![]() |
CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
Journals - Article | |
![]() |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
Česky / Czech version | Vnitř. Lék., 48, 2002, No. 4, p. 302-306 |
Between the Presence of
Resistant Pathogens, other Risk Factors and Frequency of Amputations in Patients with the
Diabetic Foot Fejfarová V., Jirkovská A., Skibová J., Petkov V.: Klinika diabetologie Centra diabetologie Institutu klinické a experimentální medicíny Praha, přednosta prof. MUDr. T. Pelikánová, DrSc. Oddělení klinické mikrobiologie Institutu klinické a experimentální medicíny Praha, přednosta MUDr. V. Petkov |
|
Summary: Patients with diabetes mellitus undergo more amputations due to peripheral vascular disease,
neuropathy and especially to infection requiring long-lasting antibiotic therapy than non diabetic
patients. The aim of our study was to assess the association between the presence of resistant
pathogens presented in diabetic ulcers and the frequency of lower limb amputations. Methods: 191
diabetic patients consecutively treated for the diabetic foot in our foot clinic were included into
two years retrospective study. Peripheral ischemia, the presence of osteomyelitis and the incidence of all Gram positive and negative resistant pathogens (defined as resistance to all oral antibiotics) especially of resistant Staphylococcus species presenting in diabetic foot ulcers were
determined. Results: 50/191 (26 %) patients underwent amputation, of whom 44/50 (88 %) had mi-
nor and 6/50 (12 %) had major amputations. 53/181 (29 %) patients with diabetic foot ulcers had
resistant pathogens in their defects. Amputated patients had significantly more resistant microorganisms than patients without amputations - 24/42 (57 %) vs. 29/139 (21 %); p < 0.001. Resistant
Staphylococcus species were found in 21 % (38/181) of all patients. Patients with amputations had
significantly more resistant Staphylococcus species in comparison with patients without amputations - 18/42 (43 %) vs. 20/139 (14 %); p < 0.001. Significantly higher incidence of peripheral vascu-
lar disease - 79 % (38/48) vs. 60 % (81/136); p < 0.05 and osteomyelitis - 69 % (33/48) vs. 13 % (18/140);
p < 0.001 - were found in patients with amputations in comparison with patients without amputations. Conclusion: The presence of pathogens resistant to all oral antibiotics and especially of
resistant Staphylococcus species was significantly higher in diabetic patients with lower limb
amputations in comparison with patients without amputations.
|
|
Order this issue
|
BACK TO CONTENTS | ||
| HOME PAGE | CODE PAGE | CZECH VERSION | |
© 1998 - 2008 CZECH MEDICAL ASSOCIATION J. E. PURKYNĚ |
Created by: NT Servis, s.r.o., hosted by P.E.S. consulting, s.r.o. |
WEBMASTER |