RISK FACTORS, MICROBIOLOGICAL PROFILE, AND ANTIBIOTIC SUSCEPTIBILITY PATTERNS OF LOWER LIMB CELLULITIS IN NON-DIABETIC PATIENTS: A TERTIARY CARE HOSPITAL STUDY

Abstract

Introduction: Cellulitis is a common acute bacterial infection of the skin and subcutaneous tissue. While diabetes mellitus is a well-established risk factor, a significant proportion of cellulitis cases occur in non-diabetic individuals. In these patients, local factors such as trauma and venous insufficiency may play a pivotal role, yet this population remains under-evaluated compared to diabetic cohorts.

​Aim: To identify the risk factors, clinical presentation, microbiological profile, and antibiotic susceptibility patterns in non-diabetic patients presenting with lower limb cellulitis.

​Materials and Methods: This observational, hospital-based cross-sectional study was conducted at the Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai, India, from July 2024 to May 2026. The study included 110 non-diabetic patients aged 20–75 years diagnosed with lower limb cellulitis. Data regarding clinical history, local examination, and wound cultures were collected. Statistical analysis was performed using SPSS version 25.0.

​Results: The mean age of the study population was 49.6 ± 12.8 years, with a male predominance (65.5%). The most common risk factors were minor trauma (38.2%), skin fissures (32.7%), and chronic edema (30.9%). Wound culture was positive in 69.1% of cases. Staphylococcus aureus was the predominant isolate (39.5%), followed by Streptococcus species (21.1%). Methicillin-resistant S. aureus (MRSA) was isolated in 10.5% of patients. High sensitivity was observed for Vancomycin (97.4%) and Linezolid (94.7%), while resistance to Ciprofloxacin was noted in 42.1% of isolates.

​Conclusion: Lower limb cellulitis in non-diabetic patients is primarily driven by local predisposing factors rather than systemic metabolic abnormalities. Gram-positive organisms remain the primary etiological agents, with a notable prevalence of MRSA. Early identification of local risk factors and culture-guided antibiotic therapy are essential for optimal outcomes.