Browse > Article

Bacteriology and Antibiotic Sensitivity for Diabetic Foot Ulcer  

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)
Publication Information
Archives of Plastic Surgery / v.33, no.3, 2006 , pp. 330-334 More about this Journal
Abstract
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.
Keywords
Diabetic foot; Microbiology; Antibiotic therapy;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 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   DOI   ScienceOn
2 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   DOI   ScienceOn
3 Frykberg RG: Diabetic foot ulcer: pathogenesis and management. Am Fam Physician 66: 1655, 2002
4 Abdulrazak A, Bitar ZI, Al-Shamali AA, Mobasher LA: Bacteriological study of diabetic foot infections. J Diabetes Complications 19: 138, 2005   DOI   ScienceOn
5 Boulton AJ: The diabetic foot: a global view. Diabetes Metab Res Rev 16: 52, 2000
6 Armstrong DG, Lipsky BA: Advances in the treatment of diabetic foot infections. Diabetes Technol Ther 6: 167, 2004   DOI   ScienceOn
7 Edmonds M, Foster A: The use of antibiotics in the diabetic foot. Am J Surg 187: 25S, 2004   DOI   ScienceOn
8 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   DOI   ScienceOn
9 Wieman TJ: Principles of management: the diabetic foot. Am J Surg 190: 295, 2005   DOI   ScienceOn
10 Lipsky BA: Evidence-based antibiotic therapy of diabetic foot infections. FEMS Immunol Med Microbiol 26: 267, 1999   DOI
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   DOI   ScienceOn
12 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   DOI   ScienceOn