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The clinical and microbiological profile of the diabetic hand: A retrospective study from South India

BACKGROUND: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre. PATIENTS AND METHODS: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-rela...

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Autores principales: Raveendran, Sreekanth, Naik, Dukhabandhu, Raj Pallapati, Samuel C., Prakash, John Jude, Thomas, Binu Prathap, Thomas, Nihal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040040/
https://www.ncbi.nlm.nih.gov/pubmed/27730070
http://dx.doi.org/10.4103/2230-8210.190539
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author Raveendran, Sreekanth
Naik, Dukhabandhu
Raj Pallapati, Samuel C.
Prakash, John Jude
Thomas, Binu Prathap
Thomas, Nihal
author_facet Raveendran, Sreekanth
Naik, Dukhabandhu
Raj Pallapati, Samuel C.
Prakash, John Jude
Thomas, Binu Prathap
Thomas, Nihal
author_sort Raveendran, Sreekanth
collection PubMed
description BACKGROUND: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre. PATIENTS AND METHODS: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-related infections admitted to the hospital between the years 2004 and 2010. RESULTS: This study included 39 patients, among whom 23 (59%) had necrotizing fasciitis (NF), and 16 (9-abscess and 7-tenosynovitis) had nonnecrotizing infection. Among 25 culture positive patients, polymicrobial infections were isolated in 13 (52%) patients, a single organism was isolated in 9 (36%) and 3 (12%) had sterile cultures. Out of the 41 different bacterial isolates, 51.12% were Gram-negative and 48.78% were Gram-positive. Patients with NF had a higher mean glycated hemoglobin (10.83 ± 2.59 vs. 8.64 ± 1.8%, P = 0.020), when compared to the nonnecrotizing group. Patients with NF also had more polymicrobial infections (P = 0.017), and a longer duration of hospitalization when compared to patients without NF (21.8 ± 9.96 vs. 12.7 ± 14.5 days, P = 0.021). Seven (17.94%) patients required amputation of the affected digits of which six (15.38%) had NF. CONCLUSION: Patients with poor glycemic control, polymicrobial infection, delay in presentation, and a prior surgical intervention at another medical center was associated with more severe necrotizing infections. The duration of hospitalization and amputation rates was greater among patients with NF.
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spelling pubmed-50400402016-10-11 The clinical and microbiological profile of the diabetic hand: A retrospective study from South India Raveendran, Sreekanth Naik, Dukhabandhu Raj Pallapati, Samuel C. Prakash, John Jude Thomas, Binu Prathap Thomas, Nihal Indian J Endocrinol Metab Original Article BACKGROUND: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre. PATIENTS AND METHODS: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-related infections admitted to the hospital between the years 2004 and 2010. RESULTS: This study included 39 patients, among whom 23 (59%) had necrotizing fasciitis (NF), and 16 (9-abscess and 7-tenosynovitis) had nonnecrotizing infection. Among 25 culture positive patients, polymicrobial infections were isolated in 13 (52%) patients, a single organism was isolated in 9 (36%) and 3 (12%) had sterile cultures. Out of the 41 different bacterial isolates, 51.12% were Gram-negative and 48.78% were Gram-positive. Patients with NF had a higher mean glycated hemoglobin (10.83 ± 2.59 vs. 8.64 ± 1.8%, P = 0.020), when compared to the nonnecrotizing group. Patients with NF also had more polymicrobial infections (P = 0.017), and a longer duration of hospitalization when compared to patients without NF (21.8 ± 9.96 vs. 12.7 ± 14.5 days, P = 0.021). Seven (17.94%) patients required amputation of the affected digits of which six (15.38%) had NF. CONCLUSION: Patients with poor glycemic control, polymicrobial infection, delay in presentation, and a prior surgical intervention at another medical center was associated with more severe necrotizing infections. The duration of hospitalization and amputation rates was greater among patients with NF. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC5040040/ /pubmed/27730070 http://dx.doi.org/10.4103/2230-8210.190539 Text en Copyright: © Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Raveendran, Sreekanth
Naik, Dukhabandhu
Raj Pallapati, Samuel C.
Prakash, John Jude
Thomas, Binu Prathap
Thomas, Nihal
The clinical and microbiological profile of the diabetic hand: A retrospective study from South India
title The clinical and microbiological profile of the diabetic hand: A retrospective study from South India
title_full The clinical and microbiological profile of the diabetic hand: A retrospective study from South India
title_fullStr The clinical and microbiological profile of the diabetic hand: A retrospective study from South India
title_full_unstemmed The clinical and microbiological profile of the diabetic hand: A retrospective study from South India
title_short The clinical and microbiological profile of the diabetic hand: A retrospective study from South India
title_sort clinical and microbiological profile of the diabetic hand: a retrospective study from south india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040040/
https://www.ncbi.nlm.nih.gov/pubmed/27730070
http://dx.doi.org/10.4103/2230-8210.190539
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