Microbiology
Hyperglycemia, impaired immunologic responses, neuropathy, and peripheral arterial disease are the major predisposing factors leading to limb-threatening diabetic foot infections[18-20]. The prevalence of infection in India was 6%-11%, whereas the prevalence of amputation was 3% in patients with type 2 diabetes[21]. Both aerobic and anaerobic bacteria have been shown to infect diabetic foot wounds[22-25]. Fungal infections are also common in diabetic foot[26-28]. Polymicrobial etiology of diabetic foot infections has been widely reported[22-25,29]. However it is not uncommon to have a predominance of mono-microbial infection in diabetic foot[30]. Researchers have shown the predominance of both gram negative[30] and gram positive[26] bacteria in diabetic foot infections. Various studies have reported a high prevalence of Pseudomonas[31], E. coli[30], and S. aureus[26,30] infections in diabetic foot. The pattern of microbial infection in patients with diabetic foot infections is inconsistent and therefore evaluation of microbial characteristics and their antibiotic sensitivity is necessary for the selection of appropriate antibiotics for management of diabetic foot infection.