J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Original Article

Volume 8, Number 5, October 2018, pages 100-105

Evaluation of Clinical and Microbiological Characteristics of Foot Infections of Patients With Diabetes: Does Antibiotic Susceptibility Change?

**Table 1.** Demographic Characteristics of the Patients and Presence of Chronic Complications
	N (%)	Mean ± SD
*No patients in Wagner stages 0 and 1.
Age (year)		63.1 ± 10.9
Duration of diabetes (year)		16.9 ± 6.9
Gender
Female	12 (23.5%)
Male	39 (77.5%)
Neuropathy	50 (98%)
Nephropathy	44 (86%)
Retinopathy	48 (94%)
Peripheral arterial disease	40 (78.4%)
Wagner stage*
Wagner 2	5 (9.6%)
Wagner 3	33 (63.5%)
Wagner 4	14 (26.9%)
Osteomyelitis	47 (90.4%)
Amputation	46 (90.1%)

Table 1. Demographic Characteristics of the Patients and Presence of Chronic Complications

N (%)

Mean ± SD

*No patients in Wagner stages 0 and 1.

Age (year)

63.1 ± 10.9

Duration of diabetes (year)

16.9 ± 6.9

Gender

Female

12 (23.5%)

Male

39 (77.5%)

Neuropathy

50 (98%)

Nephropathy

44 (86%)

Retinopathy

48 (94%)

Peripheral arterial disease

40 (78.4%)

Wagner stage*

Wagner 2

5 (9.6%)

Wagner 3

33 (63.5%)

Wagner 4

14 (26.9%)

Osteomyelitis

47 (90.4%)

Amputation

46 (90.1%)

**Table 2.** Types of Microorganisms Identified in the Wound Cultures of the Patients
Bacteria	Total (N)
Gram-positive microorganisms	96
Enterococcus faecalis	28
Staphylococcus aureus	23
Staphylococcus epidermidis	18
Other CNS	9
Streptococcus agalactiae	8
Streptococcus dysgalactiae	4
Streptococcus viridans	3
Enterococcus avium	2
Streptococcus pyogenes	1
Gram-negative microorganisms	101
Pseudomonas aeruginosa	16
Morganella morganii	15
Escherichia coli	13
Acinetobacter baumannii	11
Proteus mirabilis	11
Serratia marcescens	6
Klebsiella pneumoniae	5
Citrobacter koseri	4
Providencia rettgeri	3
Klebsiella oxytoca	2
Citrobacter braakii	2
Citrobacter freundii	2
Enterobacter cloacae	2
Stenotrophomonas maltophilia	3
Proteus penneri	1
Proteus vulgaris	1
Providencia alcalifaciens	1
Providencia stuartii	1
Serratia liquefaciens	1
Sphingomonas paucimobilis	1
Fungi
Candida species	1
Total	207

Table 2. Types of Microorganisms Identified in the Wound Cultures of the Patients

Bacteria

Total (N)

Gram-positive microorganisms

Enterococcus faecalis

Staphylococcus aureus

Staphylococcus epidermidis

Other CNS

Streptococcus agalactiae

Streptococcus dysgalactiae

Streptococcus viridans

Enterococcus avium

Streptococcus pyogenes

Gram-negative microorganisms

101

Pseudomonas aeruginosa

Morganella morganii

Escherichia coli

Acinetobacter baumannii

Proteus mirabilis

Serratia marcescens

Klebsiella pneumoniae

Citrobacter koseri

Providencia rettgeri

Klebsiella oxytoca

Citrobacter braakii

Citrobacter freundii

Enterobacter cloacae

Stenotrophomonas maltophilia

Proteus penneri

Proteus vulgaris

Providencia alcalifaciens

Providencia stuartii

Serratia liquefaciens

Sphingomonas paucimobilis

Fungi

Candida species

Total

207

**Table 3.** The Rates of Amputation in Regard to Mono Microbial and Poly Microbial Reproductions, and Gram-Staining Properties of the Pathogens
Characteristic of reproduction	Number (N)	Amputation N (%)	Osteomyelitis N (%)
Mono microbial	85	74 (87%)	54 (64%)
Gram-positive	43
Gram-negative	42
Poly microbial	54	52 (98%)	40 (75%)
All are Gram-positive	12
All are Gram-negative	7
Mixed	35

Table 3. The Rates of Amputation in Regard to Mono Microbial and Poly Microbial Reproductions, and Gram-Staining Properties of the Pathogens

Characteristic of reproduction

Number (N)

Amputation N (%)

Osteomyelitis N (%)

Mono microbial

74 (87%)

54 (64%)

Gram-positive

Gram-negative

Poly microbial

52 (98%)

40 (75%)

All are Gram-positive

All are Gram-negative

Mixed

**Table 4.** Antibiotic Sensitivity Patterns of Microorganisms Identified in Culture Media
Microorganism	Type of resistance	Resistance (N)/total (N) (%)
In S. aureus
	Methicillin resistance	5/11 (45%)
	Quinolone resistance	7/20 (35%)
	TMP/SMX resistance	2/15 (13%)
	Clindamycin resistance	7/15 (47%)
In CNS
	Methicillin resistance	19/22 (86%)
In Enterobacteriaceae
	ESBL positivity	5/12 (42%)
	Quinolone resistance	25/34 (74%)
P. aeruginosa
	Carbapenem resistance	6/17 (35%)
	Quinolone resistance	6/15 (40%)
	Aminoglycoside resistance	3/15 (20%)
In Enterococcus species
	Ampicillin resistance	12/30 (40%)
	Vancomycin resistance	0/27 (0%)
In A. baumannii
	Carbapenem resistance	8/11 (73%)
	Aminoglycoside resistance	6/11 (55%)

Table 4. Antibiotic Sensitivity Patterns of Microorganisms Identified in Culture Media

Microorganism

Type of resistance

Resistance (N)/total (N) (%)

In S. aureus

Methicillin resistance

5/11 (45%)

Quinolone resistance

7/20 (35%)

TMP/SMX resistance

2/15 (13%)

Clindamycin resistance

7/15 (47%)

In CNS

Methicillin resistance

19/22 (86%)

In Enterobacteriaceae

ESBL positivity

5/12 (42%)

Quinolone resistance

25/34 (74%)

P. aeruginosa

Carbapenem resistance

6/17 (35%)

Quinolone resistance

6/15 (40%)

Aminoglycoside resistance

3/15 (20%)

In Enterococcus species

Ampicillin resistance

12/30 (40%)

Vancomycin resistance

0/27 (0%)

In A. baumannii

Carbapenem resistance

8/11 (73%)

Aminoglycoside resistance

6/11 (55%)