Alternative antibacterial therapy of Methicillin-resistant Staphylococcus aureusin patients with diabetic foot and sepsis

  • Igor Leonidovich Savon Department of outpatient purulent septic surgery and ultrasonic diagnostics, State Institution «Zaporizhia Medical Academy of Postgraduate Education of Ukrainian Ministry of Health», Zaporizhia, Ukraine
  • Sergiy Dmytrovich Shapoval Department of outpatient purulent septic surgery and ultrasonic diagnostics, State Institution «Zaporizhia Medical Academy of Postgraduate Education of Ukrainian Ministry of Health», Zaporizhia, Ukraine
  • Olga Olegivna Maksymova Department of outpatient purulent septic surgery and ultrasonic diagnostics, State Institution «Zaporizhia Medical Academy of Postgraduate Education of Ukrainian Ministry of Health», Zaporizhia, Ukraine
  • Michael Mykhailovich Sofilkanych Department of outpatient purulent septic surgery and ultrasonic diagnostics, State Institution «Zaporizhia Medical Academy of Postgraduate Education of Ukrainian Ministry of Health», Zaporizhia, Ukraine
  • Michael Ivanovich Sheremet Surgery Department №1, Bukovinian State Medical University, Ukraine
  • Oleksandr Viktorovich Shidlovskyi Surgery Department, I. Horbachevsky State Medical University, Ukraine
  • Oleksandr Volodimirovich Lazaruk Department of Pathology (Pathology and Forensic Medicine), Bukovinian State Medical University, Ukraine
Keywords: sepsis, diabetic foot, Methicillin-resistant Staphylococcus aureus, antibacterial therapy.

Abstract

A total of 210 patients with diabetic foot and sepsis who were treated in the purulent-septic center of Zaporizhzhya, Ukraine, were examined for the period of 2007–2020. All patients had type II diabetes mellitus, with a duration of 12.6 ± 2.7 years and an age of 56.8 ± 2.5 years. The diagnosis of sepsis is established according to the criteria of Sepsis-3 (2016). The complex of therapeutic measures included the mandatory use of antibacterial drugs, which was preceded by a microbiological study of biological material (blood and wound discharge). Gram-positive flora was detected in 118 (56.2%) patients and prevailed over gram-negative 81 (38.6%), anaerobes were detected in six (2, 8%) patients, and fungal flora in five (2.4%). Among patients diagnosed with Staphylococcus aureus 52 (100%), Methicillin-resistant Staphylococcus aureus (MRSA) prevailed with 38 (73.0%) (p < 0.05). We have identified a pattern that allowed us to categorize patients with MRSA into four groups according to similar sensitivity to antibacterial drugs, which received the conventional designations MRSA type 1; MRSA type 2; MRSA type 3; MRSA type 4. Moreover, MRSA type 4–3 (7, 9%) of the patient is pan-resistant. The most universal drugs in the presence of MRSA in patients with sepsis caused by complicated DFS are daptomycin, linezolid, teicoplanin, vancomycin, and tigecycline. In patients with MRSA type 1 and MRSA type 2, except standard anti - MRSA antibiotics, aminoglycosides, fluoroquinolones and macrolides can be effectively used as first-line drugs.

Published
2021-03-31
How to Cite
Savon, Igor, Sergiy Shapoval, Olga Maksymova, Michael Sofilkanych, Michael Sheremet, Oleksandr Shidlovskyi, and Oleksandr Lazaruk. 2021. “Alternative Antibacterial Therapy of Methicillin-Resistant Staphylococcus Aureusin Patients With Diabetic Foot and Sepsis”. Romanian Journal of Diabetes Nutrition and Metabolic Diseases 28 (1), 11-17. http://rjdnmd.org/index.php/RJDNMD/article/view/940.