Diabetic foot ulcer and multidrug-resistant organisms: risk factors and impact

2004 ◽  
Vol 21 (7) ◽  
pp. 710-715 ◽  
Author(s):  
A. Hartemann-Heurtier ◽  
J. Robert ◽  
S. Jacqueminet ◽  
G. Ha Van ◽  
J. L. Golmard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Multidrug Resistant Organisms

Diabetic Foot Ulcer and Multidrug-Resistant Organisms: Prevalence and Bacteriological Profile

2018 ◽  
Vol 9 (4) ◽  
pp. 455-458
Author(s):  
Manikandan Kathirvel ◽  
◽  
Ajay Sivakumar ◽  
Jayalakshmi Jayarajan ◽  
Viswakumar Prabakaran ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Bacteriological Profile ◽  
Multidrug Resistant Organisms

scholarly journals Evaluation of various risk factors associated with multidrug-resistant organisms isolated from diabetic foot ulcer patients

2019 ◽  
Vol 11 (01) ◽  
pp. 058-062 ◽  
Author(s):  
Priya Datta ◽  
Jagdish Chander ◽  
Varsha Gupta ◽  
Gursimran Kaur Mohi ◽  
Ashok K. Attri
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Treatment Strategies ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Resistant Organism ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Beta Lactamases

Abstract AIMS: Diabetic foot ulcer is a dreaded complication of diabetes. Diabetic foot ulcer patients are often infected with multidrug resistant organism (MDRO) due to chronic course of the wound, inappropriate antibiotics treatment, frequent hospital admission, neuropathy, nephropathy, and peripheral vascular disease. MATERIALS AND METHODS: This prospective study was conducted in our 750 bedded hospital for a period of 6 months. The present study was undertaken to isolate various MDRO methicillin resistant Staphylococcus aureus; Gram-negative bacteria producing enzymes such as extended spectrum beta-lactamases (ESBL), Amp C, Carbapenamases; Pseudomonas and Acinetobacter species producing metallo-beta-lactamases (MBL). In addition we attempted to identify risk factors for association of diabetic foot ulcer and MDRO. RESULTS: A total of 149 bacterial isolates were identified. Of the total isolates 73.2% were Gram-negative and remaining 26.8% were Gram-positive bacteria. Among Enterobacteriaceae 59% were ESBL producers and 48% were Amp C producers. In addition, 41.5% of the isolates produced both ESBL and Amp C and 13.4% were carbapenem resistant Enterobacteriaceae. Among 20 Pseudomonas and Acinetobacter isolates, 5 were MBL producers (25%). Furthermore, in the study, 56% of patients with diabetic foot ulcer harbored MDRO. The risk of multidrug-resistant infection is significantly more in patients having diabetes duration >20 years and size of ulcer more than 4 cm2. CONCLUSION: The detection of MDRO in patients of diabetic foot ulcer changes the treatment strategies limits the antimicrobial options and causes higher complications among them.

scholarly journals Causation Research on Diabetic Foot Complications—What I Learned From Roger Pecoraro: The 2021 Roger E. Pecoraro Award Lecture

2021 ◽  
Author(s):  
Edward J. Boyko
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Past History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Clinical Information ◽  
Arterial Perfusion ◽  
Primary Care Population ◽  
Foot Complications ◽  
Patients With Diabetes

Roger Pecoraro made important contribution to diabetic foot research and is primarily responsible for instilling in me an interest in these complications. Our collaboration in the final years of his life led to the development of the Seattle Diabetic Foot Study. At the time it began, the Seattle Diabetic Foot Study was perhaps unique in being a prospective study of diabetic foot ulcer conducted in a non-specialty primary care population of patients with diabetes and without foot ulcer. Important findings from this research include the demonstration that neurovascular measurements, diabetes characteristics, past history of ulcer or amputation, body weight, and poor vision all significantly and independently predict foot ulcer risk. A prediction model from this research that included only readily available clinical information showed excellent ability to discriminate between patients who did and did not develop ulcer during follow-up (area under ROC curve=0.81 at one year). Identification of limb-specific amputation risk factors showed considerable overlap with those risk factors identified for foot ulcer, but suggested arterial perfusion as playing a more important role. Risk of foot ulcer in relation to peak plantar pressure estimated at the site of the pressure measurement showed a significant association over the metatarsal heads, but not other foot locations, suggesting that the association between pressure and this outcome may differ by foot location. The Seattle Diabetic Foot Study has helped to expand our knowledge base on risk factors and potential causes of foot complications. Translating this information into preventive interventions remains a continuing challenge.

scholarly journals Development of Predictive Nomograms for Clinical Use to Quantify the Risk of Amputation in Patients with Diabetic Foot Ulcer

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Bocheng Peng ◽  
Rui Min ◽  
Yiqin Liao ◽  
Aixi Yu
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Prediction Model ◽  
Predictive Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Single Factor ◽  
Independent Risk Factors

Objective. To determine the novel proposed nomogram model accuracy in the prediction of the lower-extremity amputations (LEA) risk in diabetic foot ulcer (DFU). Methods and Materials. In this retrospective study, data of 125 patients with diabetic foot ulcer who met the research criteria in Zhongnan Hospital of Wuhan University from January 2015 to December 2019 were collected by filling in the clinical investigation case report form. Firstly, univariate analysis was used to find the primary predictive factors of amputation in patients with diabetic foot ulcer. Secondly, single factor and multiple factor logistic regression analysis were employed to screen the independent influencing factors of amputation introducing the primary predictive factors selected from the univariate analysis. Thirdly, the independent influencing factors were applied to build a prediction model of amputation risk in patients with diabetic foot ulcer by using R4.3; then, the nomogram was established according to the selected variables visually. Finally, the performance of the prediction model was evaluated and verified by receiver working characteristic (ROC) curve, corrected calibration curve, and clinical decision curve. Results. 7 primary predictive factors were selected by univariate analysis from 21 variables, including the course of diabetes, peripheral angiopathy of diabetic (PAD), glycosylated hemoglobin A1c (HbA1c), white blood cells (WBC), albumin (ALB), blood uric acid (BUA), and fibrinogen (FIB); single factor logistic regression analysis showed that albumin was a protective factor for amputation in patients with diabetic foot ulcer, and the other six factors were risk factors. Multivariate logical regression analysis illustrated that only five factors (the course of diabetes, PAD, HbA1c, WBC, and FIB) were independent risk factors for amputation in patients with diabetic foot ulcer. According to the area under curve (AUC) of ROC was 0.876 and corrected calibration curve of the nomogram displayed good fitting ability, the model established by these 5 independent risk factors exhibited good ability to predict the risk of amputation. The decision analysis curve (DCA) indicated that the nomogram model was more practical and accurate when the risk threshold was between 6% and 91%. Conclusion. Our novel proposed nomogram showed that the course of diabetes, PAD, HbA1c, WBC, and FIB are the independent risk factors of amputation in patients with DFU. This prediction model was well developed and behaved a great accurate value for LEA so as to provide a useful tool for screening LEA risk and preventing DFU from developing into amputation.

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