Bacteriology and Antibiotic Sensitivity for Diabetic Foot Ulcer.

Choi, Sang Rok; Lee, Chang Kyu; Kim, Deok Woo; Han, Seung Kyu; Kim, Woo Kyung

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2006;33(3):330-334.
Published online May 1, 2006.

Bacteriology and Antibiotic Sensitivity for Diabetic Foot Ulcer.

Sang Rok Choi, Chang Kyu Lee, Deok Woo Kim, Seung Kyu Han, Woo Kyung Kim

¹Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea. pshan@kumc.or.kr
²Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract

Polymicrobial nature of diabetic foot infection has been well documented in the literature. Initial antibiotic therapy of diabetic foot infection is usually empiric until reliable culture data is shown. This study was carried out to determine the common bacteriological flora of diabetic foot infection and antimicrobial sensitivity pattern in order to enhance possible empiric treatment. The specimens were obtained from wounds of 207 cases of diabetic foot ulcer, and the bacteriological isolation, and antimicrobial susceptibility tests of the isolates were carried out by standard microbiological methods. Staphylococcus aureus was the most common isolate, with 46.2% of recover rate among total bacterial isolated cases. Among gram-negative organisms, Pseudomonas aeruginosa was most common. Gram-positive organisms showed significant susceptibility to clindamycin, trimethoprim/sulfamethoxazole, and levofloxacin, besides vancomycin. Cefoperazone, piperacillin/tazobactam, and amikacin in addition to imipenem were most effective agents compared to gram-negative organisms. Diabetic foot infection requires use of combined antimicrobial therapy for initial management. Our results indicate that the most effective antibiotic combination for diabetic foot infection of Korean patients is clindamycin plus cefoperazone.

Keywords: Diabetic foot; Microbiology; Antibiotic therapy

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