Anaerobic Bacteriological Profile of Infected Diabetic Foot Ulcers with their Antimicrobial Susceptibility Pattern: Need of the Hour

• Main Authors: Ritu Garg, Priya Datta, Varsha Gupta, Jagdish Chander
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2017-07-01
• Series: National Journal of Laboratory Medicine
• Subjects: bacteroides; polymicrobials; resistance; wagner’s grade
• Online Access: http://www.njlm.net/articles/PDF/2234/27836_CE[VSU]_F(GH)_PF1(VSUAK)_PFA(AK)_PF2(VSU_GG).pdf

Introduction: Diabetes has emerged as a major health care problem in developed as well as in developing country like India. Diabetic foot ulcers are the most common leading causes of morbidity and frequent indication for hospital admission. Limbthreatening diabetic infections are habitually polymicrobials in nature involving numerous aerobic and anaerobic organisms. Streptococcus species, Staphylococcus aureus, Enterobacteriaceae, Bacteroides fragilis, Peptostreptococcus species and Peptococcus species are the familiar organisms isolated from the cultures of diabetic foot ulcers. The upcoming resistance of anaerobes to the commonly used antibiotics is undiagnosed leading to treatment failure in diabetic foot ulcers. Aim: Isolation and identification of anaerobic bacteria from diabetic foot infections with their susceptibility pattern. Materials and Methods: A prospective study was carried out on pus samples from 100 clinically diagnosed diabetic foot ulcers patients admitted in the surgical ward of Tertiary Care Hospital of North India. Isolation and identification of anaerobic bacteria with their susceptibility testing was done. Results: Diabetic ulcers were graded as per the Wagener’s classification (Grade 1 to Grade 5). Majority of patients belong to Wagner’s Grade 2(73/100) followed by Grade 3(24/100), Grade 4(2/100) and Grade 5(1/100). In our study, out of 100 samples, 22 anaerobes were isolated. The predominant anaerobic bacteria were Bacteroides species (11%), followed by Peptostreptococcus species (5%), Peptostreptococcus anaerobius (2%), Eubacterium species (2%) followed by Peptococcus species and Prevotella species 1% each. Overall resistance was 27.27% to metronidazole, 13.63% to penicillin. There was no resistance to rest of the antimicrobials tested. Conclusion: With the emerging resistance of anaerobes to the commonly used drugs it becomes mandatory to look for antimicrobial susceptibility pattern for anaerobes along with the aerobes in diabetic foot ulcers.