| Sub-title | |
| Authors | L Micallef Grimaud M J Cachia P Camilleri |
| Abstract | Fifteen per cent of people with diabetes develop foot ulcers. The most common risk factors for ulceration include diabetic neuropathy, structural foot deformity and peripheral arterial occlusive disease. Diabetic ulcers are highly susceptible to infection, which is a major cause of amputation. Systemic antibiotics are regarded as part of standard treatment for invasive infections associated with diabetic foot ulcers. An audit of wound swab results of diabetic foot ulcers of patients being followed up at the podiatry unit of the Diabetes Clinic was carried out. This involved a total of 144 culture and sensitivity reports of wound swabs. The aim of the audit was to assess the most common infective organisms and their sensitivities. Bacteria were cultivated in 88.17% of cases. 7.6% of swabs revealed highly mixed flora suggestive of contamination whilst no pathogens were isolated in 4.16%. In 59.7% of swabs more than one organism was cultured from the same ulcer. A high recurrence rate of diabetic ulcers was also noted. The most commonly isolated organisms were Staphylococcus aureus, 43% of which were MRSA, Streptococci, Pseudomonas aeruginosa and Enterococci. Other common organisms were Proteus mirabilis, Morganella morganii, Escherichia coli, Klebsiella oxytoca and Citrobacter koseri. A common pattern of antibiotic sensitivities was noted though rarely some strains were resistant to antibiotics to which the same strain was usually sensitive. Wound swabs of infected ulcers are essential to guide antibiotic therapy in the treatment of the diabetic foot, with the ultimate aim of preventing morbidity and mortality. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | arterial disease, audit, culture and sensitivity, diabetes, foot ulcers |