Bacteriological evaluation of diabetic ulcers in Nigeria
Abstract
Author(s): F A Orji, N C Nwachukwu, and E C Udora

Diabetic foot ulcers are a common cause of morbidity and mortality in Nigeria. The lesions are usually infected, and this study was carried out in Enugu State, Nigeria to determine the common bacterial pathogens that infect ulcers and their antimicrobial susceptibly patterns. Deep wound swabs were collected from 71 consecutive diabetic patients admitted with foot ulcers into the medical wards of University of Nigeria Teaching Hospital, Enugu (26% of 274 total diabetes-related admissions). Polymicrobial isolates of Clostridium spp, Staphylococcus aureus, Escherichia coli, or Klebsiella aerogenes were found in 26 (53%) cases. Clostridium species showed susceptibility to fluoroquinolones, and high resistance to beta-lactams. Escherichia coli and Klebsiella aerogenes showed resistance to the aminoglycosides and beta-lactams. All the gram-negative organisms showed significant susceptibility to the fluoroquinolones used. Clostridium species, Staphylococcus aureus, Escherichia coli, and Klebsiella aerogenes were the most common causes of diabetic foot infections in the study and the rates of antibiotic resistance were observed to be relatively high. Antibiotic susceptibility testing remains of paramount importance in the management of diabetic foot ulceration.

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