Endocrine Abstracts

Introduction: The diagnosis of infected ulcer is mainly clinical. The goals of the microbiological studies are identification of the pathogen and evaluation of susceptibility to antibiotics to minimize exposure to drugs and selection of resistant strains.

Methods: Retrospective cohort study; Data collection: 1 January 2010 to 31 December 2014. Were included wound samples of aspirate, nonsurgical/surgical exudate, pus from abscesses and bone fragments from diabetic foot consultation and ward at Endocrinology Department. Data were obtained through the clinical process and analysed in SPSS.

Results: On gender, our sample included 71.3% of male patients with age of 62.8±14 years. Regarding the origin of the requested studies, 78% were from the endocrinology ward (n=174) and 74% were samples of nonsurgical wound exudate (n=165).

One hundred and eighty-one samples were obtained for microbiological study with identification of 223 different agents.

Of gram-positive agents, Staphylococcus aureus (SA) was the most isolated in 39.5% of the samples (n=88) followed by Enterococcus faecalis (EF) in 8.97%. Of gram-negative agents, Pseudomonas aeruginosa (PA) was isolated in 29 (13%) and Proteus mirabilis (PM) in 23 (10.31%). Of the 42 samples with polymicrobial isolation, the combination of agents most commonly found corresponded to co-infection with PA and SA (14.3%) and SA and PM (17.1%).

Regarding to antimicrobial susceptibility in SA strains, was found resistance in 35.2% to oxacillin, 39% for levofloxacin, 29% to clindamycin, 3% to gentamicin, 1% to trimethoprim/sulfamethoxazole and there were no vancomycin or linezolid resistance in vitro.

Conclusions: Microbiological study is essential in ulcerated lesions particularly in moderate and severe infections. The most gram-positive isolated agent was SA and gram-negative agent was PA. 35.2% of the SA strains were methicillin-resistant which may be related to chronicity, recent hospitalization and previous antibiotic therapy, factors that are frequently present in diabetic patients followed in a tertiary care hospital.