Archives of Plastic Surgery

  • 제33권3호
  • /
  • Pages.330-334
  • /
  • 2006
  • /
  • 2234-6163(pISSN)
  • /
  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지

당뇨족 궤양의 세균 역학과 항생제 감수성

Bacteriology and Antibiotic Sensitivity for Diabetic Foot Ulcer

  • 최상록 (고려대학교 의과대학 성형외과학교실) ;
  • 이창규 (고려대학교 의과대학 진단검사의학교실) ;
  • 김덕우 (고려대학교 의과대학 성형외과학교실) ;
  • 한승규 (고려대학교 의과대학 성형외과학교실) ;
  • 김우경 (고려대학교 의과대학 성형외과학교실)
  • Choi, Sang-Rok (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Lee, Chang-Kyu (Department of Laboratory Medicine, Korea University College of Medicine) ;
  • Kim, Deok-Woo (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Han, Seung-Kyu (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Kim, Woo-Kyung (Department of Plastic Surgery, Korea University College of Medicine)
  • 투고 : 2006.03.08
  • 발행 : 2006.05.10
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Polymicrobial nature of diabetic foot infection has been well documented in the literature. Initial antibiotic therapy of diabetic foot infection is usually empiric until reliable culture data is shown. This study was carried out to determine the common bacteriological flora of diabetic foot infection and antimicrobial sensitivity pattern in order to enhance possible empiric treatment. The specimens were obtained from wounds of 207 cases of diabetic foot ulcer, and the bacteriological isolation, and antimicrobial susceptibility tests of the isolates were carried out by standard microbiological methods. Staphylococcus aureus was the most common isolate, with 46.2% of recover rate among total bacterial isolated cases. Among gram-negative organisms, Pseudomonas aeruginosa was most common. Gram-positive organisms showed significant susceptibility to clindamycin, trimethoprim/sulfamethoxazole, and levofloxacin, besides vancomycin. Cefoperazone, piperacillin/tazobactam, and amikacin in addition to imipenem were most effective agents compared to gram-negative organisms. Diabetic foot infection requires use of combined antimicrobial therapy for initial management. Our results indicate that the most effective antibiotic combination for diabetic foot infection of Korean patients is clindamycin plus cefoperazone.

키워드

참고문헌

  1. Boulton AJ: The diabetic foot: a global view. Diabetes Metab Res Rev 16: 52, 2000
  2. Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ: Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort. Diabetes Care 26: 1435, 2003 https://doi.org/10.2337/diacare.26.5.1435
  3. Lipsky BA: Evidence-based antibiotic therapy of diabetic foot infections. FEMS Immunol Med Microbiol 26: 267, 1999 https://doi.org/10.1111/j.1574-695X.1999.tb01398.x
  4. Frykberg RG: Diabetic foot ulcer: pathogenesis and management. Am Fam Physician 66: 1655, 2002
  5. Armstrong DG, Lipsky BA: Advances in the treatment of diabetic foot infections. Diabetes Technol Ther 6: 167, 2004 https://doi.org/10.1089/152091504773731357
  6. Edmonds M, Foster A: The use of antibiotics in the diabetic foot. Am J Surg 187: 25S, 2004 https://doi.org/10.1016/S0002-9610(03)00300-3
  7. Dang CN, Prasad YD, Boulton AJ, Jude EB: Methicillin-resistant Staphylococcus aureus in the diabetic foot clinic: a worsening problem. Diabet Med 20: 159, 2002 https://doi.org/10.1046/j.1464-5491.2003.00860.x
  8. Valencia IC, Kirsner RS, Kerdel FA: Microbiologic evaluation of skin wounds: alarming trend toward antibiotic resistance in an inpatient dermatology service during a 10-year period. J Am Acad Dermatol 50: 845, 2004 https://doi.org/10.1016/j.jaad.2003.11.064
  9. Abdulrazak A, Bitar ZI, Al-Shamali AA, Mobasher LA: Bacteriological study of diabetic foot infections. J Diabetes Complications 19: 138, 2005 https://doi.org/10.1016/j.jdiacomp.2004.06.001
  10. Senneville E, Yazdanpanah Y, Cazaubiel M, Cordonnier M, Valette M, Beltrand E, Khazarjian A, Maulin L, Alfandari S, Caillaux M, Dubreuil L, Mouton Y: Rifampicin-ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis. J Antimicrob Chemother 48: 927, 2001 https://doi.org/10.1093/jac/48.6.927
  11. Ramsey SD, Newton K, Blough D, McCulloch DK, Sandhu N, Reiber GE, Wagner EH: Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care 22: 382, 1999 https://doi.org/10.2337/diacare.22.3.382
  12. Wieman TJ: Principles of management: the diabetic foot. Am J Surg 190: 295, 2005 https://doi.org/10.1016/j.amjsurg.2005.05.030