6 research outputs found
Correlation between superficial and intra-operative specimens in diabetic foot infections: results of a cross-sectional Tunisian study
Objective: To determine the correlation between superficial, and
intra-operative specimens in diabetic foot infections (DFIs). Methods:
We conducted a cross-sectional study in patients with DFIs hospitalized
in a Tunisian teaching hospital. Superficial specimens were collected
for all patients, and intra-operative specimens were collected in
operated patients. The specimens were processed using standard
microbiology techniques. Antimicrobial susceptibility testing was
carried out according to the protocol established by the European
Committee on Anti-microbial Susceptibility Testing. Intra-operative and
superficial specimens were considered correlated if they isolated the
same microorganism(s), or if they were both negative. Results: One
hundred twelve patients, 81 males and 31 females, mean age 56 years,
were included. Superficial samples were positive in 77% of cases, and
isolated 126 microorganisms. Among the positive samples, 71% were
monomicrobial. The most frequently isolated microorganisms were
Enterobacteriaceae (53%), followed by streptococci (21%) and
Staphylococcus aureus (17%). Nine microorganisms (7%) were multi-drug
resistant. Intra-operative samples were positive in 93% of cases.
Superficial specimens were correlated to intra-operative specimens in
67% of cases. Initial antibiotic therapy was appropriate in 70% of
cases. The lower-extremity amputation and the mortality rates were 41%
and 1%, respectively. Conclusion: In our study, DFIs were most
frequently caused by Enterobacteriaceae and superficial specimens were
correlated to intra-operative specimens in only two thirds of cases.
Clinicians should emphasize on the systematic practice of
intraoperative specimens in all patients with DFIs treated surgically,
while well-performed superficial specimens could be useful for
prescribing appropriate antibiotic therapy in other patients