Diabetic Foot Ulcers Infected with Bacteria Multiresistant to Antimicrobials in Venezuelan patients

Abstract

Introduction: Diabetic foot ulcers have significant morbidity and mortality, even more so if they are associated with multi-resistant bacteria to antimicrobials.

Objective: To analyze the characteristics of diabetic foot ulcers infected with bacteria multi-resistant to antimicrobials.

Methods: A descriptive, non-experimental and cross-sectional investigation was carried out in 87 patients with infected diabetic foot ulcers. They were treated in a specialized clinic in Zulia state, Venezuela. Anamnesis and physical examination were performed, especially focused on the characteristics of diabetic foot ulcers. Ulcer tissue samples were obtained to identify the bacteria existing and the corresponding antimicrobial.

Results: All the patients had previous ulcer, with exacerbation of the infection (75.86%), rehospitalization (59.77%), previous amputation (36.78%), long-lasting infected diabetic foot ulcers (86.21%). 95.40% received previous antibiotics and 57.62% had been hospitalized, the disease age was 16.17 ± 8.41 years and Hb A1c was 8.87 ± 1.23. The most frequent infected diabetic foot ulcers were neuroischemic (71.26%). The monomicrobial flora (62.07%) and gram-negative bacteria (87.36%) predominated. 79.3% had multi-resistant bacteria to antimicrobials and 20.69% pan-resistance. Multi-resistant bacteria were predominantly gram-negative and for gram-positive only staphylococcus aureus.

Conclusions: High frequency of multidrug-resistant infected diabetic foot ulcers was found, predominantly monomicrobial and all with resistance to beta-lactams and fluoroquinolones.