Saltoglu N, et al. - The clinical outcome of the diabetic patients who had foot infections with multidrug resistant organisms was discussed. As per findings, methicillin resistant Staphylococcus was detected as the most common agent among rehospitalized patients. Klebsiella spp. infections were observed to be significantly associated with fatality.

Methods

• Patients with diabetic foot infections (DFI) were included from 19 centers, between May 2011 and December 2015.
• Researchers defined infection according to IDSA DFI guidelines.
• Patients with severe infection, complicated moderate infection were hospitalized.
• After discharge, a follow-up of 6 months was performed.

Results

• Researchers included 791 patients with DFI; 531(67%) was male, median age was 62 (19-90).
• Eighty-five (11%) patients were diagnosed with severe infection.
• In 291 (36.8%) patients, osteomyelitis was diagnosed.
• Isolation of 536 microorganisms was observed; the most common microorganisms included S.aureus (20%), P.aeruginosa (19%) and E.coli (12%).
• Among Staphylococcus aureus isolates, methicillin resistance (MR) rate was 31%.
• In 21% of P.aeruginosa isolates, multidrug resistant bacteria was detected.
• In 38% of E.coli and Klebsiella isolates ESBL (+), gram negative bacteria (GNB) was detected.
• Re-hospitalization was required for 63 patients (8%).
• In this study, 127/791 (16%) had major amputation, and 24/791 (3%) patients died.
• Multivariate analysis revealed that significant predictors for fatality were; dialysis (OR: 8.3, CI: 1.82-38.15, p=0.006), isolation of Klebsiella spp. (OR:7.7, CI: 1.24-47.96, p=0.028), and chronic heart failure (OR: 3, CI: 1.01-9.04, p=0.05).
• The most common microorganism detected was MR Staphylococcus among 21% of the rehospitalized patients (p < 0.001).