Risk factors for infection of the diabetic foot with multi-antibiotic resistant microorganisms

J Infect. 2007 May;54(5):439-45. doi: 10.1016/j.jinf.2006.08.013. Epub 2006 Oct 2.

Abstract

Aim: To investigate the risk factors for infection of the diabetic foot with multidrug resistant microorganisms.

Methods: Amongst 102 diabetic patients with evidence of soft tissue infection of the foot who presented to our health center over a three year period, we investigated risk factors that might be predictive of multi-antibiotic resistance of the infecting organism.

Results: Of 102 patients with a diabetic foot wound, bacteria were cultured from 73, yielding a total of 104 isolates. The number of multidrug resistant isolates was 42 from 36 cases and the number of isolates other than multidrug resistant ones was 62 from 37 cases. Previous antibiotic therapy (p=0.002) and its duration (p=0.0001), frequency of hospitalization for the same wound (p=0.000), duration of hospital stay (p=0.000) and osteomyelitis (p=0.001) were significant risk factors for infections with multidrug resistant microorganisms.

Conclusion: In conclusion, an appropriate antibiotic should be initiated promptly, wound perfusion should be effective, duration of hospital stay should be as short as possible and optimum hygiene should be provided during wound care to prevent infections of diabetic foot wound with multidrug resistant microorganisms.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Diabetic Foot / complications*
  • Diabetic Foot / microbiology
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Positive Bacteria / classification
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / microbiology*
  • Hospitalization
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology
  • Risk Factors
  • Wound Infection / drug therapy
  • Wound Infection / microbiology*

Substances

  • Anti-Bacterial Agents