The Microbial Diversity and Antimicrobial Susceptibility Profile Underlying Diabetic Foot Osteomyelitis: A Retrospective Study Conducted in North Queensland, Australia.

Autor:	Kulasegaran, Nandini, Vangaveti, Venkat, Norton, Robert, Malabu, Usman
Předmět:	ANTIBIOTICS BACTERIA classification MEDICAL protocols MICROBIAL sensitivity tests RESEARCH funding ACADEMIC medical centers GLYCOSYLATED hemoglobin MYOCARDIAL ischemia GRAM-positive bacterial infections OSTEOMYELITIS DRUG resistance in microorganisms GLYCEMIC control SCIENTIFIC observation FISHER exact test RETROSPECTIVE studies METHICILLIN-resistant staphylococcus aureus QUANTITATIVE research DESCRIPTIVE statistics CHI-squared test LONGITUDINAL method CHRONIC kidney failure PODIATRY DIABETIC foot MEDICAL records ACQUISITION of data TYPE 2 diabetes RESEARCH ELECTRONIC health records DISEASE susceptibility BACTERIAL diseases DATA analysis software COMORBIDITY PSEUDOMONAS DISEASE incidence
Zdroj:	Foot & Ankle Orthopaedics; July-Sep2024, Vol. 9 Issue 3, p1-9, 9p
Abstrakt:	Background: Diabetic foot osteomyelitis (DFO) commonly occurs secondary to ulcerations of the skin. Empirical antibiotic agents are a key element of treatment and their use is dependent on local knowledge of the microbial spectrum of diabetic foot infections. This study aimed to retrospectively analyze the local microbiological profile, including bacterial culture/sensitivity results of DFO, and compare findings with literature. This study also aimed to review the concordance of microbiology results with national guidelines for the future treatment of DFO. Methods: A retrospective review of clinical records was performed on patients who presented to the high-risk foot clinic, Townsville University Hospital, between 2018 and 2022. All patients older than 18 years and diagnosed with DFO were included. Our exclusion criteria included all other foot presentations, including trauma, vasculitis, and neoplasms. Results: On the basis of the inclusion and exclusion criteria, 124 patients with DFO were selected. Most patients in the cohort were males (70.2%), non-Indigenous (68.5%), aged 50-69 years (55.6%), and with elevated HbA1c levels (>8.6). Chronic kidney disease (39.5%) and ischemic heart disease (41.9%) were common comorbidities. Of the pertinent microbial results, Staphylococcus aureus (~76%) was the most commonly isolated Gram-positive organism. Gram-positive bacteria were significantly increased in the elderly population with DFO (P <.05). All methicillin-resistant S aureus isolates were vancomycin- and cotrimoxazole-sensitive. Pseudomonas aeruginosa was the predominant Gram-negative organism isolated (39.3%). P aeruginosa exhibited low sensitivity to ciprofloxacin. Conclusion: This study has enhanced our understanding of the various microbial species underlying DFO at our center and may be generalizable. Level of Evidence: Level IV, retrospective case series. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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