Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon

Introduction: Approximately 80% of diabetes-related lower extremity amputations are preceded by a foot ulcer. Global studies on the epidemiology of diabetic foot ulcer (DFU) infections and guidelines detailing the most common pathogens and their respective antimicrobial susceptibilities are availab...

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Main Authors: Michele Obeid, Eric Moughames, Petra Aboulhosn, Rashad Madi, Maya Farah, Jinia Feghali, Jacques Mokhbat, Anna Farra, Rima Moughnieh, Ziad Daoud, Rita Feghaleh, Edmond Abboud, Emma Abboud, Rola Husni-Samaha
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2018-05-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/10063
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author Michele Obeid
Eric Moughames
Petra Aboulhosn
Rashad Madi
Maya Farah
Jinia Feghali
Jacques Mokhbat
Anna Farra
Rima Moughnieh
Ziad Daoud
Rita Feghaleh
Edmond Abboud
Emma Abboud
Rola Husni-Samaha
author_facet Michele Obeid
Eric Moughames
Petra Aboulhosn
Rashad Madi
Maya Farah
Jinia Feghali
Jacques Mokhbat
Anna Farra
Rima Moughnieh
Ziad Daoud
Rita Feghaleh
Edmond Abboud
Emma Abboud
Rola Husni-Samaha
author_sort Michele Obeid
collection DOAJ
description Introduction: Approximately 80% of diabetes-related lower extremity amputations are preceded by a foot ulcer. Global studies on the epidemiology of diabetic foot ulcer (DFU) infections and guidelines detailing the most common pathogens and their respective antimicrobial susceptibilities are available. While Gram-positive cocci, mainly Staphylococcus species (spp.), were the most common organisms cultured from DFU in the United States, the Gram-negative Pseudomonas spp. were found to be the most common in some Middle Eastern countries. In Lebanon, however, such studies remain scarce. This study, conducted in Lebanon, investigated the most common organisms in DFU infections and their antimicrobial profiles. Methodology: We collected data from all documented diabetic foot infections between January 2015 and March 2016, 128 participants total, from 5 different hospitals in various regions of Lebanon. Results: Among all isolates, Enterobacteriaceae (42%), Pseudomonas spp. (18.6%) and methicillin-sensitive Staphylococcus aureus (MSSA) (15.3%) were the most frequent bacteria. In addition, 72% of Pseudomonas spp. were susceptible to ciprofloxacin and 63.6% of Enterobacteriaceae were susceptible to either amoxicillin/clavulanate or ciprofloxacin, 91% were susceptible to piperacillin/tazobactam. Methicillin-resistant Staphylococcus aureus (MRSA) was only found in hospitalized patients or those who received prior antibiotics. Polymicrobial infections were documented in only 38% of patients. Conclusion: In Lebanon, the most appropriate empirical oral outpatient treatment would be a combination of amoxicillin/clavulanate and ciprofloxacin. As for admitted patients who have failed the oral regimen, piperacillin/tazobactam would then be the treatment of choice.
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spelling doaj-art-ee01e0f909f74bbc8d6092cf241b36222025-08-20T02:27:11ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-05-01120510.3855/jidc.10063Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in LebanonMichele Obeid0Eric Moughames1Petra Aboulhosn2Rashad Madi3Maya Farah4Jinia Feghali5Jacques Mokhbat6Anna Farra7Rima Moughnieh8Ziad Daoud9Rita Feghaleh10Edmond Abboud11Emma Abboud12Rola Husni-Samaha13Lebanese American University, Byblos, LebanonLebanese American University, Byblos, LebanonLebanese American University, Byblos, LebanonLebanese American University, Byblos, LebanonLebanese American University Medical Center, Beirut, LebanonLebanese American University Medical Center, Beirut, LebanonLebanese American University Medical Center, Beirut, LebanonLebanese American University Medical Center, Beirut, LebanonMakassed Hospital, Beirut, LebanonUniversity of Balamand and Centre Hospitalier du nord Hospital, Beirut, LebanonRafik Hariri University Hospital, Beirut, LebanonMiddle East Institute of Health, Mount Lebanon, LebanonMount Lebanon Hospital, Beirut, LebanonLebanese American University Medical Center, Beirut, Lebanon Introduction: Approximately 80% of diabetes-related lower extremity amputations are preceded by a foot ulcer. Global studies on the epidemiology of diabetic foot ulcer (DFU) infections and guidelines detailing the most common pathogens and their respective antimicrobial susceptibilities are available. While Gram-positive cocci, mainly Staphylococcus species (spp.), were the most common organisms cultured from DFU in the United States, the Gram-negative Pseudomonas spp. were found to be the most common in some Middle Eastern countries. In Lebanon, however, such studies remain scarce. This study, conducted in Lebanon, investigated the most common organisms in DFU infections and their antimicrobial profiles. Methodology: We collected data from all documented diabetic foot infections between January 2015 and March 2016, 128 participants total, from 5 different hospitals in various regions of Lebanon. Results: Among all isolates, Enterobacteriaceae (42%), Pseudomonas spp. (18.6%) and methicillin-sensitive Staphylococcus aureus (MSSA) (15.3%) were the most frequent bacteria. In addition, 72% of Pseudomonas spp. were susceptible to ciprofloxacin and 63.6% of Enterobacteriaceae were susceptible to either amoxicillin/clavulanate or ciprofloxacin, 91% were susceptible to piperacillin/tazobactam. Methicillin-resistant Staphylococcus aureus (MRSA) was only found in hospitalized patients or those who received prior antibiotics. Polymicrobial infections were documented in only 38% of patients. Conclusion: In Lebanon, the most appropriate empirical oral outpatient treatment would be a combination of amoxicillin/clavulanate and ciprofloxacin. As for admitted patients who have failed the oral regimen, piperacillin/tazobactam would then be the treatment of choice. https://jidc.org/index.php/journal/article/view/10063DiabetesFootInfectionLebanonAntibiotics
spellingShingle Michele Obeid
Eric Moughames
Petra Aboulhosn
Rashad Madi
Maya Farah
Jinia Feghali
Jacques Mokhbat
Anna Farra
Rima Moughnieh
Ziad Daoud
Rita Feghaleh
Edmond Abboud
Emma Abboud
Rola Husni-Samaha
Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon
Journal of Infection in Developing Countries
Diabetes
Foot
Infection
Lebanon
Antibiotics
title Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon
title_full Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon
title_fullStr Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon
title_full_unstemmed Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon
title_short Epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in Lebanon
title_sort epidemiology and susceptibility profiles of diabetic foot infections in five hospitals in lebanon
topic Diabetes
Foot
Infection
Lebanon
Antibiotics
url https://jidc.org/index.php/journal/article/view/10063
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