Fatih TEKİN, Mehmet SÜRMELİ, Ergin IŞIK, Furkan Erol KARABEKMEZ

Wagner Evre III ve IV Diyabetik Ayak Ülserlerinin Mikrobiyolojik Değerlendirmesi

GİRİŞ ve AMAÇ: Bu çalışmanın amacı patojen mikroorganizma popülasyonları ve antibiyotik dirençleri açısından kritik klinik ve cerrahi müdahale ihtiyacı duyulan Wagner evre III ve IV diyabetik ayak ülserli olguları incelemektir.YÖNTEM ve GEREÇLER: Wagner sınıflamasına göre evre 48 evre III ve 42 evre IV olmak üzere toplam 90 diyabetik ayak ülserli olgu çalışmaya dahil edildi.Hasta kayıtları gözden geçirildi ve hasta bilgileri ile mikrobiyoloji kültür sonuçları analiz için kaydedildi.BULGULAR: Gram - mikroorganizmalar 124 örnekte ve Gram + mikroorganizmalar 37 örnekte izole edildi. E. Coli, P. aeruginosa, Staphylococcus aureus ve Proteus mirabilis en sık görülen enfeksiyon ajanları olarak tespit edildi. Kültür antibiyogram sonuçlarında Enterococcus türleri % 80, Staphylococcus % 42,8, pseudomonas aeruginosa % 38,4, E.coli ise % 64,5 antibiyotik direnci gösterdi. İzole edilen bakterilerin % 31,6’sı ise birden çok ilaca direnç gösterdi.TARTIŞMA ve SONUÇ: Cerrahlar, cerrahi müdahale gerektiren Wagner Evre III ve IV ülserli diyabetik ayak olgularında yaygın antibiyotik direncinin farkında olmalıdırlar.

Anahtar Kelimeler:

Diyabetik ayak enfeksiyonu, Wagner, Antibiyotik direnci

Microbiological Evaluation of Wagner Grade III and IV Diabetic Foot Ulcers

INTRODUCTION: The aim of the study to investigate the cases of Wagner grade III and IV diabetic foot ulcers which need critical clinical and surgical intervention, regarding to the pathogen microorganism populations and their antibiotic resistances.METHODS: A total 90 cases consist of 48 grade III and 42 grade IV ulcers according to the Wagner classification were included to the study. The carts are reviewed retrospectively, and patients’ demographics and microbiological culture results were recorded for analysis.RESULTS: Gram - microorganisms were isolated in 124 samples, Gram + microorganisms were isolated in 37 samples. E. Coli, P. aeruginosa, Staphylococcus aureus and Proteus mirabilis were the most frequently detected infectious agents. Enterococcus species showed 80%, staphylococcus showed as much as 42.8%, pseudomonas aeruginosa showed as much as 38.4%, E.coli showed as much as 64.5% drug resistance in the culture antibiogram studies. 31.6% of the isolated bacteria showed a multidrug resistance.DISCUSSION AND CONCLUSION: Surgeons should be aware of common antibiotic resistance in diabetic foot cases had Wangner grade III and IV ulcer which require surgical intervention.

Keywords:

Diabetic foot infection, Wagner, Antibiotic resistant,

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