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Determinación del perfil bacteriológico en pacientes con pie diabético según la clasificación de Wagner, Hospital Vicente Corral Moscoso, Cuenca-Ecuador

Abstract:

Objective: To determine the clinical and bacteriological characteristics in diabetic foot patients diagnosed and hospitalized in the Internal Medicine Department of Vicente Corral Moscoso Hospital, from January 2004 to January 2009.- Materials and Methods A descriptive study was conducted over a universe of 54 patients. The data were obtained from the archive of medical records and analyzed with help of Excel and SPSS software.-Results: 31 patients (57.4%) were female; minimum age was 34 years, maximum age was 86 with an average of 58.3 ± 11.7. The larger prevalence of diabetic foot was observed between 45 and 65 years old, with 34 cases (63%). Wagner’s grades II, III and IV were the most frequent 50 (92.5%). Gram’ negative bacilli were isolated in 35 cases (65%) and from those 12 (34.3%) presented Escherichia coli. In 15 patients (28.0%), Gram positive cocci were identified and of these Staphylococcus aureus were the most frequent 11 (73.3%). Finally, 4 cases (7.0%) the cultures were negative. The antibiotic combination of Ciprofloxacin plus Clindamycin was the most used, 38 patients (70.4%). At 33 (89.2%) of 37 cases glycosylated hemoglobin values were found in excess of 7%. At 24 cases (44.4%) trauma was identified as triggering factor for diabetic foot lesions and the majority, 44 patients (81.5%) had a favorable clinical outcome.- Conclusions Wagner’s grades II, III and IV were the most frequent; the Gram negative were isolated more often; the combination of Ciprofloxacin plus Clindamycin was the most widely used therapeutic regimen, almost all the cases had poor metabolic control and clinical outcomes were favorable in the majority