Infections in diabetic patients - A two-year experience from the Diabetic Foot Unit at Wolfson Medical Center

Diabetes mellitus is the main cause for limb amputations in the western world. Leg ulcers among patients with diabetes mellitus is the leading cause in up to 85% of cases of non-traumatic amputations of the lower limbs in this patient population. Bacterial infections penetrate the leg ulcers causing further complications in the diabetic patient. The rationale of establishing the Diabetic Foot Unit in these patients is to strive to maintain an intact limb. Some studies indicate that there can be a substantial reduction in leg amputations in diabetics who are treated by a multidisciplinary medical team. In late 2002, the Diabetic Foot Unit was established at the Wolfson Medical Center teamed by a medical and nursing staff specializing in the treatment of the diabetic foot. The aim of this study was to identify the microbial agents leading to leg ulcers, and to follow the definitive therapy and outcome for these diabetic patients. The data was retrieved from medical files over a 2 year period (2003-2004). The patients received conservative as well as surgical treatment. The major microbial agents were Gram-negative species, and some patients harbored resistant bacteria such as ESBL and MRSA. Less than 11% of patients required major limb amputation. The percent of major amputations in our specialized unit was comparable to other such units around the world.