Outcome in Patients of Diabetic Foot Infection with Multidrug Resistant Organisms

Aim and objectives: To study the spectrum of microorganisms in patients of diabetic foot infection (DFI) and to evaluate the outcome in patients of DFI with multidrug resistant organisms (MDRO). Materials and methods:A total of 116 patients, visiting diabetic foot clinic of our institute with DFI were observed in a prospective manner.Diagnosis of infection was based on clinical findings using International Working Group on Diabetic Foot and Infection Diseases Society of America (IWGDF-IDSA).The microbiological profile of wound assessed at the time of admission and patients were followed up for wound healing rate, need for amputation and surgical interventions, hospital stay, and mortality for 6 months.Observation and results: The microbiological profile of our patients showed that Gram-negative microorganisms were commonly isolated (78.4%) from our patients.The culture trends revealed that most common isolates were E. coli (33.6%),Pseudomonas (19.8%),Proteus (18%), Klebsiella (16%), Acinetobacter and Citrobacter among the Gram-negative organisms.Among Gram-positive organisms, Staphylococcus aureus was the most common isolate which was present in 29 (25%) of the patients.MDRO were isolated from 13.8% of patients.Most common MDRO isolated were methicillin-resistant S. aureus (MRSA) and vancomycin-resistant Enterococci (VRE).The outcome was assessed in terms of mortality rate, the rate of major amputation, rate of minor amputation, the rate of multiple surgical interventions, duration of hospitalisation and requirement of intensive care unit (ICU) admission, re-admission rate, antibiotic requirement which were not significantly different in patients with MDRO than that with non-MDRO (p-value > 0.05).The mean healing rate in patients with MDRO was not significantly different than that from patients with non-MDRO (p-value > 0.05). Conclusion:Although the number of patients with MDRO is small as compared to non-MDRO, the study found that MDRO has no significance on the outcome of the patients with DFI.