Brazilian Journal of Microbiology Brazilian Journal of Microbiology
Braz J Microbiol 2018;49:401-6 - Vol. 49 Num.2 DOI: 10.1016/j.bjm.2017.09.003
Clinical Microbiology
Epidemiology of diabetic foot infections in a reference tertiary hospital in India
Sanjith Saseedharana,, , Manisa Sahub, Roonam Chaddhaa, Edwin Pathrosea, Arun Balc, Pallavi Bhalekarc, Priyadharshini Sekard, Padma Krishnand
a S L Raheja Hospital (A Fortis Associate), Intensive Care Unit, Mumbai, Maharashtra, India
b S L Raheja Hospital (A Fortis Associate), Department of Microbiology, Mumbai, Maharashtra, India
c S L Raheja Hospital (A Fortis Associate), Department of Diabetic Foot, Mumbai, Maharashtra, India
d University of Madras, Dr ALM PG Institute of Basic Medical Sciences, Department of Microbiology, Chennai, Tamil Nadu, India
Received 27 January 2016, Accepted 12 September 2017
Abstract
Introduction

The present study attempts to examine the microbial profile and antibiotic susceptibility of diabetic foot infections in the intensive care unit of a tertiary referral centre for diabetic foot. As part of the study, we also attempted to find the prevalence of blaNDM-like gene among carbapenem-resistant gram negative infections.

Methodology

A prospective study of 261 patients with diabetic foot infections was performed during the period between January 2014 and June 2014.

Results

A total of 289 isolates were obtained from 178 tissue samples from 261 patients, 156 (59.7%) males and 105 (40.2%) females, with a mean age of 58 years (−15 years), having diabetic foot infection. No growth was seen in thirty eight (17.6%) tissue samples. Out of the total samples, 44.3% were monomicrobial and 55.7% were polymicrobial. Gram negative pathogens were predominant (58.5%). Seven of the total isolates were fungal; 0.7% showed pure fungal growth and 1.7% were mixed, grown along with some bacteria. The most frequently isolated bacteria were Staphylococcus aureus (26.9%), followed by Pseudomonas aeruginosa (20.9%). Of the 58.5% gram negative pathogens, 16.5% were Enterobacteriaceae resistant to carbapenems. Among these isolates, 4 (25%) were positive for blaNDM-like gene. Among the rest, 18.6% were carbapenem-resistant Pseudomonas, among which 4 (36.3%) were blaNDM. Among the Staphylococci, 23.7% were methicillin-resistant Staphylococcus aureus.

Conclusions

Our results support the recent view that gram negative organisms, depending on the geographical location, may be predominant in DFIs. There is an increase in multidrug-resistant pathogens, especially carbapenem resistance and this is creeping rapidly. We need to be more judicious while using empiric antibiotics.

Keywords
Diabetic foot infection, blaNDM, MRSA
Braz J Microbiol 2018;49:401-6 - Vol. 49 Num.2 DOI: 10.1016/j.bjm.2017.09.003