Microbiological profile of leg ulcer infections: review study

to analyze the microbiological profile of leg ulcers of patients treated at outpatient clinics and hospitals regarding the type of microorganism, microbiological selection of antibiotics, and techniques for the collection of culture material.

Methods:

literature review performed on LILACS, IBECS, MEDLINE, and CINAHL databases, resulting in a descriptive analysis of 27 studies.

Results:

35.7% of the studies occurred in an outpatient care scenario; and 64.2% in hospitals. There was a predominance of swab (100%) in outpatient care and biopsy (55.5%) in the hospital. Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were more common at both levels of assistance. Methicillin-resistant Staphylococcus aureus was isolated in both.

Conclusions:

the microbiological profile of infections was similar, with the presence of resistant bacteria in both environments. This fact causes concern and raises the need for research to elucidate it. The studies did not compare the effectiveness between biopsy and swab.

Descriptors:
Leg Ulcer; Culture Techniques; Bacterial Growth; Infection; Nursing

Reference	Year/ Country	Study design/ Sample	Interventions	Outcome
Cooper RA, Ameen H, Price P, McCulloch DA, Harding KG. A clinical investigation into the microbiological status of 'locally infected' leg ulcers⁽⁹9 Cooper RA, Ameen H, Price P, McCulloch DA, Harding KG. A clinical investigation into the microbiological status of ‘locally infected‘ leg ulcers. Int Wound J. 2009;6(6):453-62. https://doi.org/10.1111/j.1742-481X.2009.00640.x https://doi.org/10.1111/j.1742-481X.2009... ⁾	2009 United Kingdom	Descriptive n = 20	Qualitative and quantitative assessment of the microbiological status of venous leg ulcers.	Detection of 5.8 microorganisms per ulcers.
Sotto A, Richard JL, Combescure C, Jourdan N, Shuldiner S, Bouziges N. et al. Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers⁽¹⁰10 Sotto A, Richard JL, Combescure C, Jourdan N, Shuldiner S, Bouziges N, et al. Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers. Diabetol. 2010;53:2249-2255. https://doi.org/10.1007/s00125-010-1828-3 https://doi.org/10.1007/s00125-010-1828-... ⁾	2010 France	Cross-sectional n = 405	Implementation of guidelines on microbiology and the costs of infected diabetic ulcers. Comparison of bacteriological data and costs related to the use of antimicrobials.	Prevalence of MRSA and savings in costs and workload.
Wang SH, Sun ZL, Guo YJ, Yang BQ, Yuan Y, Wei Q. et al. Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence⁽¹¹11 Wang SH, Sun ZL, Guo YJ, Yang BQ, Yuan Y, Wei Q, et al. Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence. J Med Microbiol. 2010;59:1219-24. https://doi.org/10.1099/jmm.0.020537-0 https://doi.org/10.1099/jmm.0.020537-0... ⁾	2010 China	Case-control n = 118	Culture and antibiogram	Staphylococcus aureus was the most frequent microorganism. MRSA identification.
Shanmugam P, Jeya M, Linda Susan S. The Bacteriology of Diabetic Foot Ulcers, with a Special Reference to Multidrug Resistant Strains⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ⁾	2013 India	Descriptive n = 50	Evaluation of the microbiological profile of diabetic ulcers - collection of samples for microbial culture.	Gram-negatives were more prevalent. Presence of multidrug resistance microorganisms
Souza JM, Vieira EC, Cortez TM, Mondelli LA, Miot HA, Abbade LPF. Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Crosssectional Study⁽¹³13 Souza JM, Vieira EC, Cortez TM, Mondelli LA, Miot HA, Abbade LPF. Clinical and microbiologic evaluation of chronic leg ulcers: a crosssectional study. advances in skin e wound care. 2014;27(5):222-7. https://doi.org/10.1097/01.ASW.0000445952.83084.a0 https://doi.org/10.1097/01.ASW.000044595... ⁾	2014 Brazil	Cross-sectional n = 77	Microbial culture to assess the bacteriological profile of leg ulcers.	Gram-negatives were more frequent, and infected ulcers had a higher microbial load.
Garcia EC, González RG, Albor AR, Salazar-Schettino. Infections of Diabetic Foot Ulcers With Methicillin-Resistant Staphylococcus aureus⁽¹⁴14 Garcia EC, González RG, Albor AR, Salazar-Schettino. Infections of diabetic foot ulcers with methicillin-resistant staphylococcus aureus. Int J Lower Extremy Wounds. 2015;14(1):44-9. https://doi.org/10.1177/1534734614564053 https://doi.org/10.1177/1534734614564053... ⁾	2015 Mexico	Descriptive n = 100	Microbial culture to assess the bacteriological profile of diabetic foot ulcers.	Prevalence of Staphylococcus aureus, Escherichia coli, and MRSA.
Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers⁽¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ⁾	2016 India	Prospective cohort n = 200	Microbial culture and chromosomal typing of genes that encode biofilm production.	Monomicrobial and polymicrobial infections; predominance of Staphylococcus aureus and presence of biofilm.
Ertugrul BM, Lipsky BA, Ture M, Sakarya S. Risk Factors for Infection with Pseudomonas aeruginosa in Diabetic Foot Infections⁽¹⁶16 Ertugrul BM, Lipsky BA, Ture M, Sakarya S. Risk factors for infection with pseudomonas aeruginosa in diabetic foot infections. J Am Podiatric Med Assoc. 2017;107(6):483-9. https://doi.org/10.7547/15-167 https://doi.org/10.7547/15-167... ⁾	2017 Turkey	Descriptive n = 174	Microbiological analysis	Prevalence of Pseudomonas aeruginosa and Staphylococcus aureus.
Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial Prevalence and Antibiotic Resistance in Clinical Isolates of Diabetic Foot Ulcers in the Northeast of Tamaulipas, Mexico⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl⁾	2017 Mexico	Observational n = 215	Culture and antibiogram	Staphylococcus aureus and Enterobacter sp . were more common, and penicillin and dicloxacillin were more effective against Gram-positive bacteria.
Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. Inflammatory Markers as Risk Factors for Infection with multidrug - resistance microbes in diabetic foot subjects⁽¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾	2017 India	Descriptive n = 65	Culture of wound aspirates and soft tissue biopsy for microbiological evaluation	Gram-negatives were more frequent than Gram-positives, and 57% of patients had a positive culture for multidrug resistance microorganisms.
Pemayun TGD, Naibaho RM. Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang⁽¹⁹19 Pemayun TGD, Naibaho RM. Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Diabetic Foot E Ankle. 2017;8(1):1-8. https://doi.org/10.1080/2000625X.2017.1312974 https://doi.org/10.1080/2000625X.2017.13... ⁾	2017 Indonesia	Descriptive n = 189	Analysis of medical records	Gram-negatives were more common; in 36.3%, lower limb amputations and multiple amputations occurred in seven patients. The mortality rate reached 10.7%.
Santos SLV, Martins MA, Prado MA, Soriano JV, Bachion MM. Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers?⁽²⁰20 Santos SLV, Martins MA, Prado MA, Soriano JV, Bachion MM. Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers? J Vasc Nurs. 2017;35(4):178-86. https://doi.org/10.1016/j.jvn.2017.08.001 https://doi.org/10.1016/j.jvn.2017.08.00... ⁾	2017 Brazil	Cross-sectional n = 69	Clinical observation and microbiological culture of the lesions.	Two indicators of infection were predominant: discoloration of the opaque and/or dark red type and increase in the volume of exudate; and positive culture for Staphylococcus aureus and Pseudomonas spp. It occurred in 31.6% of the samples.
Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z. et al. Distribution of Microbes and Drug Susceptibility in Patients with Diabetic Foot Infections in Southwest China⁽²¹21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... ⁾	2018 China	Cross-sectional n = 428	Culture and antibiogram of deep ulcer secretion.	Multiple pathogen infections; 36.9%, gram-positive strains; 51%, Gram-negative bacilli; and 12.1%, fungi strains.
Noor S, Raghav A, Parwez I, Ozair M, Ahmad J. Molecular and culture based assessment of bacterial pathogens in subjects with diabetic foot ulcer⁽²²22 Noor S, Raghav A, Parwez I, Ozair M, Ahmad J. Molecular and culture based assessment of bacterial pathogens in subjects with diabetic foot ulcer. Diabetes Metabol Syndr: Clin Res Rev. 2018:1-5. https://doi.org/10.1016/j.dsx.2018.03.001 https://doi.org/10.1016/j.dsx.2018.03.00... ⁾	2018 India	Prospective cohort n = 50	Conventional biochemical and genomic assays, polymerase chain reaction.	Most prevalent pathogens: Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli.
Pugazhendhi S, Dorairaj AP. Appraisal of Biofilm Formation in Diabetic Foot Infections by Comparing Phenotypic Methods With the Ultrastructural Analysis⁽²³23 Pugazhendhi S, Dorairaj AP. Appraisal of biofilm formation in diabetic foot infections by comparing phenotypic methods with the ultrastructural analysis. J Foot Ankle Surg. 2018,57:309-315. https://doi.org/10.1053/j.jfas.2017.10.010 https://doi.org/10.1053/j.jfas.2017.10.0... ⁾	2018 India	Descriptive n = 160	Culture and antibiogram	Microbial resistance was identified in biofilm-producing microorganisms. Most frequent microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa.
Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital⁽²⁴24 Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital. Foot. 2018;37:95-100. https://doi.org/10.1016/j.foot.2018.07.002 https://doi.org/10.1016/j.foot.2018.07.0... ⁾	2018 India	Cross-sectional n = 260	Culture and antibiogram	Monomicrobial infections were less common than polymicrobial. Gram-negative bacteria were the most common among the isolates. Staphylococcus aureus and Pseudomonas aeruginosa were the most frequent.
Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos⁽²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ⁾	2009 Spain	Prospective cohort n = 62	Culture and antibiogram	Predominance of Gram-positive microorganisms; Staphylococcus aureus was the most common.
Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients⁽²⁶26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... ⁾	2012 Brazil	Cross-sectional n = 69		The prevalence of Staphylococcus aureus was 83% and 15% of coagulase-negative Staphylococcus, in addition to methicillin-resistant Staphylococcus aureus (MRSA) and 47% of coagulase-resistant Staphylococcus-negative.
Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Gram-negative rods in venous ulcers and implications for nursing care in Primary Care⁽²⁷27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... ⁾	2014 Brazil	Cross-sectional n = 64	Interview, clinical examination, photographic record, and swabbing of the lesions.	Pseudomonas aeruginosa and Escherichia coli prevailed.
Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections⁽²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾	2015 Brazil	Prospective cohort n = 41	Culture and antibiogram	The infections were predominantly polymicrobial. The most common Gram-positive bacteria were Staphylococcus aureus; and Gram-negative, Proteus spp.
Balbuena JO, Madero RG, Gómez TS, Caballero MC, Romero IS, Martínez AR. Microbiología de las infecciones de úlceras por presión y de origen vascular⁽²⁹29 Balbuena JO, Madero RG, Gómez TS, Caballero MC, Romero IS, Martínez AR. Microbiología de las infecciones de úlceras por presión y de origen vascular. Rev Esp Geriatr Gerontol. 2015;50(1):5-8 https://doi.org/10.1016/j.regg.2014.08.001 https://doi.org/10.1016/j.regg.2014.08.0... ⁾	2015 Spain	Cross-sectional n = 159	Microbiological culture	Higher number of infections caused by enterobacteria and a lower number of S. aureusinfections in patients with pressure injuries compared to those with venous ulcers. Of the isolated strains of S. aureus, 41% were resistant to methicillin (MRSA).
Cardoso NA, Cisneiros LL, Machado CJ, Cenedezi JM, Procópio RJ, Navarro TP. Bacterial genera is a risk factor for major amputation in patients with diabetic foot⁽³⁰30 Cardoso NA, Cisneiros LL, Machado CJ, Cenedezi JM, Procópio RJ, Navarro TP. Gênero bacteriano é fator de risco para amputação maior em pacientes com pé diabético. Rev Col Bras Cir. 2017;44(2):147-53. https://doi.org/10.1590/0100-69912017002007 https://doi.org/10.1590/0100-69912017002... ⁾	2017 Brazil	Case-control n = 189	Deep tissue culture of lesions - Biopsy	Cultures were positive in 86.8%, with monomicrobial in 72%. In patients with major amputation, the most frequent bacterial genera were Acinetobacter spp.
Agwu E, Lhongbe J, Inyang N. Prevalence of Quinolone-susceptible Pseudomonas aeruginosa and Staphylococcus aureus in Delayed-healing DFU's in Ekpoma, Nigeria⁽³¹31 Agwu E, Lhongbe J, Inyang N. Prevalence of Quinolone-susceptible Pseudomonas aeruginosa and Staphylococcus aureus in Delayed-healing DFU's in Ekpoma, Nigeria. Int Wound J. 2010;22(4):100-5. Available from: https://www.woundsresearch.com/content/prevalence-quinolone-susceptible-pseudomonas-aeruginosa-and-staphylococcus-aureus-delayed-he https://www.woundsresearch.com/content/p... ⁾	2010 Nigeria	Descriptive n = 220	Culture and antibiogram	Predominance of Pseudomonas aeruginosa, Staphylococcus aureus, and co-infection by both microorganisms.
Xie X, Bao Y, Ni L, Liu D, NiuS, Lin H et al. Bacterial Profile and Antibiotic Resistance in Patients with Diabetic Foot Ulcer in Guangzhou, Southern China: Focus on the Differences among Different Wagner's Grades, IDSA/IWGDF Grades, and Ulcer Types⁽³²32 Xie X, Bao Y, Ni L, Liu D, NiuS, Lin H, et al. Bacterial profile and antibiotic resistance in patients with diabetic foot ulcer in Guangzhou, Southern China: focus on the differences among different Wagner‘s Grades, IDSA/IWGDF Grades, and Ulcer Types. Int J Endocrinol. 2017;(8694903):1-12. https://doi.org/10.1155/2017/8694903 https://doi.org/10.1155/2017/8694903... ⁾	2017 China	Descriptive n = 117	Culture and antibiogram	The proportion of Gram-negative bacteria was higher than that of Gram-positive bacteria, with Enterobacteriaceae and Staphylococcus standing out.
Arjunan SP, Tint AN, Aliahmad B, Kumar DK, Shukla R, Miller J et al. High-Resolution Spectral Analysis Accurately Identifies the Bacterial Signature in Infected Chronic Foot Ulcers in People With Diabetes. SAGE⁽³³33 Arjunan SP, Tint AN, Aliahmad B, Kumar DK, Shukla R, Miller J, et al. High-Resolution spectral analysis accurately identifies the bacterial signature in infected chronic foot ulcers in people with diabetes. SAGE. 2018;17(2):78-86. https://doi.org/10.1177/1534734618785844 https://doi.org/10.1177/1534734618785844... ⁾	2018 Australia	Descriptive n = 18	Swab and high-resolution spectroscopy of the wound center and peri-wound area for multispectral estimation of bacteria at the base of diabetic foot ulcers.	Swab: presence of Staphylococcus aureus and Escherichia coli. The results of the multispectral analysis showed 100% sensitivity, with 100% negative predictive values for identifying the presence of the bacteria, which was the cause of the wound infection.
Ayed MYA, Ababneh M, Robert AA, Alzaid A, Ahmed RA, Salman A, et al. Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia⁽³⁴34 Ayed MYA, Ababneh M, Robert AA, Alzaid A, Ahmed RA, Salman A, et al. Common pathogens and antibiotic sensitivity profiles of infected diabetic foot ulcers in Saudi Arabia. Int J Lower Extrem Wounds. 2018;00(0):1-8. https://doi.org/10.1177/1534734618793557 https://doi.org/10.1177/1534734618793557... ⁾	2018 Saudi Arabia	Descriptive n = 126	Culture and antibiogram	Pseudomonas aeruginosa and Staphylococcus aureus were the most frequent microorganisms.
Yildiz PA, Özdil T, Dizbay M, Tunçcan OG, Hizel K. Peripheral arterial disease increases the risk of multidrug-resistant bacteria and amputation in diabetic foot infections⁽³⁵35 Yildiz PA, Özdil T, Dizbay M, Tunçcan OG, Hizel K. Peripheral arterial disease increases the risk of multidrug-resistant bacteria and amputation in diabetic foot infections. Turk J Med Sci. 2018;48:845-50. https://doi.org/10.3906/sag-1803-217 https://doi.org/10.3906/sag-1803-217... ⁾	2018 Turkey	Descriptive n = 112	Analysis of medical records	Predominance of Gram-positive bacteria. Staphylococcus aureus and Streptococcus spp. were more frequent. Multidrug-resistant microorganisms were common in patients with peripheral arterial disease.
Lázaro-Martínez JL, Álvaro-Afonso FJ, Sevillano-Fernández D, Molines-Barroso RJ, García-Álvarez Y, García-Morales E. Clinical and Antimicrobial Efficacy of a Silver Foam Dressing With Silicone Adhesive in Diabetic Foot Ulcers With Mild Infection⁽³⁶36 Lázaro-Martínez JL, Álvaro-Afonso FJ, Sevillano-Fernández D, Molines-Barroso RJ, García-Álvarez Y, García-Morales E. Clinical and antimicrobial efficacy of a silver foam dressing with silicone adhesive in diabetic foot ulcers with mild infection. Int J Lower Extrem Wounds. 2019;18(3):269-78. https://doi.org/10.1177/1534734619866610 https://doi.org/10.1177/1534734619866610... ⁾	2019 Spain	Prospective, open, non-controled n = 21	Culture and antibiogram	Treatment with a silver dressing significantly reduced the biological load of pathogenic foot ulcer organisms, such as Staphylococcus aureus, including MRSA, Enterobacteriaceae, Pseudomonas aeruginosa, and other non-fermenting Gram-negative bacilli.

Resistant Microorganisms	Antibiotic(s)	n (%)
Gram-positives
Staphylococcus aureus	Methicillin	8 (57.1)⁽¹⁰10 Sotto A, Richard JL, Combescure C, Jourdan N, Shuldiner S, Bouziges N, et al. Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers. Diabetol. 2010;53:2249-2255. https://doi.org/10.1007/s00125-010-1828-3 https://doi.org/10.1007/s00125-010-1828-... ^-¹¹11 Wang SH, Sun ZL, Guo YJ, Yang BQ, Yuan Y, Wei Q, et al. Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence. J Med Microbiol. 2010;59:1219-24. https://doi.org/10.1099/jmm.0.020537-0 https://doi.org/10.1099/jmm.0.020537-0... ^,¹⁴14 Garcia EC, González RG, Albor AR, Salazar-Schettino. Infections of diabetic foot ulcers with methicillin-resistant staphylococcus aureus. Int J Lower Extremy Wounds. 2015;14(1):44-9. https://doi.org/10.1177/1534734614564053 https://doi.org/10.1177/1534734614564053... ^,²¹21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... ^,²⁴24 Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital. Foot. 2018;37:95-100. https://doi.org/10.1016/j.foot.2018.07.002 https://doi.org/10.1016/j.foot.2018.07.0... ^,³²32 Xie X, Bao Y, Ni L, Liu D, NiuS, Lin H, et al. Bacterial profile and antibiotic resistance in patients with diabetic foot ulcer in Guangzhou, Southern China: focus on the differences among different Wagner‘s Grades, IDSA/IWGDF Grades, and Ulcer Types. Int J Endocrinol. 2017;(8694903):1-12. https://doi.org/10.1155/2017/8694903 https://doi.org/10.1155/2017/8694903... ^,³⁴34 Ayed MYA, Ababneh M, Robert AA, Alzaid A, Ahmed RA, Salman A, et al. Common pathogens and antibiotic sensitivity profiles of infected diabetic foot ulcers in Saudi Arabia. Int J Lower Extrem Wounds. 2018;00(0):1-8. https://doi.org/10.1177/1534734618793557 https://doi.org/10.1177/1534734618793557... ^-³⁵35 Yildiz PA, Özdil T, Dizbay M, Tunçcan OG, Hizel K. Peripheral arterial disease increases the risk of multidrug-resistant bacteria and amputation in diabetic foot infections. Turk J Med Sci. 2018;48:845-50. https://doi.org/10.3906/sag-1803-217 https://doi.org/10.3906/sag-1803-217...
	Penicillin	5 (35.7)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ^,³²32 Xie X, Bao Y, Ni L, Liu D, NiuS, Lin H, et al. Bacterial profile and antibiotic resistance in patients with diabetic foot ulcer in Guangzhou, Southern China: focus on the differences among different Wagner‘s Grades, IDSA/IWGDF Grades, and Ulcer Types. Int J Endocrinol. 2017;(8694903):1-12. https://doi.org/10.1155/2017/8694903 https://doi.org/10.1155/2017/8694903...
	Tetracycline	2 (14.3)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl⁾
	Ciprofloxacino	3 (21.4)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0...
	Gentamycin	4 (28.6)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ⁾
	Erythromycin	5 (35.7)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... 26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... 27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... -²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Amoxicillin + clavulanic acid	3 (21.4)⁽²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... 26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... 27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... -²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Cefoxitin	3 (21.4)⁽¹⁴14 Garcia EC, González RG, Albor AR, Salazar-Schettino. Infections of diabetic foot ulcers with methicillin-resistant staphylococcus aureus. Int J Lower Extremy Wounds. 2015;14(1):44-9. https://doi.org/10.1177/1534734614564053 https://doi.org/10.1177/1534734614564053... ^-¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ⁾^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Cephalothin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Sulfamethoxazole + trimethoprim	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Vancomycin	3 (21.4) ⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Oxacillin	3 (21.4)⁽¹⁴14 Garcia EC, González RG, Albor AR, Salazar-Schettino. Infections of diabetic foot ulcers with methicillin-resistant staphylococcus aureus. Int J Lower Extremy Wounds. 2015;14(1):44-9. https://doi.org/10.1177/1534734614564053 https://doi.org/10.1177/1534734614564053... ^,¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Ampicillin	2 (14.3)⁽¹⁵15 Shettigar K, Jain S, Bhat DV, Achrya R, Ramachandra L, Satyamoorthy K, et al. Virulence determinants in clinical Staphylococcus aureus from monomicrobial and polymicrobial infections of diabetic foot ulcers. J Med Microbiol. 2016;65:1392-404. https://doi.org/10.1099/jmm.0.000370 https://doi.org/10.1099/jmm.0.000370... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl⁾
Staphylococcus epidermidis	Cephalothin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Erythromycin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Penicillin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Sulfamethoxazole + trimethoprim	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Vancomycin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,²¹21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... ⁾
Gram-negatives
Escherichia coli	Amikacin	3 (21.4)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^-¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾
	Ampicillin	4 (28.6)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^-¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Aztreonam	2 (14.3)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Cefotaxime	3 (21.4)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^,¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾
	Cefepime	3 (21.4)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^-¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾
	Cefoperazone	2 (14.3)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾
	Ciprofloxacin	2 (14.3)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ⁾
	Gentamycin	4 (28.6)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl^-¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Tobramycin	2 (14.3)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾
	Ceftriaxone	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl 18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... 19 Pemayun TGD, Naibaho RM. Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Diabetic Foot E Ankle. 2017;8(1):1-8. https://doi.org/10.1080/2000625X.2017.1312974 https://doi.org/10.1080/2000625X.2017.13... 20 Santos SLV, Martins MA, Prado MA, Soriano JV, Bachion MM. Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers? J Vasc Nurs. 2017;35(4):178-86. https://doi.org/10.1016/j.jvn.2017.08.001 https://doi.org/10.1016/j.jvn.2017.08.00... 21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... 22 Noor S, Raghav A, Parwez I, Ozair M, Ahmad J. Molecular and culture based assessment of bacterial pathogens in subjects with diabetic foot ulcer. Diabetes Metabol Syndr: Clin Res Rev. 2018:1-5. https://doi.org/10.1016/j.dsx.2018.03.001 https://doi.org/10.1016/j.dsx.2018.03.00... 23 Pugazhendhi S, Dorairaj AP. Appraisal of biofilm formation in diabetic foot infections by comparing phenotypic methods with the ultrastructural analysis. J Foot Ankle Surg. 2018,57:309-315. https://doi.org/10.1053/j.jfas.2017.10.010 https://doi.org/10.1053/j.jfas.2017.10.0... 24 Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital. Foot. 2018;37:95-100. https://doi.org/10.1016/j.foot.2018.07.002 https://doi.org/10.1016/j.foot.2018.07.0... 25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... 26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... 27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... ^-²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Sulbactam	2 (14.3)⁽¹²12 Shanmugam P, Jeya M, Linda Susan S. The bacteriology of diabetic foot ulcers, with a special reference to multidrug resistant strains. J Clin Diagnost Res. 2013;7(3):441-5. https://doi.org/10.7860/JCDR/2013/5091.2794 https://doi.org/10.7860/JCDR/2013/5091.2... ^,¹⁸18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... ⁾
	Amoxicillin + clavulanic acid	2 (14.3)⁽²⁵25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... ^,²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
Pseudomonas aeruginosa	Amikacin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl 18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... 19 Pemayun TGD, Naibaho RM. Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Diabetic Foot E Ankle. 2017;8(1):1-8. https://doi.org/10.1080/2000625X.2017.1312974 https://doi.org/10.1080/2000625X.2017.13... 20 Santos SLV, Martins MA, Prado MA, Soriano JV, Bachion MM. Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers? J Vasc Nurs. 2017;35(4):178-86. https://doi.org/10.1016/j.jvn.2017.08.001 https://doi.org/10.1016/j.jvn.2017.08.00... 21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... 22 Noor S, Raghav A, Parwez I, Ozair M, Ahmad J. Molecular and culture based assessment of bacterial pathogens in subjects with diabetic foot ulcer. Diabetes Metabol Syndr: Clin Res Rev. 2018:1-5. https://doi.org/10.1016/j.dsx.2018.03.001 https://doi.org/10.1016/j.dsx.2018.03.00... 23 Pugazhendhi S, Dorairaj AP. Appraisal of biofilm formation in diabetic foot infections by comparing phenotypic methods with the ultrastructural analysis. J Foot Ankle Surg. 2018,57:309-315. https://doi.org/10.1053/j.jfas.2017.10.010 https://doi.org/10.1053/j.jfas.2017.10.0... 24 Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital. Foot. 2018;37:95-100. https://doi.org/10.1016/j.foot.2018.07.002 https://doi.org/10.1016/j.foot.2018.07.0... 25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... 26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... 27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... ^-²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Levofloxacin	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl 18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... 19 Pemayun TGD, Naibaho RM. Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Diabetic Foot E Ankle. 2017;8(1):1-8. https://doi.org/10.1080/2000625X.2017.1312974 https://doi.org/10.1080/2000625X.2017.13... 20 Santos SLV, Martins MA, Prado MA, Soriano JV, Bachion MM. Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers? J Vasc Nurs. 2017;35(4):178-86. https://doi.org/10.1016/j.jvn.2017.08.001 https://doi.org/10.1016/j.jvn.2017.08.00... 21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... 22 Noor S, Raghav A, Parwez I, Ozair M, Ahmad J. Molecular and culture based assessment of bacterial pathogens in subjects with diabetic foot ulcer. Diabetes Metabol Syndr: Clin Res Rev. 2018:1-5. https://doi.org/10.1016/j.dsx.2018.03.001 https://doi.org/10.1016/j.dsx.2018.03.00... 23 Pugazhendhi S, Dorairaj AP. Appraisal of biofilm formation in diabetic foot infections by comparing phenotypic methods with the ultrastructural analysis. J Foot Ankle Surg. 2018,57:309-315. https://doi.org/10.1053/j.jfas.2017.10.010 https://doi.org/10.1053/j.jfas.2017.10.0... 24 Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital. Foot. 2018;37:95-100. https://doi.org/10.1016/j.foot.2018.07.002 https://doi.org/10.1016/j.foot.2018.07.0... 25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... 26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... 27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... ^-²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾
	Cefepime	2 (14.3)⁽¹⁷17 Sánchez-Sanchez M, Cruz-Pulido WL, Bladinieres-Cámara E, Alcalá-Durán R, Rivera-Sánchez G, Bocanegra-Garcia V. Bacterial prevalence and antibiotic resistance in clinical isolates of diabetic foot ulcers in the Northeast of Tamaulipas, Mexico. Int J Lower Extremy Wounds. 2017;1-6. https://doi.org/10.1177/1534734617705254journals.sagepub.com/home/ijl 18 Noor S, Borse AG, Ozair M, Raghav A, Parwez I, Ahmad J. inflammatory markers as risk factors for infection with multidrug - resistance microbes in diabetic foot subjects. Foot. 2017;1-19. https://doi.org/10.1016/j.foot.2017.05.001 https://doi.org/10.1016/j.foot.2017.05.0... 19 Pemayun TGD, Naibaho RM. Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Diabetic Foot E Ankle. 2017;8(1):1-8. https://doi.org/10.1080/2000625X.2017.1312974 https://doi.org/10.1080/2000625X.2017.13... 20 Santos SLV, Martins MA, Prado MA, Soriano JV, Bachion MM. Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers? J Vasc Nurs. 2017;35(4):178-86. https://doi.org/10.1016/j.jvn.2017.08.001 https://doi.org/10.1016/j.jvn.2017.08.00... 21 Wu M, Pan H, Leng W, Lei X, Chen Liu, Liang Z, et al. Distribution of microbes and drug susceptibility in patients with diabetic foot infections in Southwest China. J Diabetes Res. 2018;1-9. https://doi.org/10.1155/2018/9817308 https://doi.org/10.1155/2018/9817308... 22 Noor S, Raghav A, Parwez I, Ozair M, Ahmad J. Molecular and culture based assessment of bacterial pathogens in subjects with diabetic foot ulcer. Diabetes Metabol Syndr: Clin Res Rev. 2018:1-5. https://doi.org/10.1016/j.dsx.2018.03.001 https://doi.org/10.1016/j.dsx.2018.03.00... 23 Pugazhendhi S, Dorairaj AP. Appraisal of biofilm formation in diabetic foot infections by comparing phenotypic methods with the ultrastructural analysis. J Foot Ankle Surg. 2018,57:309-315. https://doi.org/10.1053/j.jfas.2017.10.010 https://doi.org/10.1053/j.jfas.2017.10.0... 24 Sonal SM, Rodrigues GS, Vyasc N, Mukhopadhyay C. Antimicrobial susceptibility pattern of aerobes in diabetic foot ulcers in a South-Indian tertiary care hospital. Foot. 2018;37:95-100. https://doi.org/10.1016/j.foot.2018.07.002 https://doi.org/10.1016/j.foot.2018.07.0... 25 Martínez-Gomes DA, Ramírez-Almagro C, Campillo-Soto A, Morales-Cuenca G, Pagán-Ortiz J, Aguayo-Albasini JL. Infecciones del pie diabético: prevalencia de los distintos microorganismos y sensibilidad a los antimicrobianos. Enfermed Infec Microbiol Clín. 2009;27(6):317-21. https://doi.org/10.1016/j.eimc.2008.07.004 https://doi.org/10.1016/j.eimc.2008.07.0... 26 Martins MA, Santos SLV, Leão LSNO, Araujo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop. 2012,45(6):717-22. https://doi.org/10.1590/S0037-86822012000600012 https://doi.org/10.1590/S0037-8682201200... 27 Santos SLV, Martins MA, Vasconcelos LSNOL, Lima ABM, Malaquias SG, Bachion MM. Bastonetes Gram-negativos em úlceras venosas e implicações para o atendimento de enfermagem na atenção primária. Rev Eletr Enf. 2014;(16):2. https://doi.org/10.5216/ree.v16i2.24670 https://doi.org/10.5216/ree.v16i2.24670... ^-²⁸28 Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic bacterial proﬁle and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546-54. https://doi.org/10.1590/0037-8682-0146-2015 https://doi.org/10.1590/0037-8682-0146-2... ⁾

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[1] Corresponding author: Taysa de Fátima Garcia. E-mail: taysafati@hotmail.com