ANALIZA PROFILU MIKROBIOLOGICZNEGO DROBNOUSTROJÓW IZOLOWANYCH Z ZAKAŻONYCH OWRZODZEŃ STOPY CUKRZYCOWEJ W MATERIALE WŁASNYM.

Introduction One of the most severe complications of diabetes is the diabetic foot syndrome. Left untreated, it may result in the loss of a limb, and patients who have undergone a high-level amputation are at an extremely high risk of mortality. Diabetic neuropathy presents as three main concurrent clinical manifestations - sensory neuropathy, motor neuropathy and autonomic neuropathy. Together, these phenomena account for the development of the neuropathic ulceration. Infection represents the main factor complicating the healing process, thus, leading to the amputation of the extremity. Aim The objective of this study was to analyse the microbial species composition of infection-causing microorganisms in patients treated due to a diabetic foot wound infection at the Laboratory of Wound Healing in Łódź (Pracownia Leczenia Ran, Łódź). Material and methods A retrospective analysis of the randomly selected medical histories of 27 patients aged 36-80 years was performed. The study involved patients with neuropathic, or neuropathic and ischaemic foot lesions, who were clinically diagnosed with a wound infection according to the criteria provided in the guidelines of the IWGDF (Inter-national Working Group on Diabetic Foot). The material for the study included microbiological specimens collected from the infected diabetic foot wounds. Testing was performed for aerobic and anaerobic bacteria, following the culture method. Results In the study group, the most common type of diabetic foot was the neuropathic foot, diagnosed in 16 subjects, including 10 patients of mature age and 6 patients of senile age. Diabetic neuropathic-ischaemic foot was found in 11 participants, including 2 patients of mature age and 9 patients of senile age. In patients over 60 years of age, a mixed diabetic foot was more frequently observed than in the younger subjects. The most common pathogen isolated from wound infections was Staphylococcus aureus, present in 48.1% of isolates. In terms of multispecies infections (13 isolations), Staphylococcus aureus was also most frequently isolated, and was present in 7 patients, whereas Enterococcus faecalis was found in 6 participants. Discussion The lack of correlation between diabetes type one or two and the diabetic foot type stems from the similar progression of complications, although the pathomechanism leading to the development of diabetes itself is different. Furthermore, no correlation was found between the number of bacterial species isolated and the diagnosis of the diabetic foot type. In diabetic foot infections developing in temperate climates, Gram-positive cocci are the most commonly identified pathogens. Conclusions The results of the microbiological tests provide the basis for the most favourable local empirical antibiotic therapy, which needs to be initiated immediately after the infection diagnosis, even before the objective identification of the aetiological agent. The therapeutic decision should also be based on the clinical status evaluation and on the outcome of the empirical treatment to date. [ABSTRACT FROM AUTHOR]