Clinical Profiles, Microbiological Findings and Biochemical Factors Associated with Surgical Intervention among Diabetic Foot Infection Patients

Abstract

Background: Diabetic foot infection (DFI) is a common and serious complication of diabetes mellitus, often leading to hospitalization, surgical intervention, and limb loss. Timely identification of patients requiring surgical management is crucial to prevent morbidity and mortality.

Objective: The purpose of the present study was to evaluate the clinical, microbiological, and biochemical factors associated with surgical intervention in patients with DFI and to assess outcomes in surgically versus non-surgically managed cases.

Methodology: This prospective observational study included 86 patients with DFI admitted to the Department of Surgery in Monno Medical College and Hospital, Dhaka, Bangladesh. Demographic, clinical, laboratory, and microbiological data were collected. Patients were categorized based on infection severity and treatment approach. Outcomes such as cure rate, amputation, recurrence, and hospital stay were compared. Statistical analysis was performed using SPSS v26, and p-values <0.05 were considered significant.

Results: The mean age of the study population was 58.32 ± 12.96 years; 75.58% were male. Surgery was performed in 54.65% of patients, with a higher frequency in severe infections (p<0.001). Amputation occurred in 26.74% and was significantly associated with diabetes duration >15 years (p=0.003), HbA1c >8.0% (p=0.001), wound size >5 cm² (p<0.001), osteomyelitis (p<0.001), and multidrug-resistant organisms (p=0.005). Gram-negative and gram-positive bacteria were isolated equally (47.67%), with high resistance observed in Acinetobacter species, Klebsiella pneumoniae and Pseudomonas aeruginosa. Recurrent infection was linked to prior foot infection, high HbA1c, MDR infection, and peripheral vascular disease.

Conclusion: Surgical intervention is frequently required in moderate to severe DFI, especially in the presence of osteomyelitis and multidrug-resistant organisms. Individualized treatment strategies based on infection severity, glycemic control, and microbiological findings are essential to reduce amputation and recurrence risk.

Journal of Monno Medical College December, 2025;11(2):79-85