DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151124

Clinical presentation and bacteriological profile of diabetic foot in Eastern Bihar, India

Deepak Pankaj, Sweta Muni, Indudhar Narayan Jha, Alka Kumari

Abstract


Background: Diabetes is a worldwide problem. A majority of diabetic patients develop foot ulcers in one point of time or other during the course of their illness. Chronic wound, especially non-healing types are the most common surgical conditions. The etiopathogenesis of diabetic foot lesions are multi-factorial like diabetic neuropathies, vasculopathy, poor control of diabetes and bacterial infection. The aim of the present study was to study various modes of presentation and microbiological profile in management of diabetic foot.

Methods: 100 diagnosed cases of diabetic foot were studied over a period of three years in the department of General Surgery at Katihar Medical College with emphasis on clinical features and microbiological picture of diabetic foot and its complications.

Results: Males are more prone to surgical complications three times than females because of more outdoor activities. It is more prevalent in age group 51-60 years (36%). In the present study, cases presenting with ulcer were maximum (52%) followed by cellulitis (20%), cases presenting with gangrene of toe or foot was minimum (12%). Staphylococcus Aureus was found in majority of cases of septic lesions on culture of pus (41%). Other organisms isolated were Pseudomonas, Klebsiella, E.Coli, Proteus etc.

Conclusions: Diabetic foot has varied presentation. The prevalence of diabetes mellitus and its surgical complications can be attributed to poor patient knowledge, education and awareness of the disease. Patient education for care of feet such as pairing of nails, wearing proper footwear and prompt reporting to doctor in case of early lesions is essential.

 


Keywords


Abscess, Diabetic Foot, Gangrene, Staphylococcus aureus, Ulcer

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References


International working group on the Diabetic foot. In: International consensus on the diabetic foot. International working group on diabetic foot. Netherlands. 1999:20-96.

Shaw JE, Sicree RA, Zinnet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diab Res Clin Pract. 2010;87:4-14.

Lavin ME, O’Neal LW. The diabetic foot. St. Louis: C W Mosby Co. 1988:203-205.

Apelqvist J, Bakker K, Van Houtum WH, Schaper NC. The development of global consensus guidelines on the management of diabetic foot. Diabetes Metab Res Rev. 2008;Suppl1:S116-8.

Chincholikar DA, Pal RB. Study of fungal and bacteriological infections of the diabetic foot. Indian journal of pathology and microbiology. 2002;45:15 -22

Wagner FW Jr. The dysvascular foot: A system for diagnosis and treatment. Foot Ankle 1981;2(2):62-122.

Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes care. 1998;21:855-9.

Lavery LA, Armstrong DG, Murdoch DP et al. Validation of the infectious diseases society of America’s diabetic foot infection classification system. Clin Infec Dis. 2007;44(4):562-5.

International Diabetes Federation. Time to act: Diabetes and foot care. IDF, 2005

Boyko EJ, Ahroni JH, Smith DC, Davignon D. Increased mortality associated with diabetic foot ulcer. Diabet Med. 1996;13:967-72.

Wheelock FC Jr et al. Study of foot lesions in diabetics. Annals of Surgery. 1969 ; 99 : 776

Madan M, Naveen TK, Balachandra M. A study of surgical management of diabetic limb complications among rural population. Indian Journal of Surgery. 2012;74(2):131-5.

Vinod kumar CS, Hiresave S, Bandekar N. Metallobeta lactamase producing pseudomonas aeruginosa and its association with diabetic foot. Indian Journal of Surgery. 2011;73(4):291-4.

Ngim NE, Ndifon WO, Udosen AM, Ikpeme IA, Isiwele E. Lower limb amputation in diabetic foot disease: experience in a tertiary hospital in southern region: African Journal of Diabetic Medicine. 2012;20(1):13-5.

Mummidi DS, Dugar D, Mishra RK, Mohapatra JS, Houghton T. Clinicopathological study: Management of diabetic foot and its complications. J Pharm Biomed Sci. 2015;05(04):308-11.

Tanveer PS, Vikash L, Pranav N, Subha S, Sandesh D. Study of diabetic ulcer with surgical complications of diabetes, their outcome and management modalities in 72 cases studied in Navi Mumbai. Int J Res Med Sci. 2015;3(1);122-9.

Jigar VS, Utsav VS, Mahesh MP. Role of colour Doppler in management of diabetic foot. International journal of research in health sciences. 2015;3(2):235-40.

Aamir AH, Nasir A, Jadoon MZ, Mehmood K, Ali SS. Diabetic foot infections and their management in a tertiary care hospital. J Ayub Med Coll Abbottabad. 2011;23(1):58-62.

Tiwari S, Pratyush DD, Dwivedi A, Gupta SK, Rai M, Singh SK. Microbiological and clinical characteristics of diabetic foot infection in northern India. J Infect Dev Ctries. 2012;6(4):329-32.