Clinical and bacteriological survey of diabetic foot infections in Lisbon

Autor: João J. Mendes, A. Marques-Costa, José Melo-Cristino, Patrícia Cavaco-Silva, N. Candeias, Cristina L. Vilela, José Neves
Rok vydání: 2011
Předmět:
Adult
Male
medicine.medical_specialty
Staphylococcus aureus
medicine.drug_class
HSAC
Endocrinology
Diabetes and Metabolism
Antibiotics
Diabetic Foot/epidemiology
medicine.disease_cause
Staphylococcal Skin Infections/epidemiology
Endocrinology
Internal medicine
Diabetes mellitus
Epidemiology
Internal Medicine
Prevalence
Medicine
Humans
Staphylococcal Skin Infections/microbiology
HCC
HSM
Aged
Staphylococcal Skin Infections/drug therapy
Aged
80 and over
Portugal
business.industry
General Medicine
Middle Aged
medicine.disease
Fluoroquinolones/therapeutic use
Methicillin-resistant Staphylococcus aureus
Diabetic foot
Diabetic Foot
Surgery
Anti-Bacterial Agents
Anti-Bacterial Agents/therapeutic use
Diabetic foot ulcer
Staphylococcus aureus/isolation & purification
Diabetic Foot/microbiology
Female
Staphylococcal Skin Infections
business
Staphylococcus
Fluoroquinolones
Zdroj: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação
instacron:RCAAP
ISSN: 1872-8227
Popis: a b s t r a c t Aims: An epidemiological survey of diabetic foot infections (DFIs) in Lisbon, stratifying the bacterial profile based on patient demographical data, diabetic foot characteristics (PEDIS classification), ulcer duration and antibiotic therapy. Methods: A transversal observational multicenter study, with clinical data collection using a structured questionnaire and microbiological products (aspirates, biopsies or swabs collected using the Levine method) of clinically infected foot ulcers of patients with diabetes mellitus (DM). Results: Forty-nine hospitalized and ambulatory patients were enrolled in this study, and 147 microbial isolates were cultured. Staphylococcus was the main genus identified, and methicillin-resistant Staphylococcus aureus (MRSA) was present in 24.5% of total cases. In the clinical samples collected from patients undergoing antibiotic therapy, 93% of the antibiotic regimens were considered inadequate based on the antibiotic susceptibility test results. The average duration of an ulcer with any isolated multi-drug resistant (MDR) organism was 29 days, and previous treatment with fluoroquinolones was statistically associated with multidrug resistance. Conclusions: Staphylococcus aureus was the most common cause of DFIs in our area. Prevalence and precocity of MDR organisms, namely MRSA, were high and were probably related to previous indiscriminate antibiotic use. Clinicians should avoid fluoroquinolones and more frequently consider the use of empirical anti-MRSA therapy.
Databáze: OpenAIRE
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