Epidemiologia, caracterização microbiológica e avaliação dos custos com o tratamento de infecções do pé diabético

Abstract

Diabetic foot infection (DFI) is one of the most serious and costly complications of diabetic patients. This study aimed to analyze the microbiological and epidemiological aspects of DFI and to determine the costs of treating these patients. We collected clinical and epidemiological data from the medical records. To analyze the costs, we collected data referring to the real cost invested in the treatment of each patient. The antimicrobial susceptibility was determined using agar diffusion or E-test. Genetic polymorphisms were analyzed by the PFGE technique. The study included 46 patients with DFI; the majority were men (58.7%) who were elderly (mean age 63.9 ± 10.8 years) with associated cardiovascular diseases (60.8%). The amputation rate was 56.5 %. The average treatment cost of DFI was US$ 9,936.84 (ranging from US$ 14.19 to US$ 58,230.71). Forty-seven isolates were collected, and a predominance of Gram-negative microorganisms (70.8 %) was observed. PFGE revealed a large clonal diversity. Time and costs of hospitalization and antimicrobial treatment were higher in cases of multidrug-resistant and polymicrobial infections. We observed that DFIs are serious complications with long times of hospitalization and costly antimicrobial treatment. Bacterial resistance and polymicrobial nature of wounds can increase the costs of such morbidity.