Investigation Of Causing Microorganisms And Antimicrobial Sensitivity Patterns In Diabetic Foot Wounds

Year 2025, Volume: 35 Issue: 2, 276 - 284, 30.04.2025

Aynur Ismayıl , Bayram Çolak , Serdar Yormaz , Hatice Türk Dağı , Salih Maçin

https://doi.org/10.54005/geneltip.1586166

Abstract

Abstract
Background/Aims: Diabetic foot is the clinical term describing a series of diabetes-related lower extremity complications such as ulceration, infection, and gangrene. Aim of the study is to prospectively investigate the causative aerobic bacteria in diabetic foot ulcer samples, as well as anaerobic bacteria and fungi, which are thought to have an important place in diabetic foot infections. At the same time, the antimicrobial susceptibility of the causative microorganisms obtained from the culture will be investigated.
Methods: 59 samples taken from 50 patients with type 2 Diabetes Mellitus were included in the study. The BD Phoenix TM automated system was used for species-level identification of microorganisms and antimicrobial susceptibility testing. The antimicrobial susceptibility of anaerobic microorganisms was tested with the gradient gradient test method.
Results: It was determined that the most common (65%) agent in DFI was Gram-negative aerobic bacteria and the majority of them (65%) were multidrug resistant. The most common cause of monomicrobial infection is Staphylococcus aureus and the MRSA rate was found to be 27%. The results of the study showed that vancomycin, teicoplanin and linezolid were the most effective antibiotics against Gram-positive agents. The most effective antibiotics against gram-negative agents were found to be ceftolozane/tazobactam, piperacillin/tazobactam, meropenem, ertapenem, colistin and amikacin.
Conclusions: Considering that the majority of Gram-negative agents consist of multidrug resistant microorganisms, the importance of prudent antibiotic use is once again increasing. It should be taken into account that diabetes is a disease that is 80% preventable with lifestyle changes, and the importance of increasing public awareness about healthy living should be emphasized.

Keywords

Diabetic foot, diabetic foot ulcer, antibiotic susceptibility, microorganism

Ethical Statement

This study was reviewed and approved by the Clinical Investigations Ethics Committee of Selçuk University (No: 2022/64 and Date: 02/03/2022). Signed informed consents of all participants will be obtained.

Supporting Institution

The study was funded by Selçuk University Scientific Research Project (BAP) during the design of the research, data collection, analysis, interpretation and writing of the article (Project no: 22122023).

Diyabetik Ayak Yaralarında Etken Mikroorganizmaların Ve Antimikrobiyal Duyarlılık Paternlerinin Araştırılması

Abstract

ÖZET
Amaç: Diyabetik ayak (DA), ülserasyon, enfeksiyon ve gangren gibi diyabete bağlı bir dizi alt ekstremite komplikasyonlarını tanımlayan klinik terimdir. Bu çalışmadaki amaç diyabetik ayak enfeksiyonu (DAE)’nda etken aerob, anaerop bakteriler ve mantarların prospektif olarak araştırılmasıdır. Aynı zamanda kültürlerden elde edilen etken mikroorganizmaların antimikrobiyal duyarlılıkları araştırılacaktır.
Gereç ve Yöntemler: Tip 2 Diabetes Mellitus’u olan 50 hastadan alınan 59 örnek çalışmaya dahil edilmiştir. Mikroorganizmaların tür düzeyinde tanımlanması ve antimikrobiyal duyarlılık testleri için BD Phoenix TM otomatize sistem kullanılmıştır. Anaerob mikroorganizmaların antimikrobiyal duyarlılığı gradyan E- test yöntemiyle test edilmiştir.
Bulgular: Çalışma sonucuna göre DAE’de en sık (%65) etken Gram-negatif aerob bakteriler olup, bunların büyük çoğunluğu (%65) çoklu ilaca dirençli olarak saptanmıştır. Monomikrobiyal enfeksiyon nedeni olarak en sık S. aureus izole edilmiş ve MRSA oranı % 27 olarak bulunmuştur. Çalışmanın sonuçları Gram-pozitif etkenlere vankomisin, teikoplanin ve linezolidin en etkili antibiyotikler olduğunu göstermiştir. Gram-negatif etkenlere karşı en etkili antibiyotikler ise seftolozan/tazobaktam, piperasilin/tazobaktam, meropenem, ertapenem, kolistin ve amikasin olarak bulunmuştur.
Sonuç: Gram-negatif etkenlerin büyük çoğunluğunun çok ilaca dirençli olduğu dikkate alındığında akılcı antibiyotik kullanımının önemi bir kez daha ortaya çıkmaktadır. Diyabetin yaşam tarzı değişikliklerine bağlı %80 önlenebilir bir hastalık olduğu dikkate alınmalı ve sağlıklı hayat tarzı konusunda toplumsal bilinçlendirmenin önemi vurgulanmalıdır.

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