Background: Diabetes is one of the oldest diseases known to mankind.  Ulceration of the foot in diabetes is a common complication. Diabetic foot ulcers are at high risk of infection secondary to high glucose levels and poor tissue perfusion. The aim is to identify the microorganisms and the antibiotic susceptibility pattern involved in different grades of diabetic foot ulcer.

Materials and Methods: 50 patients with diabetic foot ulcers (DFU) were included in this study. Pus was processed for Gram positive, Gram negative and Fungal isolates by culture. Antibiotic sensitivity testing was done by Kirby-Bauer disc diffusion test. 

Results: Out of 135 isolates, Gram negative bacteria comprised the major group of 73 (54.1%) followed by Gram positive bacteria 54 (40%) and Fungus 08 (5.9%) were observed on culture. Staphylococcus aureus (61.1%) in the Gram positive group is the commonest pathogen followed by Enterococcus spp (27.8%) and Streptococcus spp (11.1%). 44.5% of Staphylococci were methicillin resistant.  Multi-drug resistance was seen in 28.26% of isolates. We observed ESBL producer in 18 (58.06%) isolates out of 31 Gram negative strain.  Elderly male with Type II diabetes (NIDDM) cases were frequently observed to develop foot ulcer.  

Conclusion: Diabetic foot infections are polymicrobial in nature.  Pseudomonas aeruginosa in Gram negative organisms followed by Staphylococcus aureus in Gram positive group and Candida spp  in fungal were the predominant pathogens. Empirical antibiotic selection should be followed by culture guided adjunctive therapy. Erythromycin, Lincomycin, Imipenem or Cefoperazone + Sulbactam would be appropriate for empirical treatment.

Abbreviations: NIDDM – non insulin dependent diabetes mellitus.

Key words: NIDDM, Gram-negative bacilli, polymicrobial.

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Dharma Niranjan Mishra

Assistant Professor, Department of Anatomy S. C. B. Medical College Cuttack753007, Odisha, India

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