Determination of the Resistance Pattern of Prevalent Aerobic Bacterial Infections of Diabetic Foot Ulcer

Background and Objective: Diabetes mellitus is one of the main problems in health systems in the world. Diabetic Foot infections (DFI) is one of the main complications and the most cause  of non-traumatic lower limb amputation .This study aimed to determine the prevalence of bacteria involved in DFI and their antibiotic resistance in patients with DFI diagnosis. Patients and Methods: This descriptive-analytical and cross-sectional study was designed in 4 years period from April 2007 to March 2010 on 90 patient in Shahid Mostafa  Khomeini Hospital,Tehran, Iran .For bacteriological analysis, all wound samples culture grown by standard methods bacteriology and Disk diffusion method was used for antibiogram. Patient’s clinical and epidemiologic data were collected from recorded  file. The data were analyzed by using SPSS16 statistical software. Results: 104 bacteria were isolated from 90 patients. 57.70% were gram-positive and 42.30% were gram-negative. Among gram-positive bacteria Staphylococcus aureus (60%) and enteroccoci spp.(33.3%) and  among gram-negative bacteria E. coli (47.73%), Pseudomonas Aeroginosa  (22.73%) and Proteus spp.(18.18%) were the most common isolates respectively. 75% of isolates were resistant to two antibiotics or more. Previous antibiotic therapy was significant risk factor for multidrug resistant (MDR) infections (P: 0.003). All gram-positive isolates were sensitive to Vancomycin. Imipenem and Amikacin had good activity against gram-negative bacteria. Conclusion:Infection with MDR bacteria in patients with diabetic foot ulcers is high and have significant association with recent antibiotic therapy. So the proper use of antibiotics in order to prevent the creation of multi-drug resistant bacteria is recommended.