Microbiological Characteristics of Ulcers in Patients Diagnosed with Neuroinfectious Diabetic Foot

Abstract

Introduction: Diabetic foot ulcers are one of the most serious complications of diabetes mellitus. They are the leading cause of non-traumatic lower-limb amputation. Local microbiological characterization is essential for guiding empirical antibiotic therapy and reducing complications.

Objective: To describe the microbiological characteristics in hospitalized patients diagnosed with neuroinfectious diabetic foot ulcers.

Methods: An observational, retrospective, cross-sectional study was conducted on 100 patients with neuroinfectious diabetic foot ulcers admitted to the “Dr. Antonio Luaces Iraola” Provincial General Teaching Hospital in Ciego de Ávila between January 2022 and June 2025. Samples for culture were collected via biopsy of the ulcer bed and syringe aspiration of purulent exudate.

Results: A total of 100 patients were included; 68% had had diabetes for between 10 and 19 years. Wagner grade 3 ulcers and moderate-severity cellulitis were predominant. The most frequently isolated microorganisms were Escherichia coli (21%), Staphylococcus aureus (20%), Enterobacter spp. (16%), and Pseudomonas spp. (15%). The antibiotics with the highest sensitivity rates were meropenem, ceftazidime, cefepime, amikacin, and gentamicin; those with the lowest activity were ampicillin and azithromycin.

Conclusions: Escherichia coli and Staphylococcus aureus were found to be the predominant pathogens in cultures associated with Wagner grade 3 ulcers and moderate cellulitis. The isolates were susceptible to carbapenems, cefepime, amikacin, and gentamicin, while they were resistant to ampicillin and azithromycin.