Document Type : Original Article


1 Department of Community Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India

2 Oman Medical Specialty Board, Oman

3 Department of Internal Medicine, Sohar Hospital, Oman

4 Deparment of Podiatric, Sohar Hospital, Oman


BACKGROUND: In diabetic foot infections (DFIs), the diversity of microbial profile and ever‑changing
antibiotic‑resistance patterns emphasize accurate characterization of microbial profile and antibiotic
susceptibility pattern. The aim of the study was to investigate the pathogens associated with DFI
and their antibiotic susceptibility patterns.
MATERIALS AND METHODS: A cross‑sectional retrospective study was conducted at a tertiary‑care
hospital, Oman. The socio‑demographic and microbiological profile and antibiotic susceptibility
patterns of pathogens isolated from patients with DFIs from January 2013 to December 2018 were
reviewed. Quantitative and qualitative variables were expressed as mean ± standard deviation
and percentages, respectively. A Chi‑square test was used for testing the association between
multidrug‑resistant (MDR) organisms and variables.
RESULTS: In total, 233 isolates recovered from 133 clinical specimens with an average of
1.8 organisms per specimen were included in the study. Fifty‑six and forty-four percent of specimens
showed monomicrobial and polymicrobial growth of two or more organisms, respectively. The
frequency of isolation was predominant among males (65%). Aerobic Gram‑negative rods were
predominantly (75%) isolated compared to Gram‑positive organisms (25%). Staphylococcus aureus
and Pseudomonas aeruginosa were the most frequently isolated Gram‑positive and Gram‑negative
bacteria, respectively. Thirty‑eight percent of them were MDR strains. Gram‑negative organisms
showed fairly good susceptibility ranging from 75% to 100% to carbapenems, aminoglycosides,
and piperacillin‑tazobactam. While doxycycline and trimethoprim‑sulfamethoxazole showed good
susceptibility toward Gram‑positive organisms.
CONCLUSION: DFIs are often polymicrobial with a predominance of Gram‑negative pathogens. This
study recommends the use of carbapenems and doxycycline for empirical therapy of Gram‑negative
and Gram‑positive bacterial DFIs, respectively.


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