BACTERIAL PROFILE AND ANTIBIOTIC SENSITIVITY IN CHRONIC LEG ULCERS IN DIABETICS AND NON-DIABETICS IN A TERTIARY CARE CENTRE IN SOUTH INDIA

Abstract

Background
Because of poor wound healing and an elevated risk of infection, chronic leg ulcers (CLUs) pose a serious healthcare challenge, especially for patients with diabetes. Multidrug-resistant organisms like MRSA, Pseudomonas aeruginosa, and Klebsiella spp. are commonly involved in these infections, which are frequently polymicrobial. Empirical antibiotic therapy is frequently used in environments with limited resources, which raises the possibility of ineffective treatment and antibiotic resistance. Regional information on antibiotic sensitivity and bacterial profiles in diabetic versus non-diabetic ulcers is scarce, despite the burden. By contrasting microbial patterns and resistance trends in a tertiary care facility in South India, this study seeks to close this gap.

Methodology
Over a five-year period, a retrospective descriptive study was carried out at the Government Medical College's General Surgery Department in Ernakulam. A total of 152 patients, both diabetic and non-diabetic, with chronic leg ulcers lasting longer than six weeks were included. Hospital records were used to gather patient information, such as demographics, clinical history, and microbiological culture and sensitivity reports. Patients with diabetes who were solely on diet control or cases without microbiological reports were not included. SPSS software was used to analyse the data.

Result
91 (60%) of the 152 patients had diabetes, while 61 (40%) did not. The most frequent isolate in both groups was Staphylococcus aureus (30.8% in diabetics and 16.4% in non-diabetics). Additionally, MRSA, Pseudomonas aeruginosa, and Klebsiella spp. were more common in diabetic ulcers. 45.1% of diabetic cases and 47.5% of non-diabetic cases had antibiotic resistance. Compared to non-diabetics, the spectrum of bacterial isolates in diabetic patients was wider and more resistant.

Conclusion
Bacterial infections in diabetic leg ulcers were more varied and resistant to medication than those in non-diabetic ulcers. These results highlight the necessity of localised bacterial surveillance and culture-guided therapy to maximise antibiotic use, particularly in environments with limited resources. Preventing antimicrobial resistance and improving outcomes depend on the rational prescription of antibiotics based on local data.