Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Microbiology and Antibiotic Selection for Diabetic Foot Infections

감염된 당뇨병성 족부 병변의 균주 조사 및 항생제 선택

  • Park, Se-Jin (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine) ;
  • Jung, Haw-Jae (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine) ;
  • Shin, Hun-Kyu (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine) ;
  • Kim, Eu-Gene (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine) ;
  • Lim, Jong-Jun (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine) ;
  • Yoon, Ji-Woong (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine)
  • 박세진 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 정화재 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 신헌규 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 김유진 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 임종준 (성균관대학교 의과대학 강북삼성병원 정형외과학교실) ;
  • 윤지웅 (성균관대학교 의과대학 강북삼성병원 정형외과학교실)
  • Published : 2009.12.15
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Abstract

Purpose: To help the empirical antibiotics selection in diabetic foot infection patients, we investigated prevalence of microorganisms and their antibiotics sensitivity results. Materials and Methods: Patients who came to our clinics to treat diabetic foot infections with deep ulceration and were followed up more than 6 months until complete recovery were adopted. From March 2006 to June 2009, there were 140 patients who corresponded with such a inclusion criteria. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Microorganisms which was documented by wound culture and most susceptible antibiotics by minimum inhibitory concentrations were surveyed retrospectively. Results: Microorganisms were confirmed in 113 cases (80.7%). In the other 27 cases (19.3%), there were no cultured microorganisms. In bacterial growth group, there were 72 cases (63.7%) of gram-positive bacteria and 41 cases (36.3%) of gram-negative bacteria. All of them were aerobic microorganisms and there were no anaerobic microorganisms. Methicillin-sensitive staphylococcus aureus was the most common pathogen and accounted for 35 cases (31.0%). As other common pathogens, there were Enterobacter cloacae (11 cases, 9.7%), pseudomonas aeruginosa (10 cases, 8.8%), Methicillin-resistant staphylococcus aureus (10 cases, 8.8%) and enterococcus faecalis (6 cases, 5.3%), and so on. Common susceptible antibiotics in gram positive microorganism were vancomycin (60 cases, 83.3%), teicoplanin (60 cases, 83.3%), nitrofurantoin (60 cases, 83.3%) and ciprofloxacin (53 cases, 73.6%). In gram negative ones, common susceptible antibiotics were imipenem (35 cases, 85.3%), piperacillin/tazobactam (33 cases, 80.5%) and gentamicin (31 cases, 75.6%). Conclusion: Methicillin-sensitive Staphylococcus aureus in gram positive and enterobacter cloacae in gram negative was the most common pathogen in each group. Ciprofloxacin and gentamicin might be adaptable as a first-line empirical antibiotics in infected diabetic foot patients.

Keywords

References

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