The relationship between bacterial characteristics and mortality in diabetic foot ulcers' patients admitted to Dr. H. Abdul Moeloek General Hospital, Lampung
Abstract
ABSTRACT
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Around 25% of people with diabetes experience diabetic foot ulcers in their lives, accompanied by infections due to various types of bacteria. Infection due to Gram-negative and Gram-positive bacteria are reported to have different inflammation patterns, where the latter being reported to have a higher mortality rate. This study was an analytic observational study with a cross-sectional design to determine the relationship between bacterial characteristics and mortality in diabetic foot ulcers. Data were obtained from medical records of diabetic ulcer patients admitted to Dr. H. Abdul Moeloek General Hospital, Lampung, in 2017–2020. There were 131 diabetic foot ulcers patients identified, with the median age of the subjects was 53 years, 43.5% of the subject were male, and 56.5% were female. The mean hemoglobin was 9.3 g/dl, WBCs were 19.0 ×103/ml, and platelets were 422.1 ×103/ml. The mean length of stay in the hospital was 10.7 days. Eighteen subjects died during the hospital stay, with 15 of them were from the Gram-negative monomicrobial group. The results of the Fischer Exact test on mortality and bacterial characteristics among monomicrobial infections (p=0.688) indicate no relationship between the characteristics of the infectious pathogen and mortality in diabetic foot ulcers.
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Keywords: bacteria, diabetes, diabetic foot ulcers, mortality
Correspondence: iswandi.darwis@gmail.com
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References
Amin, N. and Doupis, J. (2016) ‘Diabetic foot disease: From the evaluation of the “foot at risk†to the novel diabetic ulcer treatment modalities’, World Journal of Diabetes, 7(7), p. 153.
Benavent, E. et al. (2019) ‘The impact of gram-negative bacilli in bacteremic skin and soft tissue infections among patients with diabetes’, Diabetes Care, 42(7), pp. E110–E112.
Blot, S. (2019) ‘Setting the baseline to fight Gram-negative bacteraemia: the necessity of epidemiological insights’, Infectious Diseases. Taylor & Francis, 51(1), pp. 23–25.
Chotirmall, S. H. et al. (2016) ‘Blood cultures in emergency medical admissions : a key patient cohort’, pp. 38–43.
Disselkamp, M., Coz Yataco, A. O. and Simpson, S. Q. (2019) ‘POINT: Should Broad-Spectrum Antibiotics Be Routinely Administered to All Patients With Sepsis as Soon as Possible? Yes’, Chest. Elsevier Inc, 156(4), pp. 645–647.
Frykberg, R. G. and Banks, J. (2016) ‘Management of Foot Ulcers: A Review’, Federal Practitioner, 33(2), pp. 16–23.
Goh, T. C. et al. (2020) ‘Clinical and bacteriological profile of diabetic foot infections in a tertiary care’, Journal of Foot and Ankle Research. Journal of Foot and Ankle Research, 13(1), pp. 1–8.
Gradel, K. O. et al. (2017) ‘Impact of appropriate empirical antibiotic treatment on recurrence and mortality in patients with bacteraemia: A population-based cohort study’, BMC Infectious Diseases. BMC Infectious Diseases, 17(1), pp. 1–9.
Jeyaraman, K. et al. (2019) ‘Amputations in patients with diabetic foot ulcer: a retrospective study from a single centre in the Northern Territory of Australia’, ANZ Journal of Surgery. BMC Endocrine Disorders, 89(7), pp. 874–879.
Kushwaha, A. et al. (2020) ‘Analysis of Culture-Positive Vs Culture-Negative Sepsis in Urban ICU’, CHEST. American College of Chest Physicians, 158(4), pp. A604–A605.
Lipsky, B. A. et al. (2020) ‘Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)’, Diabetes/Metabolism Research and Reviews, 36(S1), pp. 1–24.
Maskarinec, S. A. et al. (2020) ‘Positive follow-up blood cultures identify high mortality risk among patients with Gram-negative bacteraemia’, Clinical Microbiology and Infection, 26(7), pp. 904–910.
Phua, J. et al. (2013) ‘Characteristics and outcomes of culture-negative versus culture-positive severe sepsis’, Critical Care, 17(5).
Powers, A. C. (2015) ‘Diabetes mellitus: complications’, in Kasper, D. L. et al. (eds) Harrison’s principles of internal medicine. 19th edn. New York: McGraw-Hill Education, pp. 2422–2430.
Surbatovic, M. et al. (2015) ‘Cytokine profile in severe gram-positive and gram-negative abdominal sepsis’, Scientific Reports. Nature Publishing Group, 5, pp. 1–12.
Tabah, A. et al. (2012) ‘Characteristics and determinants of outcome of hospital-acquired bloodstream infections in intensive care units: The EUROBACT International Cohort Study’, Intensive Care Medicine, 38(12), pp. 1930–1945.
Vincent, J. L. et al. (2006) ‘Sepsis in European intensive care units: Results of the SOAP study’, Critical Care Medicine, 34(2), pp. 344–353.
Wen, F. et al. (2016) ‘Macrophage migration inhibitory factor in the regulation of myoblast proliferation and differentiation’, Bioscience, Biotechnology and Biochemistry, 80(7), pp. 1313–1320.
Xu, X. J. et al. (2013) ‘Inflammatory cytokine measurement quickly discriminates gram-negative from gram-positive bacteremia in pediatric hematology/oncology patients with septic shock’, Intensive Care Medicine, 39(2), pp. 319–326.
Zahar, J. R. et al. (2011) ‘Outcomes in severe sepsis and patients with septic shock: Pathogen species and infection sites are not associated with mortality’, Critical Care Medicine, 39(8), pp. 1886–1895.
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