당뇨병성 족부병변에서 분리된 혐기성 세균

Abstract

Background: Although diabetic persons with foot lesions are prone to anaerobic infections, such infection may frequently be overlooked. This report describes anaerobic bacteriologic findings in foot ,lesions of 34 diabetic patients. Methods: Culture specimens obtained by aspiration or swabbing of wound(after exposing the surface), were promptly transported to the laboratory in Stuart´s medium or in syringe. The specimens were processed anaerobically using a combination of 5 media(brucella blood agar, phenyethyl alcohol blood agar, thioglycollate medium, bacteroides bile esculin agar and kanamycin-vancomycin laked blood agar). Results: 1) Ninety-four organisms were isolated from foot lesions of diabetics. The mean number of isolates per specimen was 2.8. Among 72 aerobes, Staphylococcus was the most frequently isolated. 2) Anaerobes were isolated in 11 cases(44%) out of 25 patients with deep-seated foot lesions, but not isolated in any of 9 patients with supeficial foot infections. Isolated anaerobes were 11 Peptostreptococcus spp., 7 Bacteroides spp. and 2 Prevotella spp.. The most common anaerobes were P. magnus(20.0%) and B. fragilis(20.0%). 3) Among patients with deep-seated lesions, surgical treatment was more frequently needed in cases of anaerobic polymicrobial infection(90.9%) than aerobiconly infection(57.1%). Conclusion: In deep-seated foot lesions of diabetics, anaerobic infections are common and affect the outcome of treatment. Therefore accurate identification and treatment of infected anaerobes in patients with diabetic foot lesions is necessary.