MRSA Linked to Higher Failure Rates in Diabetic Foot Infections

2006 ◽  
Vol 39 (21) ◽  
pp. 51
Author(s):  
DOUG BRUNK
Keyword(s):  
Diabetic Foot ◽  
Failure Rates ◽  
Diabetic Foot Infections

scholarly journals 1422. Evaluation of Diabetic Foot Infections and Osteomyelitis in a Veteran Population: Targets for Improved Outcomes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S518-S518
Author(s):  
Michael T Carter ◽  
Grishma Trivedi ◽  
Kristen Fodero ◽  
Bethany A Wattengel ◽  
John Sellick ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Treatment Strategies ◽  
Prolonged Treatment ◽  
Failure Rates ◽  
Diabetic Foot Infections ◽  
Initial Intervention ◽  
Poor Outcomes ◽  
The Impact

Abstract Background Diabetic foot infections (DFI) complicated with osteomyelitis are a difficult infection to treat often resulting in poor outcomes. DFIs often require amputations, including serial amputations due to inadequate initial intervention and infection progression. This study examines various diagnostic and treatment strategies aimed to improve outcomes. Methods This retrospective cohort study included patients greater than or equal to 18 years of age with a DFI as identified via ICD 9 and ICD 10 codes from January 2005 to December 2018. Outcomes were analyzed to measure the impact of baseline characteristics on outcomes. The severity of infection was defined by PEDIS score (perfusion, extent, depth, infection, and sensation). Descriptive statistics were used to report differences. Results One hundred and thirty patients were included, 72% with osteomyelitis. The median PEDIS score was 3 (interquartile range 2–3). Magnetic resonance imaging was used to evaluate 38% of the population. Osteomyelitis patients who had an MRI performed were noted to have a higher rate of appropriate treatment and cure (56%) when compared with a similar group of patients who did not receive an MRI (25%) (P = 0.005). Comparing prolonged (> 4 weeks) therapy to short therapy, there was a significantly higher proportion of cures noted (62.71% vs. 36.62%, P < 0.0001). Failure was associated with less than 4 weeks of therapy (66.7%, P = 0.03) and presence of residual inflammation/infection after amputation (58.3%, P < 0.0001). Route of antibiotic had no impact on failure rates. However, patients with an initial drug-bug mismatch were more likely to fail. Sixty-six percent of patients with decreased ankle brachial index failed (P = 0.02). Conclusion Diabetic foot infections have serious consequences. Over a third of patients required further amputation or additional antibiotic therapy. Risk of failure was associated with short durations of therapy, poor perfusion, and residual inflammation after amputation. However, a higher rate of cures was noted with use of an MRI and prolonged therapy in patients. Stewardship initiatives may wish to focus on ensuring prolonged treatment courses and appropriate surgical intervention rather than on route of antibiotic therapy as there was no difference in failure rates. Disclosures All authors: No reported disclosures.

scholarly journals Spectral and Antibiotic Susceptibility of Pathogens Isolated from Saudi Patients with Diabetic Foot Infections

2021 ◽  
Vol 12 (1) ◽  
pp. 16-20
Author(s):  
Samiah Hamad S Al-Mijalli
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Antibiotic Susceptibility ◽  
Empirical Therapy ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Diabetic Foot Infections ◽  
Microbiological Methods

Diabetic foot infections (DFIs) are a significant health issue and a common complication among patients with diabetes. To develop antibiotic therapy for these high-risk patients, the current study evaluates the scope of DFIs and identifies the causing microbes. It also measures spectrum and antibiotic susceptibility of the pathogens isolated from adults with DFIs in Saudi Arabia. To achieve the study objectives, a cross-sectional study was implemented and the baseline characteristics for 44 patients with DFIs were defined. Optimal aerobic and anaerobic microbiological techniques were utilized to culture specimens isolated from infected foot ulcers. The standard microbiological methods were employed to identify the bacterial isolates and antibiotic susceptibility testing was conducted following the procedures of the Clinical and Laboratory Standards Institute (CLSI). Results showed that 12 microorganisms were isolated from the participants’ diabetic foot ulcers. Staphylococcus Aureus was ranked first because it appeared in 29 (65.9%) cases. Streptococcus Agalactiae was ranked second and multi-microbial infections were also found. Most of the organisms were susceptible to Vancomycin, Ciprofloxacin, and Cefalexin, but they were resistant to Methicillin, Gentamicin, and Ampicillin antibiotics. Staphylococcus Aureus was most sensitive to Ciprofloxacin, while it was resistant to Methicillin. About 10% of the isolates were multidrug-resistant. The study concludes that while Vancomycin should be used empirically for Gram-positive isolates, Ciprofloxacin can be taken into consideration for most of the Gram-negatives aerobes. Based on including various microorganisms and the advent of multidrug-resistant strains, proper culture and sensitivity testing are necessary prior to the empirical therapy.

Clinical, Microbiological and Inflammatory Markers of Severe Diabetic Foot Infections

2021 ◽  
Author(s):  
Javier Aragón‐Sánchez ◽  
Gerardo Víquez‐Molina ◽  
María Eugenia López‐Valverde ◽  
Javier Aragón‐Hernández ◽  
José María Rojas‐Bonilla ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Inflammatory Markers ◽  
Diabetic Foot Infections

scholarly journals Association Between Diabetic Foot Infection Wound Culture Positivity and 1-Year Admission for Invasive Infection: A Multi-Center Cohort Study

2021 ◽  
Author(s):  
Westyn Branch-Elliman ◽  
Daniel Sturgeon ◽  
Adolf W Karchmer ◽  
Hillary J Mull
Keyword(s):  
Diabetic Foot ◽  
Systemic Infection ◽  
Causative Organism ◽  
Invasive Infection ◽  
Diabetic Foot Ulcers ◽  
Diabetic Foot Infections ◽  
Culture Positivity ◽  
Wound Culture ◽  
Culture Positive ◽  
Culture Negative

Abstract Inpatients with culture-positive diabetic foot infections are at elevated risk for subsequent invasive infection with the same causative organism. In outpatients with index diabetic foot ulcers, we found that wound culture positivity was independently associated with increased odds of 1-year admission for systemic infection when compared to culture-negative wounds.

scholarly journals Prevalence of Peripheral Vascular Disease in Diabetic Foot Infections and its Effect on Management Outcome

2019 ◽  
Vol 38 (1) ◽  
pp. 12-17
Author(s):  
Farah Nobi ◽  
Syed Al Nahian ◽  
Afrin Sultana ◽  
Rokhsana Sarmin ◽  
Ayesha Rahman ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Peripheral Vascular ◽  
Tertiary Care Centre ◽  
Term Care ◽  
Diabetic Foot Infection ◽  
Diabetic Foot Infections

Background: Foot infection is a common problem affecting diabetics. Ischemia is a major factor contributing to progress and morbidity of the disease. The prevalence of peripheral vascular disease is higher in diabetics with faster progression. Aim: This study aimed to observe the prevalence of peripheral vascular disease in patients with diabetic foot infections presenting to this tertiary care centre. Methods: This prospective observational study evaluated 250 patients with diabetic foot infection admitted to Ibrahim Medical College and BIRDEM General Hospital, Dhaka, from 1st January 2015 to 31st December 2015.Total 72 patients were selected for Duplex study of lower limb vessels, Ankle Brachial Pressure Index (ABPI) and Pulse oxymetrywhich established the diagnosis of peripheral vascular disease and all patients were treated according to the standard protocol. Results: Of the 72 patients peripheral vascular disease was found in 25 patients (34.7%) and majority of them (88%) had distal below the knee vessel stenosis. There was significant correlation with older age (75%) and history of tobacco use (64%). The clinical presentations and outcomes such as hospital stay, healing time, pain were worse in individuals with peripheral vascular compromise on Duplex study of lower limb vessels, ABPI and pulse oxymetry. Conclusion: In this study we observed that significant number of diabetics presenting with foot infections have underlying peripheral vascular disease .The patients might not all be symptomatic or show obvious signs of PVD but need to be investigated for the same. Early detection of peripheral vascular disease in patients presenting with diabetic foot infection, using Duplex study,ABPI and Pulse oxymetrywith routine clinical and laboratory assessment can be of great value in long term care of these individuals. J Bangladesh Coll Phys Surg 2020; 38(1): 12-17

Diabetic Foot Infections

2009 ◽  
pp. 143-146
Author(s):  
Melinda Sharkey ◽  
Serena S. Hu
Keyword(s):  
Diabetic Foot ◽  
Diabetic Foot Infections

scholarly journals Joint Consultation Clinic by Infectious Diseases Specialists and Podiatry team (ID-POD) Compliments the Care of Diabetic Patients with Foot Infections by Reducing Cost and Decreasing Outpatient Clinic Visits

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S328-S328
Author(s):  
Pushpalatha Bangalore Lingegowda ◽  
Say-Tat Ooi ◽  
Jyoti Somani ◽  
Chelsea Law ◽  
Boon Kiak Yeo
Keyword(s):  
Infectious Diseases ◽  
Diabetic Foot ◽  
Wound Care ◽  
Cost Savings ◽  
Outpatient Setting ◽  
Multidisciplinary Teams ◽  
Diabetic Patients ◽  
Wound Debridement ◽  
Diabetic Foot Infections ◽  
Before And After

Abstract Background Management of diabetic foot infections (DFI) is challenging and involves multidisciplinary teams to improve outcomes (1). Appropriate wound care of patients with DFI plays an important role in successfully curing infections and promote wound healing. In Singapore, Infectious Diseases (ID) specialists help in the management of DFI by recommending appropriate antibiotics for infected wounds while wound debridement are managed by Podiatrists (POD). When patients are hospitalized multidisciplinary teams including Vascular Surgery review patients. In the outpatient setting patients have multiple appointments including ID and Endocrinology etc. The time spent and costs incurred by patients for traveling to multiple appointments is considerable. A joint ID-POD clinic was initiated to reduce the cost and inconvenience for patients. Methods A joint weekly clinic was initiated in October’16 and the data was analyzed upto May’17. Finance was involved in deriving costs. The service costs for consultations payable by patients before and after the initiation of the joint clinic were compared. Results First 6 months experience of initiating the joint ID-POD clinic is reported. 35 unique patients had a total of 88 visits. 1/third of the patients had more than 2 visits to the joint clinic. For each visit to the joint clinic the patient paid 25% less compared with having separate clinics. The hospital lowered the service cost for the new clinic by 11%. This was done by minimizing the time involvement of the ID physician. Conclusion Joint ID-POD clinic for managing diabetic patients with foot infections revealed several advantages. Hospital outpatient visits for each patient decreased by 50% for those requiring care of both ID and POD, without compromising care. With the consolidation of care each individual patient had a cost savings of 25% for the joint consultation. This joint clinic while making it convenient for patients has revealed significant cost savings to patients especially for those requiring multiple visits. We recommend hospitals with high prevalence of Diabetes and Diabetic foot infections to consider joint ID-POD clinics to reduce hassle and increase saving for patients. Disclosures All authors: No reported disclosures.

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