Infection Agents Detected with Wound Culture in Patients with Diabetic Foot who will Undergo Hyperbaric Oxygen Treatment

摘要

AIM: We aimed to obtain the knowledge of appropriate antibiotic therapy and to make a contribution to improving treatment efficacy by conducting a microbiological study of diabetic foot ulcers. METHOD: 30 patients (18 male and 12 female) with diabetic foot ulcer applying to our center for hyperbaric oxygen (HBO) treatment in 2010 were enrolled in this study. The wounds were graded according to Meggitt-Wagner classification system. Wound cultures were obtained before starting antibiotic therapy and HBO treatment. Phoenix system (Becton Dickinson, USA) and Kirby-Bauer disk diffusion antibiotic sensitivity testing were used in order to detect the antimicrobial susceptibility of the infection agents. The number of HBO sessions, glycemic control and treatment results were assessed. RESULTS: Mean age of the patients was 61.3 years (range: 35-83). 24 patients had a good glycemic control and 6 patients had not. The patients were given 5 to 55 HBO sessions (mean: 20). Of the 30 patients 19 (63.33%) recovered from the infection but 11 (36.67%) have not responded to the treatment. 14 different infectious agents were detected in diabetic foot ulcers we examined. Gram-positive agents were isolated in 12 (40%) out of 30 wound cultures and gram-negative agents were isolated in 18 (60%) wound culture. Pseudomonas aeruginosa was predominantly isolated and the other agents isolated were enterococcus faecalis, klebsiella pneumoniae, staphylococcus aureus and escherichia coli. CONCLUSION: The outcomes can not represent the general population rates due to the restriction factors. They give only an idea about the probability of infectious agent spectrum in diabetic foot ulcers and their antibiotic susceptibility. We want to attract attention to the fact that although pseudomonas aeruginosa infections are mostly encountered in hospital, they can also be acquired from the community and it will be useful to develop appropriate antibiotic policies and treatment protocols.