Author(s): P. Rajagopal1, S. Senthilvel2, N. Sandeep3
BACKGROUND AND OBJECTIVES
Infections of all types are more common in patients with diabetes, on the basis of outcome of retrospective study in Canada. Many types of infections are very common in diabetic than non-diabetic patients. Foot is the most common site. Diabetic foot infections range from mild infections to limb threatening conditions. Most require emergency medical attention. Diabetic foot infection is a global burden and projected to increase from 246 million people to over 380 million people by the year 2025. Many people with diabetes develop complications that seriously affect their quality and length of life. Lower limb complications are common, particularly foot ulcers and gangrene. Development of these complications is attributed to individual risk factors, poverty, racial and ethnic differences, and quality of local and national health care systems. The wide variations noted suggest that best practices in low incidence areas could easily be adapted in high incidence areas to reduce the burden of complications. Almost every infection begins in a wound, often as neuropathic ulceration or a traumatic break in the skin. Infections that begin as a small problem may progress to involve soft tissue, bones and joints.
Because of these morbidity and occasional mortality by these foot infections several authoritative groups have recently developed guidelines for assessing and treating diabetic foot.
100 Diabetic patients with foot ulcers were admitted and wounds were classified using wagner’s classification. Pus was sent for culture and sensitivity and treated accordingly.
In our study the most common organism cultured from the wound with diabetes mellitus was staphylococcus. The most sensitive drug for these organisms was found to be chloramphenicol on most occasions.
The rationale of pus culture and sensitivity is not only to definitively treat the diabetic wound after the culture sensitivity report is available, but also to treat the wounds in places where the culture sensitivity facilities are not available or delayed. So as to target commoner organisms with the drugs which are sensitive on more occasions so as to avoid drug resistance and in a cost effective manner.