabetology, Frankfurt am Main, Germany
,
M Rudy
1   Goethe-University Hospital Frankfurt am Main, Department of Internal Medicine 1, Division of Endocrinology&Diabetology, Frankfurt am Main, Germany
,
F Schlereth
1   Goethe-University Hospital Frankfurt am Main, Department of Internal Medicine 1, Division of Endocrinology&Diabetology, Frankfurt am Main, Germany
,
V Kempf
2   Goethe-University Hospital Frankfurt am Main, Institute for Medical Microbiology and Infection Control, Frankfurt am Main, Germany
,
K Badenhoop
1   Goethe-University Hospital Frankfurt am Main, Department of Internal Medicine 1, Division of Endocrinology&Diabetology, Frankfurt am Main, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
05 May 2017 (online)

Also available at
 
 

    Diabetic foot infections (DFI) are a common cause for hospitalization as a complication of diabetes mellitus. Identifying the infection causing bacteria is an important step for the diagnosis, stratification and treatment.

    Aim:

    The aim of this study was to define the bacteriological profile in complicated DFIs and determine prognostic factors. All patients had wound samples taken through deep scraping and swabing at diagnosis.

    Methods:

    253 bacterial isolates in 99 wounds of 76 diabetic patients (median age = 71 years, median BMI = 31.1 kg/m2) with DFI were included. The HbA1c(%Hb) and 25(OH)VD3(ng/ml) levels were measured in peripheral blood.

    Results:

    The median HbA1c and 25(OH)VD3 were 7.86%Hb and 15.11 ng/ml respectively. Most of the culture results were trimicrobial (27.84%). The most frequent germ group was Gram-positive bacteria (n = 136, 53.75% of samples) with Staphylococcus aureus (n = 48, 18.82%) in the first position, followed by Pseudomonas (n = 22, 8.56%), Enterobacter cloacae (n = 20, 7.78%) and Enterococcus spp. (n = 19, 7.39%). Stratifying our patients for glycemic control (HbA1c < 6.5, > 6.5 and < 7.5, > 7.5%Hb) revealed significantly less coagulase-negative staphylococci (15 isolates vs. 20 and 18 respectively, global p = 0.05) and more Escherichia coli (6 isolates vs. 4 and 5 respectively, global p = 0.05) for higher HbA1c levels. Hyperglycemia also correlated with more wounds per subject (WPS) (3WPS vs. 1 and 1 respectively, global p = 0.007), but also with less multimicrobial infections (global p < 0.001).

    Conclusions:

    Most of the samples were trimicrobial, with Staphylococcus aureus being the most prevalent microorganism, followed by Pseudomonas and Enterobacteriae spp. Glycemia demonstrated a significant influence on the microbial profile of the foot infections.


    #

    No conflict of interest has been declared by the author(s).