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August 17, 2025Open Access

Bacteriological Profile and Antimicrobial Susceptibility Patterns in Patients with Diabetic Foot Infections in a Tertiary Care Hospital in South India

SGSwathy GovindaswamySri Ramachandra Institute of Higher Education and Research ESElankumar SubbarayanRiverkeeper VJV.M. Jaishwanth

Key Points

Polymicrobial disease was found in 41% of patients with diabetic foot infections, underscoring complex treatment challenges.
E. coli and K. pneumoniae were identified as the most common pathogens, each accounting for 17% of isolates.
Gram-negative pathogens were prevalent at 88%, with multidrug-resistant Acinetobacter baumannii noted among the findings.
Antimicrobial susceptibility patterns emphasize the need for culture-based treatment strategies, particularly in managing resistant infections.

Abstract

Patients with diabetes mellitus frequently develop foot infections, which can progress to gangrene and ultimately limb amputation. This study aimed to determine the microbiological profile and antibiotic susceptibility patterns of the causative agents of infections in diabetic feet. This six-month prospective observational study included 78 Type 2 diabetic patients with Wagner’s grade 1 or higher. The microbiological profile and patterns of antibiotic susceptibility of the agents responsible for the infections in diabetic feet were determined. Culture tests were carried out on the tissue or pus that had been removed from the ulcer bases. An analysis of antibiotic sensitivity was performed following the identification of the organisms. Gram-negative pathogens (88%) were more prevalent than Gram-positive pathogens (12%). It was found that 41% of the patients had polymicrobial disease. Escherichia coli (17%), Klebsiella pneumoniae (17%), Staphylococcus aureus (13.8%), and Pseudomonas aeruginosa (12.7%) appeared to be the most frequent pathogens found in isolations. Ciprofloxacin was more resistant to Escherichia coli, whereas cotrimoxazole was more resistant to K. pneumoniae. In addition, Acinetobacter baumannii, a multidrug-resistant bacterium, was identified. The presence of multidrug-resistant organisms in diabetic foot infection treatment plan is important. The results of the present study further highlight the necessity of choosing antimicrobial treatments based on antimicrobial sensitivity patterns displayed by isolates and culture outcomes.

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