Correlation between superficial and intra-operative specimens in diabetic foot infections: results of a cross-sectional Tunisian study

To determine the correlation between superficial, and intra-operative specimens in diabetic foot infections (DFIs). 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 spec...

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Bibliographic Details
Published in:African health sciences 2019-09, Vol.19 (3), p.2505-2514
Main Authors: Bellazreg, Foued, Guigua, Ahmed, Ferjani, Asma, Hattab, Zouhour, Boukadida, Jalel, Ach, Koussay, Letaief, Rached, Hachfi, Wissem, Letaief, Amel
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy
Bacterial Infections - epidemiology
Bacterial Infections - microbiology
Bacterial Infections - surgery
Cross-Sectional Studies
Diabetic Foot - epidemiology
Diabetic Foot - microbiology
Female
Glycated Hemoglobin A
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Risk Factors
Severity of Illness Index
Socioeconomic Factors
Tunisia - epidemiology
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Summary:To determine the correlation between superficial, and intra-operative specimens in diabetic foot infections (DFIs). 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. 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 (53%), followed by (21%) and (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. In our study, DFIs were most frequently caused by 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.
ISSN:1680-6905
1729-0503
1680-6905
DOI:10.4314/ahs.v19i3.26