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Diabetic Foot Infections with Pseudomonas: Jabir Abueliz Diabetic Center Khartoum Experience

Waiel Faisal Abdel Wahab, Mohayad A Bakhiet, Seif ElDin I Mahadi, Shadad M Mahmoud, AbuBakr Hassan Widataa and Mohamed ElMakki Ahmed

Background: The isolation of Pseudomonas organism in diabetic foot infection (DFI), is notorious of being multidrug resistant. The objective of this study is to report on the incidence, antibiotic sensitivity, treatment and outcome of pseudomonas infection.

Patients and methods: This is a prospective observational analytic hospital based study in which all diabetic patients with Pseudomonas aeruginosa infected wounds seen in JADC during 18 months period were included.

Results: Pseudomonas was grown in 302 out of 3620 cultures (8.3%) of whom 70 cultures were true pathogenic (1.9%). 41.4% of patients infected with pseudomonas were clinically septic when first seen in the clinic of whom 92.9% were febrile at presentation and 67.1% had chills. Ceftriaxone and ciprofloxacin were the most commonly used antibiotics. Amikacin was the most sensitive antibiotics in 77.1%. All patients took antibiotics >21 days after the isolation of pseudomonas to complete the eradication in combination of daily sharp excision of all coloured infected tissues. Forty six patients (66%) needed amputation, 30 had minor toes (43%) and 16 had transtibial amputation, (23%).

Conclusion: Diabetic foot infected with pseudomonas carries a higher risk for toe or lower limb amputation. For complete medical eradication of P. aeruginosa; antibiotics should be used for at least 21 days combined with daily sharp excision of infected discoloured tissues.