Quantification & scaling of risk factors of diabetes mellitus and isolation of microorganisms from diabetic foot ulcer: a cross sectional study

Abstract

Diabetes mellitus (DM) is a chronic noncommunicable disease (CNCD) and a leading global health problem. In the last few decades, especially in the developing world, diabetes is the fourth leading cause of deaths. The prevalence of diabetes in Bangladesh is increasing rapidly, as well as complications of chronic diabetes. Diabetic foot is one of the most serious complications associated with diabetes and affects quality of life among patients in all ages and races. The study is aimed at identifying the risk factors & complications of DM and isolate microorganisms from diabetic foot ulcer. In addition, we tried to see the antibiotic sensitivity of the microorganisms along with identifying the antibiotic resistant genes. This is a cross sectional study and was performed among patients of Chattogram Diabetic General Hospital, Chattogram and responses from 106 cases on general and specific variables were documented. Data was collected with predesigned questionnaire along with random blood glucose measurement using glucometer. Sample was taken from diabetic foot ulcer. Microbial culture and CS test was conducted. Out of 106 patients, most were having an age more than 59 years (40; 37.70%) followed by the age group having 55-59 years of age (18; 17.00%) while the lowest number of patients were from the relatively younger age having an age less than 35 years (2; 1.90%). A total of six microorganisms were found in culture. Staphylococcus was the most prevalent organism causing the foot ulcers in diabetic patients (28; 26.40%) followed by coliforms (16; 15.10%), Klebsiella (12; 11.30%), Enterococcus (10; 9.40%), Pseudomonas and E. Coli (8; 7.50%). We have found that gram positive bacteria both Staphylococcus and Enterococcus 100% sensitive to only Tigecycline among 18 antibiotics alternatively Enterococcus showed 100 % resistant to Cefuroxime, Erythromycin and Oxacillin. Among gram negative bacteria, E. coli showed 100% sensitive to Colistin, Cefepime, Imipenem, Levofloxacin, Tigecycline in addition Klebsiella showed 100% sensitive to Colistin only. To better understand the risk of the diabetes mellitus and proper management of diabetic foot ulcer the data will be helpful in prescribing appropriate antibiotics, reducing hospital stay, preventing major surgical interventions and thereby saving resources.