Determinación del perfil bacteriológico en pacientes con pie diabético según la clasificación de Wagner, Hospital Vicente Corral Moscoso, Cuenca-Ecuador
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Date
2010-11-11
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Universidad de Cuenca
Abstract
Objective: To determine the clinical and bacteriological characteristics in diabetic foot
patients diagnosed and hospitalized in the Internal Medicine Department of Vicente Corral Moscoso Hospital, from January 2004 to January 2009.- Materials and Methods A descriptive study was conducted over a universe of 54 patients. The data were obtained from the archive of medical records and analyzed with help of Excel and
SPSS software.-Results: 31 patients (57.4%) were female; minimum age was 34 years, maximum age was
86 with an average of 58.3 ± 11.7. The larger prevalence of diabetic foot was observed between 45 and 65 years old, with 34 cases (63%). Wagner’s grades II, III and IV were the most frequent 50 (92.5%). Gram’ negative bacilli were isolated
in 35 cases (65%) and from those 12 (34.3%) presented Escherichia coli. In 15 patients (28.0%), Gram positive cocci were identified and of these Staphylococcus aureus were the most frequent 11 (73.3%). Finally, 4 cases (7.0%) the cultures were negative. The antibiotic combination of Ciprofloxacin plus Clindamycin was the most used, 38 patients (70.4%). At 33 (89.2%) of 37 cases glycosylated hemoglobin values were found in excess of 7%. At 24 cases (44.4%) trauma was
identified as triggering factor for diabetic foot lesions and the majority, 44 patients (81.5%) had a favorable clinical outcome.- Conclusions
Wagner’s grades II, III and IV were the most frequent; the Gram negative were isolated more often; the combination of Ciprofloxacin plus Clindamycin was the most widely used therapeutic regimen, almost all the cases had poor metabolic control and clinical outcomes were favorable in the majority
Resumen
Se realizó un estudio descriptivo sobre un universo de 54 pacientes. Los datos se obtuvieron de los registros de las historias clínicas y fueron analizados con la ayuda del software Excel y SPSS. Resultados: 31 pacientes (57.4%), fueron de sexo femenino; la edad mínima fue de 34 años, la máxima, de 86 y el promedio de 58.3 ± 11.7. Entre los 45 y 65 años tenían el mayor porcentaje de pie diabético, 34 (63%). Los grados II, III y IV de Wagner fueron los más frecuentes, 50 (92.5%). Los bacilos Gram se aislaron en 35 casos (65%), y de estos la Escherichia coli en 12 (34.3%). En 15 pacientes (28.0%), se identificaron cocos Gram +, y de estos, el Staphylococcus aureus fue el más frecuente 11 (73.3%). Por último, en 4 casos (7.0%) los cultivos fueron negativos. La combinación antibiótica de Ciprofloxacina más Clindamicina fue la más utilizada, 38 pacientes (70.4%). En 33 (89.2%), de 37 casos se encontró los valores de Hemoglobina glucosilada superiores al 7%. En 24 casos (44.4%), se identificó el trauma como factor desencadenante de las lesiones del pie diabético
Keywords
Medicina Interna, Bacteria, Patología, Historia Clínica, Tesis de Especialización en Medicina Interna, Cantón Cuenca
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MEDMI;30