Relationship of Microbes to Different Grades of Wagner's Classification in Diabetic Foot & their Sensitivity to Commonly Available Antibiotics

Abstract

OBJECTIVE: To evaluate the relationship of microbes with different Wagner's Classification in diabetic foot infections and assess their susceptibility to the antibacterial agents. METHODOLOGY: A prospective observational study was conducted from February 2014 to January 2019. A total of 100 patients of Type II Diabetic patients with age 30-70 years without any gender bar according to Wagner's type 2, 3, 4, and 5 were included. A sample of pus/tissue was taken by culture swab stick or sterile jar bottle from the Ulcer or infected tissue and sent for culture and sensitivity as per CLSI guidelines. Bacterial isolation concerning different grades of Wagner's Classification and their relative susceptibility to antibiotics was assessed. RESULTS: Of 100 diabetic feet infections, the mean age of the patients was 43.1±10.0 years making male to female ratio 1.8׃1. 40% of patients come in Wagner's grade III, followed by 38%, 12% and 10% in Wagner's grade IV, V and II, respectively. We found that out of n=190 microbes cultured maximum number n=85(44.7%) related with Wagner’s grade IV from which 25(13.1%) species were gram +ve and 60(31.5%) were gram–ve species, followed by 65(34.2%) microbes related with grade III from which 20(10.5%) species were gram+ve and 45(23.6%) were gram–ve species, 23(12.1%) microbes related with grade II(gram+ve=08(4.2%), gram–ve=15(7.8%)) and 17(8.9) microbes related with grade V(gram +ve=07 (3.6%), gram–ve=10(5.2%)). CONCLUSION: Maximum number of microbes related to Wagner grade IV and Imipenem was the most susceptible drug among all organisms, and Ampicillin was the most resistant drug.

Keywords

• diabetic
• foot
• infection
• wagner grading
• microbes