Endocrine Abstracts

Introduction: Diabetic foot infection (DFI) is a major public health problem, both for its morbid clinical consequences mainly ulcers and the economic social cost due to repeated hospitalisations and the high rate of amputation.

Objectives: Analyse the clinical presentation of DFI, study risk factors of developing this infection and describe the therapeutic management.

Materials and methods: Retrospective study spread over 8 years old, of 109 patients hospitalised in the University Hospital of Endocrinology of Sfax and who had a DFI.

Results: The average age of patients was 57.5 years (25–82). Sex ratio was 2.02. Most patients were type 2 diabetics (87.2%) with diabetic history of more than 15 years in 34% of cases. A history of hospitalisation for diabetic feet before the study period was found in 39.4%. On admission diabetes were poorly controlled in the majority of our patients. Among the chronic microangiopathic complications, we found neuropathy (64.2%), nephropathy (20.2%), and retinopathy 37.6%. Macroangiopathic complications were dominated by arteriopathy of the lower limbs in 20.2%. The DFI were unique or multiple. It was ‘non-threatening member’ infection in 64.2%, dominated by infected wounds in 57.1%. The infection was severe, dominated by infected gangrene in 33%, followed by infected plantar ulcer in 22%. Samples for bacteriological test were performed in 29 patients. The bacteria involved were dominated by Staphylococcus 20.7% and gram-negative bacteria in 17.2%. 105 of our patients received an antibiotherapy. The association amoxicillin–clavulanic acid +/− ciprofloxacin were prescribed in first intention in 47%. The average duration of antibiotherapy was 9.7 days in case of infection ‘non-threatening member’ and 17.3 days for severe infection. Surgical treatment was performed in 45%. Conservative treatment or amputations were done in 15 and 30% cases respectively.

Conclusion: Prevention is the only way to reduce morbidity caused by lesions of the diabetic foot.