Infecciones en pie diabético : gérmenes, tratamiento y desenlace en el Hospital Universitario Mayor - MEDERI

Abstract

INTRODUCTION: The objective of this work is to describe the clinical characteristics, the isolated germs in cultures taken in surgery, the type of surgical procedures and the outcomes in the treatment performed in patients with diabetic foot in the Hospital Universitario Mayor – Mederi. MATERIALS AND METHODS: Retrospective observational descriptive study in a serial clinical cases of the results obtained from the culture samples taken intra-surgically, the clinical characteristics of the patients, the number and type of procedures performed by the Orthopedic Service at the Hospital Universitario Mayor – Universidad del Rosario between January 2012 and December 2016 due to complications derived from diabetic foot. RESULTS: We obtained 58 patients with an average age of 65 years, 69% men and 31% women. The intraoperative Wagner stage was 32.8% III, 50% IV. Germs isolated, in the first place were found 2 types of germs, each in 15.5% of the cultures, which are Escherichia Coli and Pseudomonas Aeruginosa. One third of the patients required major amputations, of which 46.6% had infections due to multi-resistant germs such as multiresistant Escherichia coli, 93.3% of them required change in the empirical antibiotic therapy. CONCLUSIONS: The predominant germs are gram-negative bacilli like multi-resistant enterobacteria and Pseudomonas aeruginosa. Due that there was a 77.5% change in antibiotic therapy, we suggest taking samples intra-surgically for microbiological isolation prior to empirical antibiotic therapy and due the isolated bacterial flora in this series we suggest the use of carbapenems as empirical antibiotic therapy in the Hospital Universitario Mayor.