Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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A Prospective Study Correlating Histopathological Grading and Microbial Spectrum in Chronic Diabetic Foot Ulcers: Implications for Diagnosis, Drug Resistance and Tissue Healing
Ganga Singh and Anu Gupta
Page: 741-746 | Received 12 Oct 2016, Published online: 29 Nov 2016
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Abstract
Diabetic foot ulcers (DFUs) are a significant cause of morbidity, often leading to lower extremity amputation. Understanding the correlation between histopathological and microbiological findings in DFUs may improve diagnostic precision and guide targeted therapy. To evaluate the histopathological grading and microbial spectrum in chronic diabetic foot ulcers and assess their diagnostic correlation, with a focus on antimicrobial resistance and its relationship to tissue pathology. A prospective observational cross‐sectional study was conducted at Rohilkhand Medical College and Hospital, Bareilly, from May 2015 to April 2016. Eighty adult patients with chronic DFUs underwent tissue biopsy for histopathological and microbiological evaluation. Inflammation grade, necrosis, fibrosis, granulation, neo vascularization and osteomyelitis were assessed histologically. Microbial isolates were identified and tested for antimicrobial resistance. Correlations between histopathology and microbiological findings were analyzed using chi‐square tests. Moderate to severe inflammation was observed in 68.7% of cases., necrosis and granulation were present in 65% and 56.2%, respectively. Staphylococcus aureus (MSSA and MRSA) and Gram‐negative bacilli were the most common isolates, with 12.5% showing fungal infections. No statistically significant correlation was observed between inflammation grade and isolate type (χ²=5.47, p=0.485). Likewise, drug‐resistant organisms (MRSA/ESBL) did not significantly correlate with necrosis (χ²=1.18, p=0.277) or osteomyelitis (χ²=2.69, p=0.101). Combined pathology and microbiology improved diagnostic yield in 30% of cases. An integrative diagnostic approach involving histopathological and microbiological analysis enhances the evaluation of diabetic foot ulcers. While drug resistance is common, it may not predict histological severity. Tissue‐based diagnosis remains essential in tailoring effective management strategies.
How to cite this article:
Ganga Singh and Anu Gupta. A Prospective Study Correlating Histopathological Grading and Microbial Spectrum in Chronic Diabetic Foot Ulcers: Implications for Diagnosis, Drug Resistance and Tissue Healing.
DOI: https://doi.org/10.36478/makrjms.2016.741.746
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2016.741.746