Infected diabetic foot is the most common reason for hospitalization and complications in patients with type 2 diabetes mellitus (DM2). Methicillin-resistant Staphylococcus aureus (MRSA) is frequently isolated from such lesions, and its presence is growing, seriously deteriorating the infected patient’s quality of life. The aim of this study was to assess the prevalence of MRSA as well as other microbiota in 100 patients diagnosed with (DM2) and with infected foot ulcers at the Hospital General de Mexico. The main results obtained show a prevalence of Staphylococcus aureus (42%), followed by Escherichia coli (36%) and, in lower percentages, other bacteria. MRSA was predominant (34%), and we conclude that the use of cefoxitin instead of oxacillin as the first-choice antibiotic has an advantage because it is a better inducer of methicillin-resistance expression.
WildSRogelicGGreenASicreeRKingH. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-1053.
2.
ShawJESicreeRAZimmetPZ. Global estimates of the prevalence of diabetes for 2020 and 2030. Diabetes Res Clin Pract. 2010;87:4-14.
3.
BoultonAJVileikyteLRagmarson-TennvalGApelquistJ. The global burden of diabetic foot disease. Lancet. 2005;366:1719-1724.
LaveryLAArmstrongDGMurdochDPPetersEJLipskyBA. Validation of the Infectious Diseases Society of America’s diabetic foot infection classification system. Clin Infect Dis. 2007;44:562-565.
6.
LipskyBABerendtARDeeryHG; Infectious Diseases Society of America. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004;9:885-910.
7.
DangCNPrasadYDBoultonAJJudeEB. Methicillin-resistant Staphylococcus aureus in diabetic foot clinic: a worsening problem. Diabet Med. 2003;20:159-161.
8.
CitronDMGoldsteinEJMerrianCVLipskyBAAbramsonMA. Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. J Clin Microbiol. 2007;45:2819-2820.
9.
KandamirOAkbayESakinEMilcanAGenK. Risk factors for infection of the diabetic foot with multiantibiotic resistant microorganisms. J Infect. 2007;54:439-445.
10.
ShanakarEMMohanVPremalathaGSrinivasanRSUshaAR. Bacterial etiology of diabetic foot infections in South India. Eur J Intern Med. 2005;16:567-570.
11.
EleftheriadouITentolourisNArgianaVJudeEBoultonAJ. Methicillin-resistant Staphylococcus aureus in diabetic foot infections. Drugs. 2010;70:1785-1797.
12.
TentolourisNJSmirnofEBKnowlesEABoultonAJ. Methicillin resistant Staphylococcus aureus: an increasing problem in a diabetic foot clinic. Diabet Med. 1999;16:767-771.
13.
ChangSSievertDMHagemanJC. Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene. N Engl J Med. 2003;348:1342-1347.
14.
HowdenBPDavisJKJohnsonPDRStinearTPGraysonML. Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin intermediate and heterogeneous vancomycin-intermediate strains: resistance mechanisms, laboratory detection and clinical implications. Clin Microbiol Rev. 2010;23:99-139.
15.
Hartemann-HeutierARobertJJacqueminetS. Diabetic foot ulcers and multidrug resistant organisms risk factors and impact. Diabet Med. 2004;21:710-715.
WagnerFW. The dysvascular foot: a system for diagnosis and treatment. Foot Ankle. 1981;2:64-122.
18.
MajnoGJorisI. Cells, Tissues, and Disease: Principles of General Pathology. 2nd ed.Oxford, UK: Oxford University Press; 2004.
19.
Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; Approved Standard. 10th ed.Wayne, PA: CLSI; 2011.
20.
GravetterFJWallnauLB. Statistics for the Behavioral Sciences. 7th ed.Belmont, CA: Thomson Wadsworth; 2007.
21.
TentolourisNPetrikkosGVallianouN. Prevalence of methicillin resistant Staphylococcus aureus in infected and uninfected diabetic foot ulcers. Clin Microbiol Infect. 2006;12:186-189.
22.
SottoALinaGRichardJL. Virulence potential of Staphylococcus aureus strains isolated from diabetic foot ulcers: a new paradigm. Diabetes Care. 2008;31:2318-2324.
23.
MendesJJMarques-CostaCVillelaJ. Clinical and bacteriological survey of diabetic foot infections in Lisbon. Diabetes Res Clin Pract. 2012;95:153-161.
24.
GadapelliRDhawnBSreenivasVKapilAAmminiACChaudhtryRA. Clinico-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital. Diabetes Care. 2006;29:1727-1732.
25.
GraffunderEMVeneziaRA. Risk factors associated with nosocomial methicillin resistant Staphylococcus aureus (MRSA) infection resistant previous use of antimicrobials. J Antimicrob Chemother. 2002;49:999-1005.
