Studying the Microbial Landscape and Antibiotic Effectiveness in Patients with Diabetic Foot Syndrome

Tokhtamurod Ziyodulla Zikrilla; Abdullaeva Zulkhumor  Fayzullaevna

doi:10.51699/cajmns.v7i1.3072

Authors

Tokhtamurod Ziyodulla Zikrilla Associate Professor (PhD), Department of General Surgery, Tashkent State Medical University (Pediatric Campus), Uzbekistan
Abdullaeva Zulkhumor Fayzullaevna Pediatric Faculty of Tashkent State Medical University (Pediatric Campus), Uzbekistan

DOI:

https://doi.org/10.51699/cajmns.v7i1.3072

Keywords:

diabetic foot, wound infection, microbial landscape, antibiotic therapy, levofloxacin.

Abstract

The goal of this work was to determine the qualitative and quantitative structure of microbial landscape in purulent-necrotic wounds in patients with diabetic foot syndrome, defining dominant causative agents and efficacy evaluation antibiotic therapy on the basis of detection an antimicrobial resistance. A prospective observational study included 113 patients with diabetic foot syndrome admitted for treatment in the purulent surgery department during one year. Bacteriological culture of wound discharge was done by standard microbiological methods. Isolated microorganisms were identified by standard test systems, and susceptibility to antibiotics was tested by the disk diffusion on a medium of Mueller–Hinton agar. Severe cases were complex treated with intra-arterially infused levofloxacin. The microbial population of purulent-necrotic wounds was diverse. Gram positive organisms, mainly Staphylococcus spp., were the most common organisms identified, and Gram negative bacteria such as Escherichia coli or Pseudomonas aeruginosa were less commonly isolated. High Geometric Mean (>5µg/ml) for Levofloxacin was found for all but few Acinetobacter spp. strains. Faster wound debridement, disappearance of signs of inflammation and an earlier commencement of granulation tissue and epithelialization were found in patients who received intraarterial antibiotic therapy. This investigation offers regional microbiological information on diabetic foot infections and it also reconfirms the high clinical activity of levofloxacin against the prevalent wound pathogens. The results play up the value of routine bacteriological control and selection of antibiotics in patients with diabetic foot syndrome, especially in severe forms that need point antibiotic treatment. The limitations in the study are that it is single center and without long term outcomes. More multi-center studies are needed to evaluate the recent trends of resistant antibiotics and refine treatment strategy.

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