Abstract

COMPARISION OF MICROBIOLOGICAL PROFILE AND ANTIBIOTIC TREATMENT AMONG DIABETIC, NON DIABETIC PATIENTS HOSPITALIZED FOR LOWER LIMB CELLULITIS/ULCER

B.V.S. Lakshmi*, Hima Bindhu, M. Sudhakar, G. Apoorva, J. Uha Sri, M. Pradeep and D. Sahaja

Abstract

Objectives: Acute bacterial skin infections in diabetics represent a spectrum of conditions ranging from cellulitis to more complicated infections such as infected ulcers or deep tissue infections. Studies evaluating microbiological etiology and treatment patterns are scarce. To Compare the Microbiological profile and antibiotic treatment among Diabetic, Non Diabetic patients hospitalized for lower limb cellulitis /foot ulcers. Methods: Prospective study was conducted on 80 patients. Relevant data pertaining to demographics characteristics, duration of diabetes was taken from the patients. Samples of pus were collected from deep wounds and bacterial isolates was detected using culture and sensitivity testing Antimicrobial susceptibility testing to different agents was carried out using the disc diffusion method. Key findings: There was no significant difference in the microbiological etiology and treatment patterns between diabetic and non diabetic subjects hospitalized with cellulitis/ulcer. Among the Ulcer cases, Gram positive organism was isolated in 11.4% of Diabetic and 11.7% of Non diabetic subjects; Gram negative organism was isolated in 60% of Diabetic and 64.7% Non diabetic subjects; Poly microbial species were isolated in 25.7% of Diabetic, 17.6% of Non diabetic subjects; Candida albicans were isolated in 2.87% of Diabetic, 5.88% of Non diabetic subjects respectively. Beta-lactamase inhibitor (Amoxicillin+Clavulanic acid) combination is mostly prescribed as Initial treatment in both Ulcer (16.77%) and Cellulitis(22.22%). Whereas for Empirical treatment, Amoxicillin (U; 33.78%, C; 33.33%) along with Metronidazole(U;24.32%, C;33.33%) are commonly prescribed drugs irrespective of Diabetes Mellitus. Conclusion: Gram negative organisms were predominant in Diabetic and Non diabetic subjects hospitalized with cellulitis/ foot Ulcer. With this knowledge of causative organisms and their Antibiotic prescribing patterns the most suitable antibiotic can be started without waiting for the result. This would help in avoiding unnecessary medication with ineffective antibiotics and prevent development of drug resistance.

Keywords: Diabetic foot ulcer, Cellulitis, Microbiological profile, Polymicrobial infection.