Annals of African medicine · 2026
Common Pathogens Associated with Diabetic Charcot Neuroarthropathy in the Indian Population: A Retrospective Observational Study.
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Pawar Prashant, Bakshi Supriya
Аннотация
BACKGROUND: Diabetic Charcot neuroarthropathy (CN) is a limb-threatening complication of long-standing diabetes mellitus and is frequently complicated by secondary infection. India-specific data on the microbiological spectrum and antimicrobial susceptibility patterns of infections complicating diabetic CN are limited.
MATERIALS AND METHODS: This retrospective observational study included 82 adult patients with diabetic CN and associated foot ulcers. Deep tissue or ulcer-base samples were collected under aseptic precautions and processed for bacterial culture, organism identification, and antimicrobial susceptibility testing using standard microbiological methods.
RESULTS: Culture positivity was observed in 61 (74.4%) cases, with monomicrobial growth in 39 (47.6%) and polymicrobial growth in 18 (22.0%) cases. A total of 96 microbial isolates were identified. Gram-negative organisms predominated, accounting for 60/96 (62.5%) bacterial isolates, while Gram-positive organisms constituted 34/96 (35.4%). The most frequent isolates were Staphylococcus aureus 24 (25.0%), of which methicillin-resistant S. aureus accounted for 9 isolates, representing 37.5% of all S. aureus isolates, followed by Pseudomonasaeruginosa 18 (18.75%), Escherichiacoli 16 (16.67%), and Klebsiellapneumoniae 11 (11.46%). Fungal isolates were infrequent 2 (2.08%). Gram-positive organisms showed high sensitivity to linezolid (94.1%) and vancomycin (91.2%), whereas Gram-negative organisms were most sensitive to meropenem (80.0%) and piperacillin-tazobactam (73.3%). Detailed characterization of extended-spectrum β-lactamase production and carbapenem resistance was not systematically performed in this retrospective dataset; however, the observed antimicrobial susceptibility patterns suggest the presence of clinically relevant multidrug resistance among Gram-negative organisms.
CONCLUSION: Infected diabetic CN in this Indian cohort demonstrated a predominance of Gram-negative pathogens with substantial polymicrobial infection and antimicrobial resistance. These findings highlight the importance of early, culture-guided, and region-specific antimicrobial strategies to optimize limb salvage outcomes.
MATERIALS AND METHODS: This retrospective observational study included 82 adult patients with diabetic CN and associated foot ulcers. Deep tissue or ulcer-base samples were collected under aseptic precautions and processed for bacterial culture, organism identification, and antimicrobial susceptibility testing using standard microbiological methods.
RESULTS: Culture positivity was observed in 61 (74.4%) cases, with monomicrobial growth in 39 (47.6%) and polymicrobial growth in 18 (22.0%) cases. A total of 96 microbial isolates were identified. Gram-negative organisms predominated, accounting for 60/96 (62.5%) bacterial isolates, while Gram-positive organisms constituted 34/96 (35.4%). The most frequent isolates were Staphylococcus aureus 24 (25.0%), of which methicillin-resistant S. aureus accounted for 9 isolates, representing 37.5% of all S. aureus isolates, followed by Pseudomonasaeruginosa 18 (18.75%), Escherichiacoli 16 (16.67%), and Klebsiellapneumoniae 11 (11.46%). Fungal isolates were infrequent 2 (2.08%). Gram-positive organisms showed high sensitivity to linezolid (94.1%) and vancomycin (91.2%), whereas Gram-negative organisms were most sensitive to meropenem (80.0%) and piperacillin-tazobactam (73.3%). Detailed characterization of extended-spectrum β-lactamase production and carbapenem resistance was not systematically performed in this retrospective dataset; however, the observed antimicrobial susceptibility patterns suggest the presence of clinically relevant multidrug resistance among Gram-negative organisms.
CONCLUSION: Infected diabetic CN in this Indian cohort demonstrated a predominance of Gram-negative pathogens with substantial polymicrobial infection and antimicrobial resistance. These findings highlight the importance of early, culture-guided, and region-specific antimicrobial strategies to optimize limb salvage outcomes.