Microbial profile and antimicrobial resistance patterns of diabetic wound infections in Nelson Mandela Bay Metro: A retrospective multi-hospital study
1
1 Pharmacy, Nelson Mandela University, Gqeberha, South Africa
2
2 Nanomedicine Platform, Medical School, Nelson Mandela University, Gqeberha, South Africa
3
3 Biostatistician, Faculty of Health Science, Nelson Mandela University, Gqeberha, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A221
ABSTRACT
INTRODUCTION:
Diabetic wound infections represent a major cause of morbidity and mortality globally, with disproportionate impact in resource-limited settings where access to timely diagnostic services is limited1. In South Africa, delayed diagnosis and reliance on empiric antibiotic therapy contribute to preventable complications including cellulitis, gangrene, sepsis, and lower limb amputations. Addressing these challenges is essential for advancing equitable and sustainable healthcare delivery2.
METHODS:
A retrospective analysis was conducted on 154 diabetic wound infection cases managed in both public and private hospitals within the Nelson Mandela Bay Metro. Microbial profiles, antimicrobial resistance patterns, hospitalization trends, surgical outcomes, and infection-related complications were evaluated.
RESULTS:
Hospitalization was required in 80.5% of patients, with 41.5% experiencing multiple admissions. Length of stay ranged from 3 to 18 days (mean: 10.38 days). Polymicrobial infections were predominant and were associated with more severe clinical presentations. High levels of antimicrobial resistance was identified among frequently prescribed antibiotic classes, including penicillin’s, cephalosporins, and carbapenems, limiting the effectiveness of empiric therapy. Severe complications, such as cellulitis, gangrene, and sepsis, were commonly observed, with sepsis showing a strong association with progression to major amputation. Surgical interventions comprised major amputations in 43.9% of cases, minor amputations in 14.6%, and debridement in 19.5%.
CONCLUSIONS:
Diabetic wound infections impose substantial clinical, psychosocial, and economic burdens, particularly in settings where diagnostic services are not readily accessible. Delays associated with conventional culture-based diagnostics (2–7 days) hinder timely clinical decision-making and contribute to disease progression, prolonged hospitalization, and high amputation rates. Many primary healthcare facilities lack on-site microbial testing, reinforcing dependence on empiric antibiotics despite escalating antimicrobial resistance. These results support the urgent need for rapid, accessible point-of-care diagnostic tools capable of guiding early targeted therapy. Such innovations have the potential to improve antimicrobial stewardship, reduce preventable amputations, and promote sustainable healthcare delivery in resource-limited settings.
Diabetic wound infections represent a major cause of morbidity and mortality globally, with disproportionate impact in resource-limited settings where access to timely diagnostic services is limited1. In South Africa, delayed diagnosis and reliance on empiric antibiotic therapy contribute to preventable complications including cellulitis, gangrene, sepsis, and lower limb amputations. Addressing these challenges is essential for advancing equitable and sustainable healthcare delivery2.
METHODS:
A retrospective analysis was conducted on 154 diabetic wound infection cases managed in both public and private hospitals within the Nelson Mandela Bay Metro. Microbial profiles, antimicrobial resistance patterns, hospitalization trends, surgical outcomes, and infection-related complications were evaluated.
RESULTS:
Hospitalization was required in 80.5% of patients, with 41.5% experiencing multiple admissions. Length of stay ranged from 3 to 18 days (mean: 10.38 days). Polymicrobial infections were predominant and were associated with more severe clinical presentations. High levels of antimicrobial resistance was identified among frequently prescribed antibiotic classes, including penicillin’s, cephalosporins, and carbapenems, limiting the effectiveness of empiric therapy. Severe complications, such as cellulitis, gangrene, and sepsis, were commonly observed, with sepsis showing a strong association with progression to major amputation. Surgical interventions comprised major amputations in 43.9% of cases, minor amputations in 14.6%, and debridement in 19.5%.
CONCLUSIONS:
Diabetic wound infections impose substantial clinical, psychosocial, and economic burdens, particularly in settings where diagnostic services are not readily accessible. Delays associated with conventional culture-based diagnostics (2–7 days) hinder timely clinical decision-making and contribute to disease progression, prolonged hospitalization, and high amputation rates. Many primary healthcare facilities lack on-site microbial testing, reinforcing dependence on empiric antibiotics despite escalating antimicrobial resistance. These results support the urgent need for rapid, accessible point-of-care diagnostic tools capable of guiding early targeted therapy. Such innovations have the potential to improve antimicrobial stewardship, reduce preventable amputations, and promote sustainable healthcare delivery in resource-limited settings.
| eISSN: | 2654-1459 |
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