Analisis Deskriptif Perbedaan Hasil Uji Kepekaan Antibiotik Berdasarkan Pemeriksaan Kultur Jaringan dan Kultur Pus pada Pasien dengan Ulkus Kaki Diabetikum di RS. Adam Malik

Abstract

Background : Diabetic foot ulcer (DFU) is severe complications of diabetes mellitus, contributing to increased morbidity, mortality, and risk of amputation. Effective antibiotic therapy requires accurate pathogen identification, yet diagnostic bias may arise depending on specimen type. Tissue culture is regarded as the gold standard, whereas swab culture remains widely used due to its convenience. This study aimed to evaluate differences in antibiotic resistance profiling between swab and tissue cultures in patients with DFU, with particular focus on culture-based bias. Methods : A prospective study was conducted over 6 months found with 41 patients treated as DFU at Adam Malik tertiary Hospital. Data were obtained from swab and tissue cultures sampling, following standardized methods with levine technique. Variable analyzed including cause of pathogen, antibiotic susceptibility testing. Bias was analyzed with plot, when there was difference susceptibility more than 5%. Result : Gram-negative bacteria predominated, particularly Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae, whereas Staphylococcus aureus (including MRSA) was the main Gram-positive isolate. Swab cultures more frequently yielded single isolates (62.5%), while tissue cultures revealed polymicrobial infections. Notable bias resistance was observed among Gram-negative isolates to ciprofloxacin (19.4%), ceftazidime (18.1%), and ertapenem (16.7%), and among Gram-positive isolates to moxifloxacin and erythromycin (37.5%) and clindamycin (23.2%). Swab cultures tended to underestimate microbial diversity and often failed to detect resistant strains identified in tissue cultures. Conclusion : Tissue culture demonstrated higher diagnostic yield and accuracy compared to pus culture in identifying pathogens and antibiotic resistance patterns in diabetic foot ulcers.