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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905
EISSN: 1680-6905
Vol. 19, No. 3, 2019, pp. 2505-2514
Bioline Code: hs19141
Full paper language: English
Document type: Study
Document available free of charge

African Health Sciences, Vol. 19, No. 3, 2019, pp. 2505-2514

 en Correlation between superficial and intra-operative specimens in diabetic foot infections: results of a cross-sectional Tunisian study
Bellazreg, Foued; Guigua, Ahmed; Ferjani, Asma; Hattab, Zouhour; Boukadida, Jalel; Ach, Koussay; Letaief, Rached; Hachfi, Wissem & Letaief, Amel


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 check for this species in other resources (53%), followed by streptococci check for this species in other resources (21%) and Staphylococcus aureus check for this species in other resources (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.

Diabetic foot infections; superficial specimens; intra-operative specimens.

© Copyright 2019 - Bellazreg et al.

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