Kandemir et al reported risk factors for a diabetic foot wound becoming infected with multi-drug resistant (MDR) bacteria. A diabetic foot wound faces many opportunities for exposure to antibiotic-resistant organisms. The authors are from Mersin University in Turkey.
Patient selection: infected diabetic foot
Risk factors for infection with multi-drug resistant bacteria:
(1) previous antibiotic therapy
(2) exposure to inpatient care (frequency of admission for the same wound, prolonged)
(3) osteomyelitis
(4) poor perfusion of the foot
(5) suboptimal hygiene for wound
Additional factors not mentioned in the paper include:
(1) prevalence of multi-drug resistant organisms in the region
(2) colonization of wound care personnel
(3) a long-standing or recurring ulcer
Isolated organisms included:
(1) methicillin resistant Staphylococcus aureus
(2) methicillin resistant Staphylococcus epidermidis
(3) penicillin-resistant Streptococcus (? MDR)
(4) enterococcus species
(5) Gram-negative bacteria with extended-spectrum beta-lactamase or inducible beta-lactamase
(6) Pseudomonas aeruginosa resistant to ceftazidime and imipenem
(7) Acinetobacter baumannii resistant to imipenem
Preventing or minimizing risk factors can reduce the chances of developing an infection due to multi-drug resistant organisms.
