Diabetic foot amputations in patients at the Peltier hospital in Djibouti

Abstract

Diabetes is a chronic (lifelong) condition that arises when the pancreas does not secrete adequate insulin or when the body does not utilize the produced insulin. Diabetes can cause serious health complications such as diabetic foot infections. This study aimed to investigate the problem of diabetic foot amputations and to evaluate the prevalence of pathogenic bacteria that cause diabetic foot infections. A retrospective study was conducted on hospitalized patients over a period of three years from 2020 to 2022. We analyzed 254 (34 %) patients who satisfied the study inclusion criteria. The average age of the patients was 59 years ± 6 years. The study focused on diabetic patients with foot ulcers that had at least two local clinical signs of infection. In our study, we reported 68 amputation cases in 254 diabetic patients with a foot wound, representing 27 % prevalence. The main causative organisms of diabetic foot infections were Staphylococcus aureus (35 %), Staphylococcus sp. (19 %), Streptococcus sp. (16 %), Klebsiella pneumoniae (14 %), Pseudomonas aeruginosa (12 %) and Escherichia coli (4 %). Methicillin-resistant Staphylococcus aureus (MRSA) strains were resistant to gentamicin and ciprofloxacin (38 %). Linezolid was the most effective anti-MRSA chemical.The incidences of diabetic foot become a growing public health issue. A gram-positive coccus was the main pathogen responsible for diabetic foot infections with Staphylococcus predominating. The isolated bacteria were resistant to first-line antibiotics posing a substantial therapeutic challenge.