Common Pathogens Isolated from Infected Diabetic Foot Ulcers at King Abdulaziz University Hospital, Saudi Arabia: A Retrospective Study

M. Alkhatieb, Rahaf Alrayiqi, Omar A. Alsulami, Ziyad M. Albassam, Sahal Wali, Haifa Alnahdi
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Abstract

Objectives: To determine the common pathogens isolated from DFI to administer appropriate antibiotic treatment, followed by surgical interventions. Methods: A retrospective study was performed on 260 patients who presented with diabetic foot at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2014 to September 2020. All patients underwent swabs and tissue culture for microbiological evaluation. Patient medical records were reviewed to collect demographic and clinical data, including Glycated Hemoglobin (HgA1C), Diabetes Mellitus (DM) type, duration of diabetes, swab, tissue culture, type of surgery, and type of isolated organism. Results: Escherichia coli was the most common organism isolated from the feet of diabetic patients, followed by Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus agalactiae, and Pseudomonas aeruginosa. Amputations were significantly higher in patients who did not have Staphylococcus aureus or Pseudomonas aeruginosa infection, with no significant relationship between amputation and any other isolated organisms. A significant negative correlation between patient age and HgA1C level was discovered, as well as a significant positive correlation between HgA1C and the number of minor amputations. Patients with major and minor amputations had a significantly higher percentage of non-Multidrug Resistance (MDR), whereas patients with MDR had a significantly higher rate of infection with Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, or Staphylococcus aureus. Conclusion: DM is a metabolic syndrome that affects all the body systems and impacts both morbidity and mortality. The most common organism isolated from the feet of diabetic patients was Escherichia coli, followed by Staphylococcus aureus. Ulcer specimens should be collected for culture and identification of causative organisms. Preventive measures such as good glycemic control, appropriate foot care, targeted antibiotic therapy, and patient education can reduce the incidence of amputation.
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沙特阿拉伯阿卜杜勒阿齐兹国王大学医院感染糖尿病足溃疡中分离的常见病原体:一项回顾性研究
目的:确定从DFI分离的常见病原体,给予适当的抗生素治疗,然后进行手术干预。方法:对2014年10月至2020年9月在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院就诊的260例糖尿病足患者进行回顾性研究。所有患者均接受拭子和组织培养以进行微生物学评估。回顾患者的医疗记录,收集人口统计学和临床数据,包括糖化血红蛋白(HgA1C)、糖尿病(DM)类型、糖尿病持续时间、拭子、组织培养、手术类型和分离生物类型。结果:糖尿病患者足部分离到的细菌以大肠杆菌最多,其次为金黄色葡萄球菌、肺炎克雷伯菌、无乳链球菌和铜绿假单胞菌。没有金黄色葡萄球菌或铜绿假单胞菌感染的患者截肢率明显更高,截肢与任何其他分离生物之间没有显著关系。患者年龄与HgA1C水平呈显著负相关,HgA1C与轻微截肢次数呈显著正相关。严重和轻微截肢患者的非多药耐药(MDR)比例明显较高,而多药耐药患者的肺炎克雷伯菌、大肠杆菌、铜绿假单胞菌或金黄色葡萄球菌感染率明显较高。结论:糖尿病是一种影响全身各系统的代谢综合征,影响发病率和死亡率。从糖尿病患者足部分离出的最常见的细菌是大肠杆菌,其次是金黄色葡萄球菌。应收集溃疡标本进行病原菌培养和鉴定。预防措施,如良好的血糖控制,适当的足部护理,有针对性的抗生素治疗和患者教育可以减少截肢的发生率。
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