Diabetes mellitus (DM) affects 23.6 million people in the USA and approximately 20–25% of diabetic patients will develop foot ulceration during the course of their disease. Up to a quarter of these patients will develop infections that will necessitate amputation. Although many studies report that the rates of antibiotic resistant infections have increased dramatically in the DM population over the last decade, to our knowledge there have been no reports directly comparing the rates of antibiotic resistant infections in DM versus non-DM wounds. We performed a retrospective study comparing the wound infections of 41 DM patients to those of 74 non-DM patients to test the hypothesis that infections with multidrug resistant organisms (MDRO) were more prevalent in the DM population. We found that 63.4% of DM and 50% of non-DM patients had MDRO infections, which was not statistically different. However, 61% of the DM patients had Pseudomonas infections compared to only 18.9% of non-DM patients. Furthermore, DM patients had significantly more coinfections with both Pseudomonas and Staphylococcus aureus. Though our initial hypothesis was incorrect, we demonstrated a significant correlation between Pseudomonas and Pseudomonas/S. aureus coinfections within DM wounds. 1. Introduction Diabetes mellitus (DM) currently affects approximately 8.3% of the population and more than 79 million people have prediabetes [1]. Diabetics are more susceptible to infections due to increased glucose levels and suppressed immune response as well as the neuropathy and decreased blood flow to extremities that lead to slow-healing wounds [2]. For example, approximately 20–25% of the 23.6 million diabetics in the USA will develop foot ulceration during the course of their disease [3]. A quarter of these patients will develop infections, often with antibiotic resistant bacteria, that will necessitate amputation of their foot or leg. More than one-half of the lower extremity amputations in the USA occur among people with DM (approximately 82,000 amputations/year [4]) and are associated with significant morbidity and mortality. For example, up to 50% of patients die within the first 18 months following amputation [3, 5], and survivors face significant lifestyle impairments and frequent loss of their contralateral extremity within 5 years [6]. Amputation in diabetic patients is usually precipitated by the development of a chronic wound, clinically defined as a wound that fails to heal within 30 days [7]. Infection of these wounds, often by multidrug resistant organisms (MDRO), makes them
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