Sensibilidad y resistencia bacteriana en pacientes con diagnóstico de pie diabético del Hospital IESS de la Ciudad de Machala 2019

Abstract

Diabetes mellitus is determined as a group of metabolic diseases that is characterized by hyperglycemia, whose defect is the destruction of the affected β cells to absolute insulin deficiency. This pathology involves different organs and systems, for example, the central nervous system, kidney, heart affected to certain complications such as blindness, kidney failure, vascular disease, diabetic foot and diabetic peripheral neuropathy. In Ecuador, diabetes mellitus became the leading cause of mortality until 2013, with an annual mortality rate of 7.44%. The diabetic foot is a serious sequela of diabetes, causing the destruction of tissue in the lower extremities, this is accompanied by a series of abnormalities of neurology and in turn several degrees of vascular disease at a peripheral level, affected by patients with Diagnosis of patients Diabetes Mellitus. In patients with diabetes mellitus, approximately 25% suffer from diabetic foot, 50% of this population has an infection and approximately 20% require amputation. Once the diagnosis of infection is established, it is very important to classify its severity according to the type of lesion, which is associated with the Wagner scale. This provides a much more specific perception, knowing in this way if the wound is a superficial or deep level. The objective of this titration work was to characterize the microorganisms most frequently in patients with diabetic foot admitted to the IESS Hospital in the city of Machala, by performing microbiological analysis and using an antibiogram with the identification of sensitivity and resistance of these bacteria. An experimental and cross-sectional descriptive study was conducted. The research consisted of 81 patients with an established range of 24 to 89 years of age, of which 42.70% belonged to the male gender in the range of 60 to 89 years of age. In the microbiological identification assessment 81 bacteria of which 63 were identified as Gram negative, having E. coli, Klebsiella Pneumoniae and Pseudomona Aeruginosa as the most representative, all with a percentage of 20.6%. Gram positive, 44.4% represent S. Epidermis, 27.8% belong to S. Betahemolytic, S. Aureus is in a percentage of 16.7% while 11.1% constitutes bacteria Enterobacter Aerogenes. According to the frequent culture results in patients with diabetic foot of the IESS Hospital of the city of Machala, the most frequent bacteria were Gram Negative bacteria such as Pseudomona Aeruginosa, E. coli, K. Pneumoniae with a percentage of 20, 6% of infected patients. According to the Wagner scale, the degree of injury that occurs most in patients with diabetic foot is grade III with a percentage of 44.4%. On the other hand, by means of the antibiogram, the medications with the highest bacterial resistance are determined: Ciprofloxacin with 26.13% and Ceftriaxone with 15.58%, while the medications with the highest bacterial sensitivity are Amikacin with 15.9%, Imipenem. and Piperazilina + Tazobactam with 63%.