Vol. 1, Issue 10 (2012)

Author(s):
Dr. Lysetty Rajendra Prasad and Dr. Kukkala Seetharamaraju

Abstract:

Background and Objectives: People with diabetes are more likely to get skin and soft tissue infections because their immune systems are weak, their blood sugar levels are not well controlled, and their blood vessels are not working properly. The range of bacteria that cause infections and their patterns of susceptibility to antimicrobials differ from place to place. The objective of this investigation was to ascertain the microbiological profile, antibiotic susceptibility, and resistance trends of bacteria isolated from skin infections in diabetes individuals.

Materials and Methods: A prospective study was performed with 60 diabetes patients from the dermatology and medicine departments of a tertiary care hospital for a duration of 12 months. This study was conducted at the department of Dermatology, Sardar Rajas Medical College and Hospital, Bhawanipatna, Odisha from March 2010 to February 2011. Pus or wound swab samples were aseptically obtained and subsequently processed for the isolation of bacteria and fungi utilizing standard microbiological methods. We used Gram staining, culture characteristics, and biochemical assays to figure out what species were there. Demographic information on the patients, clinical aspects, and types of infections were written down.

Results: Six (10%) of the 60 samples were sterile, while 54 (90%) showed positive microbial growth. The most frequent isolates were Staphylococcus aureus (40%) and Pseudomonas aeruginosa (23%), Escherichia coli (15%), Klebsiella pneumoniae (10%), Proteus mirabilis (5%), and Candida species (7%). Of the isolates of S. aureus, 25% had methicillin-resistant S. aureus (MRSA). Although gram-negative isolates were responsive to carbapenems and aminoglycosides, they exhibited a high level of cephalosporin resistance. In 12% of patients, mixed infections were found. The most frequent clinical presentations were abscesses (20%), cellulitis (25%), and diabetic foot ulcers (55%).

Conclusion: Staphylococcus aureus is still the most common cause of skin infections in people with diabetes. MRSA and multidrug-resistant Gram-negative pathogens are becoming more common. Early identification of infections and their antimicrobial susceptibility is essential for efficient care and the prevention of problems in diabetic patients. It is suggested to keep an eye on resistance trends all the time to help with empirical therapy.