In patients with diabetic foot infection is compare deep tissue culture and superficial culture

Introduction and Aims: Diabetic foot wounds, which are a chronic complication of Diabetes Mellitus,are a medical, social and economic problem, and increasingly continue to be a serious health issue.Therefore, isolation of effective microorganisms is of vital importance in the treatment of Diabetic footulcers. For isolation of effective microorganisms, there are various collection methods of specimen. n thisstudy, we aimed to determine the coherence rate between microorganisms isoleted from deep tissueculture and those from superficial culture, which were primarily accepted to have high risk ofcontamination but whose contamination risk has been reduced recently through sterilization.Material and Method: A total of 63 patients with Diabetic foot infection, who were admitted to theclinics of Microbiology and nfection Diseases, Orthopedia and Travmatology, and Endocrinology ofDicle University Hospital between October 2006 and November 2007, were ncluded into the study. Thediagnosis of Diabetic foot nfection was clinically made on the basis infection findings. The wounds weredivided as ulcer, abcess and osteomyelitis. Ulcer type was classified as neuropathy, ischemia andneuroischemia wound localization was studied as toe, metatars, middle-toe and heel. Wound formationtime was specified as acute ( > 30 days ) and chronic ( > 30 days ). In wound classification, Wagner sphasing method was used. For microbiologic culture, sterilized superficial culture and deep tissue culturewere spontaneously taken from each patent, and were rapidly sent to laboratory for aerob and anaerobculture. Microbiologic data obtained were analyzed and interpreted in line with sensitivity and specifityformula.Results: Of the cases, 52 % were female, and the mean age was 58,1±12 years; 94 % had type II diabetes.Mean diabetic time was 9,3±6,8 years. In add t on, 60 % of the patients were receiving Oral AntidiabeticAgent treatment. The HbA1C ( % ) awerage was 9,8±2,6, and 68 % of the cases had an acute period.Wagner scale was 1+2 in 60 % , and 3+4 in 40 % of the patients. Wound localization was in toes andmetatars in 73 %, and middle-toe and heel in 27 %. The wounds were of ulcer formation in 63 %,osteomyelitis in 24 % and abcess in 13 %. For wound aetiology, there wasneuropaty in 81 %,neuroischemia n 13 % and ischemia in 6 % of the cases. n deep tissue culture, 77microorganisms weregrown, and the mean was 1,2 per materal, whereas in superficial culture, 91 microorganisms were grown,and the mean was 1,4 per material. As a result of microbiological analysis, in both cultures, the sameamount of microorganisms was grown at a rate of 58,7 %, more microorganisms were grown in superficial54cultures, but there were also microorganisms in those grown in deep tissue cultures. Different amounts ofmicroorganisms were grown in both cultures at a rate of 20,6 %. The mean sensitivity and specifity rateswere found to be 84,4 % and 84,6 %, respectively. The most commonly isolated microorganisms wereS.aureus ( 32% in superficial cultures and 36,5 % in deep tissue cultures ), followed by Klebsiella spp.Conclusion: Diabetic foot ulcers increasingly continue to be a serious health issue, Therefore, in patientsin whom diabetic foot development is inevitable, regular foot controls should be made before ulcerdevelops, and protective precaution should be taken when diabetic foot infection has developed, thenecessary attention should be paid to isolation of effective microorganisms, and proper treatment shouldbe initiated, which seems to be the most effective way both in reducing amputation risk and prevetingmortality.