Infecciones del pie diabético. Prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos / Diabetic foot infections. Prevalence and antibiotic sensitivity of the causative microorganisms

Introducción: las causas más frecuentes de hospitalización y complicaciones en diabéticos son las infecciones graves del pie. El objetivo de este trabajo es estudiar la prevalencia de los microorganismos que se cultivan en las infecciones complicadas del pie diabético así como la sensibilidad a los antimicrobianos en sujetos hospitalizados. Sujetos y métodos entre diciembre de 2001 y diciembre de 2005, se recogieron prospectivamente 84 muestras para un estudio microbiológico en 62 sujetos diabéticos que ingresaron en el Servicio de Cirugía General y Digestiva del Hospital General Universitario José María Morales Meseguer con diagnóstico de infección del pie de moderada a grave. Resultados en el 88% de las muestras se aisló al menos un microorganismo. El grupo de gérmenes aislado con mayor frecuencia fue el de los microorganismos grampositivos (el 55% de las muestras); de éstos, Staphylococcus aureus fue el más habitual (el 33% de las muestras). Le siguieron en frecuencia Pseudomonas aeruginosa (12%), Enterococcus spp. (9%) y Entamoeba coli (8%). Para el cultivo de anaerobios sólo se procesaron la mitad de las muestras, de las que resultaron positivas un 25%; los peptoestreptococos fueron los microorganismos predominantes. Entre los patógenos multirresistentes destacó S. aureus resistente a meticilina (SARM), que supuso el 38% de las cepas aisladas de S. aureus, lo que implica que estaba presente en el 12% de las muestras totales. Respecto a los microorganismos gramnegativos, E. coli mostró casi un 30% de resistencia a la combinación de amoxicilina con ácido clavulánico y a la ciprofloxacina. No hubo diferencias significativas en cuanto al aislamiento de Pseudomonas spp. según el tipo de muestra, mientras que el aislamiento de enterococos, de acuerdo con las muestras de exudado, fue significativamente mayor que en los otros tipos de muestras (AU)

Background Foot infections are a common reason for hospitalization and a cause of complications in patients with diabetes. The aim of this study was to determine the prevalence of microorganisms found on culture in complicated diabetic foot infections in hospitalized patients, and the sensitivity of the causative microorganisms to antimicrobial agents. Methods Between December 2001 and December 2005 in our department, 84 samples in 62 diabetic patients with moderate/severe infection were collected for microbiological study. Results At least one microorganism was isolated in 88% of samples. The most frequently isolated germ group was gram-positive bacteria (55% of the samples), with Staphylococcus aureus (33%) in the first position, followed by Pseudomonas aeruginosa (12%), Enterococcus spp. (9%), and Escherichia coli (8%). Culture for anaerobic microorganisms was only performed in half the samples; 25% were positive, and Peptostreptococcus spp. predominated. Among the multiresistant microorganisms, methicillin-resistant staphylococci aureus (MRSA) were the most common, accounting for 38% of the isolated strains of S. aureus, ie, 12% of all samples. As to the gram-negative microorganisms, nearly 30% of E. coli strains were resistant to amoxicillin/clavulanic acid and ciprofloxacin. Conclusion Most of the cultures in our study were monomicrobial, with S. aureus being the most prevalent microorganism, followed by enterobacteria and P. aeruginosa. The main resistant microorganism in diabetic foot infections requiring hospitalization was methicillin-resistant golden staphylococcus, which was found in 12% of the serie (AU)

[Diabetic foot infections. Prevalence and antibiotic sensitivity of the causative microorganisms]. / Infecciones del pie diabético. Prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos.

BACKGROUND: Foot infections are a common reason for hospitalization and a cause of complications in patients with diabetes. The aim of this study was to determine the prevalence of microorganisms found on culture in complicated diabetic foot infections in hospitalized patients, and the sensitivity of the causative microorganisms to antimicrobial agents. METHODS: Between December 2001 and December 2005 in our department, 84 samples in 62 diabetic patients with moderate/severe infection were collected for microbiological study. RESULTS: At least one microorganism was isolated in 88% of samples. The most frequently isolated germ group was gram-positive bacteria (55% of the samples), with Staphylococcus aureus (33%) in the first position, followed by Pseudomonas aeruginosa (12%), Enterococcus spp. (9%), and Escherichia coli (8%). Culture for anaerobic microorganisms was only performed in half the samples; 25% were positive, and Peptostreptococcus spp. predominated. Among the multiresistant microorganisms, methicillin-resistant staphylococci aureus (MRSA) were the most common, accounting for 38% of the isolated strains of S. aureus, ie, 12% of all samples. As to the gram-negative microorganisms, nearly 30% of E. coli strains were resistant to amoxicillin/clavulanic acid and ciprofloxacin. CONCLUSION: Most of the cultures in our study were monomicrobial, with S. aureus being the most prevalent microorganism, followed by enterobacteria and P. aeruginosa. The main resistant microorganism in diabetic foot infections requiring hospitalization was methicillin-resistant golden staphylococcus, which was found in 12% of the series.