Authors
Zemlynoj A.B.1, Zelenina T.A.2, Salukhov V.V.2, Matveev S.A.1
1 Federal State Public Institution «National Medical and Surgical Center named after N.I. Pirogov» of the Ministry of Healthcare of the Russian Federation
2 S.M. Kirov Military Medical Academy, Saint Petersburg
Abstract
Objective: to assess the impact of multidrug resistant bacteria on postsurgical wounds healing in diabetic outpatients with follow-up period of 54 weeks.
Methods: We included in the study 102 diabetic foot outpatients with postsurgical wounds. The age was 58.6±1.06 years, duration of diabetes 11.5±1.02 years. All patients were treated according to the international standards. Cultures were obtained in the cases of clinical symptoms of infection. The bacterial profile and its antibioticresistants’ were detected. Appropriate antimicrobials were prescribed.
Results: The clinical symptoms of infection presented in 55.9% of cases. Osteomyelitis was found in 18.6% infected wounds. Most of patients grew mixed agents. Staphylococcus aureus was most frequently isolated agent (73% samples, including MRSA in 53% of cases). Gram-negative bacilli were found: Acinetobacter baumani in 24.4% of isolates (resistant to penicillins and fluoroquinolones in 90%, and aminoglycosides in 75% of cases); Proteus mirabilis in 17% of isolates (resistant to penicillins and fluoroquinolones in 86%, to aminoglycosides in 71% of cases). Multidrug resistant bacteria were evaluated in 76% of isolates. All wound without clinical symptoms of infection healed to 12 week of treatment as well as 50% of wounds with multidrug sensitivity infection. 85 and 26% of infected wounds healed to 24 week with multidrug sensitivity and multidrug resistant bacteria respectively. 92 and 61% infected wounds healed to 54 week with multidrug sensitivity and multidrug resistant bacteria respectively.
Conclusions: The multidrug resistant bacteria delays of wounds healing in diabetic foot outpatients after surgical operations. It could expect in cases of osteomyelitis, wounds square more than 18 cm², time before specialized treatment more than 14 weeks.
Keywords: diabetes mellitus, osteomyelitis, diabetic foot syndrome, multidrug resistant bacteria, postsurgical wounds healing.
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