Clinical and microbiological evalution in diabetic foot infections

Aim: Diabetic foot infections are one of the most important complications of diabetes mellitus. These infections are the most common cause of foot amputations. In this study we aimed determination of demographic data; detection of causative microorganism and evalution of the appropriateness of empirical antimicrobial therapy in patients with diabetic foot infections who were addmitted Afyon Kocatepe University Medicine Faculty Department of Infectious Disease and Clinical Microbiology with Diabetic foot infection. Methods:This prospective study was planned in our clinic between March 2015 and September 2016.The inclusion criterias were the patients with DFI (Diabetic foot infections) classified with ≥ PEDIS 3 ve ≥ WAGNER 2. All patients' demografic datas, diabetes type, diabetic foot staging according to PEDIS and Wagner classification, treatment modalities , laboratory parameters, cultures and treatment results were recorded. All patients' deep tissue cultures were taken and microbiological sampling was made. Results: Eighty diabetic foot infection attacks detected in 68 patients were included in this study. Forty five patient was(%66.2) male and 23 patient was (%33.8) female.The mean age was 61.59±11.93(30-86 ) year. When patients were classified according to PEDIS 74 (%92.5) were grade 3, 6(%7.5) were grade 4. According to Wagner classification 13 patients(%16.2) were Wagner 2, 24(%30) patients were Wagner 3, 38 patients were (%47.5) were Wagner 4 and 5 patients were(%6.3) Wagner 5. In 80 diabetic foot infection attacks 56 bacteria ; 30(53.6%) GRAM(-) bacteria , 24 (42.9%) GRAM (+) bacteria, 2(3.5% ) Candida albicans were isolated. The most common bacteria were S. Aureus(n=16, 28.5%), Proteus spp(n=9, 16%), E. Coli(n=6, 10%). Surgical treatment was applied in addition to antibiotic treatment in 73(91.25%) of the diabetic foot infection attacks 63 and amputation rate was found 33.75%. The healing was higher in the patients whom emphrical treatment was not changed (p=0.02). Conclusion:In this study, the causative mikroorganism was isolated 70% of the evaluated DFI attacks. Most of the isolates were GRAM (-) bacteria. Appropriate empirical antimicrobial therapy increases possibility of healing. For this reason, determination causative microorganism in DFĠ according to regions is important. So empirical antimicrobial therapy would be appropriate and prognosis will also be beter. Key words: Diabetic foot infection, amputation, Wagner classification, sedimentation