Increase in antibiotic resistance in diabetic foot infections among peruvian patients: a single-center cross-sectional study.

Background: Diabetic foot is one of the most significant complications in individuals with diabetes and is closely associated with lower limb amputation. The antibiotic susceptibility patterns of these bacterial isolates play a critical role in guiding effective treatment strategies We aimed to determine the most common bacterial agents causing diabetic foot infections in a tertiary-care hospital in Peru. Methods: Clinical and microbiological data were collected from 181 patients diagnosed with diabetic foot infections and positive microbiological culture results. All the samples were analyzed with the Vitek 2 compact system and the cut-off points were defined with the CLSI M100 guide. The data were segregated based on mono-microbial or poly-microbial cultures, bacterial types, and antibiotic susceptibility profiles. Results: A total of 32 bacterial species were identified, predominantly Gram-negative (63%). The most frequent bacterial agents isolated were Staphylococcus aureus (19.9%), Escherichia coli (12.2%), Pseudomonas aeruginosa (8.3%), and Proteus vulgaris (6.6%). These bacteria commonly exhibited resistance to Ampicillin, Ciprofloxacin, Levofloxacin, Trimethoprim-sulfamethoxazole, and Cefuroxime. E. coli showed the highest antibiotic resistance (19 antibiotics), while Gentamicin, Tobramycin, and Levofloxacin demonstrated the highest sensitivity against the most prevalent bacteria. Gram-negative bacteria also exhibited notable antibiotic-susceptibility to Meropenem, Piperacillin/tazobactam, and Amikacin. Regarding the presence of Extended-Spectrum Beta-Lactamase, 54 isolates tested positive, with 35 (64.8%) and 14 (42.4%) of these being S. aureus and E. coli. Conclusions: Bacterial agents causing diabetic foot infections pose a constant concern, particularly due to the increasing antibiotic resistance observed. This difficulty in treating the condition contributes to a higher risk of amputation and mortality. Further research on bacterial susceptibility is necessary to determine appropriate dosages for pharmacological treatment and to prevent the overuse of antibiotics.

The Age of Young Nurses Is a Predictor of Burnout Syndrome during the Care of Patients with COVID-19.

BACKGROUND: Burnout Syndrome (BS) is a work fatigue phenomenon that leads to physical exhaustion during care work, and there could be an increase in the proportion of nurses affected during the COVID-19 pandemic, especially in those caring for infected patients. We aimed to determine BS in nurses during the COVID-19 pandemic. METHODS: An observational study was conducted on 100 nurses over the age of 18 and working in COVID-19 medical units in 2021. The 22-item Maslach Burnout Inventory questionnaire was used to estimate BS, and differences between age groups, gender, work time, and previous infection were estimated. RESULTS: The majority of nurses (mean 30 ± 5.5 years) were women (78%), and the most frequent working time was from 1 to 10 years (58%). A total of 88% of the nurses had moderate BS, affecting more males, aged between 20 and 30 years, and without previous infection. The youngest age group, 20-30 years, presented the highest mean BS with 53.8 (SD 4.18) points (95% CI: 52.79 to 54.8), showing differences with older nurses (p < 0.05). Prediction analysis showed that only age was a significant predictor for the development of SB (p < 0.001). CONCLUSIONS: BS negatively impacts young nurses during the care of COVID-19 patients, so strategies should be promoted to ensure a better working environment. Improving the workspace can include self-care strategies, changes in the system and work organization, an improvement of interpersonal relationships, and risk prevention.