Abstract
Background: Diabetic foot ulcer (DFU) is considered a major social and economic problem, and it is also known as a leading cause of morbidity and mortality. Patients with DFUs frequently require amputation of the lower limbs, and in more than half of the cases, infection is the predominant factor. The aim of this systemic review is to highlight the risk factors such as age and gender associated with DFU infections, whether the infection is caused by single bacteria or polymicrobial infection and what is the most prevalent bacteria and their susceptibility pattern to currently used antibiotics. Methods: Three databases were searched from December 2020 to February 2021 including PubMed, Hinari, and Google Scholar. A total of 12 articles were included in the current meta‑analysis. Results: Higher frequency of DFU in males than in females and maximum number of DFU mostly occur within the age group 40–60 years was reported. Monomicrobial infections in DFU were higher than monomicrobial infection. Escherichia coli, Pseudomonas, and Staphylococcus aureus were the most prominent microorganism.
The higher grades of the DFUs were infected with more than one organism. High resistance rates of the isolated bacteria to the most commonly used antibiotics were documented and there were alarming growing resistance rate to Carbapenems which were considered the most effective Antibiotics nowadays. Conclusions: DFU infections are one of the major social and economic problems. There is an urgent need for continuous antibiotic sensitivity testing for the isolated bacteria to choose the appropriate antibiotics during the management and limit the spreading of multidrug‑resistant bacteria and reduce the burden of health‑care cost.
Keywords: Antibiotic susceptibility, bacterial infections, diabetic foot ulcer, risk factors