scholarly journals Different Patterns of Bacterial Species and Antibiotic Susceptibility in Diabetic Foot Syndrome with and without Coexistent Ischemia

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Rafał Małecki ◽  
Kamil Klimas ◽  
Aleksandra Kujawa
Keyword(s):  
Diabetic Foot ◽  
Bacterial Species ◽  
Treatment Success ◽  
Hospitalized Patients ◽  
Diabetic Foot Syndrome ◽  
Diabetic Patients ◽  
Beta Lactamase ◽  
Bacterial Strains ◽  
Culture Methods ◽  
The Impact

Aims. Infection in diabetic foot syndrome (DFS) represents serious medical problem, and the annual risk of DFS in diabetic patients is 2.5%. More than half of the patients with DFS have symptoms of extremity ischemia (peripheral arterial disease (PAD)). The aim of the present study was to analyze the frequency of particular bacterial strains in people with DFS, analyze the impact of arterial ischemia on the occurrence of a given pathogen, and evaluate the antibacterial treatment based on the results of bacterial culture. Methods. The analysis included 844 bacterial strains obtained from 291 patients with DFS hospitalized in the Department of Angiology in years 2016–2019. Results. The most common isolates were Staphylococcus aureus, Enterococcus faecalis, Enterobacter cloacae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Nearly 20% of the species were found to have at least one resistance mechanism. In patients with PAD, Gram-negative species were isolated more commonly than in people without PAD. The most useful drugs in DFS in hospitalized patients are penicillins with beta-lactamase inhibitors, 3rd- to 5th-generation cephalosporins (with many exceptions), carbapenems, aminoglycosides, and tigecycline. Conclusions. Bacterial strains isolated from ischemic DFS are more resistant to commonly used antibacterial agents, i.e., penicillins (including penicillins with beta-lactamase inhibitors), cephalosporins (except for the 4th and 5th generations), glycopeptides, and linezolid. When planning treatment of hospitalized patients with DFS, the presence of ischemia in DFS should always be taken into consideration. It determines the occurrence of particular bacterial species and the choice of antibacterial agent and may determine the rate of treatment success.

scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

Pro- and Anti-Angiogenic Factors: Their Relevance in Diabetic Foot Syndrome—A Review

Angiology ◽  
2021 ◽  
pp. 000331972110426
Author(s):  
Martyna Schönborn ◽  
Patrycja Łączak ◽  
Paweł Pasieka ◽  
Sebastian Borys ◽  
Anna Płotek ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Arterial Disease ◽  
Angiogenic Factors ◽  
Diabetic Foot Syndrome ◽  
Tissue Loss ◽  
Comprehensive Treatment ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Peripheral Arterial

Peripheral arterial disease can involve tissue loss in up to 50% of patients with diabetic foot syndrome (DFS). Consequently, revascularization of narrowed or occluded arteries is one of the most common forms of comprehensive treatment. However, technically successful angioplasty does not always result in the healing of ulcers. The pathomechanism of this phenomenon is still not fully understood, but inadequate angiogenesis in tissue repair may play an essential role. Changes in pro- and anti-angiogenic factors among patients with DFS are not always clear and conclusive. In particular, some studies underline the role of decreased concentration of pro-angiogenic factors and higher levels of anti-angiogenic mediators. Nevertheless, there are still controversial issues, including the paradox of impaired wound healing despite high concentrations of some pro-angiogenic factors, dynamics of their expression during the healing process, and their mutual relationships. Exploring this process among diabetic patients may provide new insight into well-known methods of treatment and show their real benefits and chances for improving outcomes.

scholarly journals Pedographic assessment of the impact of off-the-shelf orthopedic shoes on the load distribution under the feet in patients with a high risk of developing diabetic foot syndrome

2021 ◽  
Vol 23 (5) ◽  
pp. 442-451
Author(s):  
Vadim B. Bregovskiy ◽  
Oleg V. Udovichenko ◽  
Anastasia G. Demina ◽  
Eugenia Aleksandrovna Berseneva ◽  
Irina A. Karpova
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
Load Distribution ◽  
Objective Assessment ◽  
Daily Basis ◽  
Diabetic Foot Syndrome ◽  
Lateral Part ◽  
Plantar Surface ◽  
The Impact ◽  
Orthopedic Shoes

BACKGROUND: It is known that the so-called “rocker” outsole helps to reduce the load on the forefoot and toes. Such an outsole is available in ready-made orthopedic shoes of some Russian manufacturers, however, an objective assessment of their impact on the load distribution under the foot during walking has not been carried out.AIMS: To study the pressure distribution inside the off-the-shelf orthopedic shoes“Sursil-Ortho” in comparison with the load inside the shoes used by patients on a daily basis.METHODS: We studied 20 patients (40 feet) with a high risk of diabetic foot syndrome. According to clinical data, a risk regions were determined on the plantar surface of the feet. In-shoe pedography (pedar, novel,Germany) was performed in shoes usually worn by the patients, and in orthopedic shoes“Sursil-Orto”(Moscow). The maximum peak pressure (MPP) was calculated. Criterion of efficiency: MPP in the risk region<200 kPa or reducing it by 25% or more.RESULTS: There was a significant decrease of the median MPP in the forefoot and in the risk region. The percentage of feet with MPP >200 kPa in the risk region decreased from 58% to 30% (p=0,014), in any area of the forefoot — from 63% to 30% (p=0,04). The increase in MPP under the midfoot and hindfoot did not exceed +14% (ns). Tested footwear was effective in 71% of cases. Predictors of the insufficient effect were: higher initial MPP in the risk region, risk region on the hallux or in the lateral part of the forefoot.CONCLUSIONS: Shoes with a rigid rocker outsole significantly reduce the pressure under the forefoot and under the toes during walking. The degree of load reduction varies: the lateral part of the forefoot and 2-5 toes are most unloaded, and the hallux and medial forefoot are slightly less.

scholarly journals Understanding the relationship between depression and diabetic foot ulcers

2016 ◽  
Vol 04 (01) ◽  
pp. 017-024 ◽  
Author(s):  
Andrew Steel ◽  
John Reece ◽  
Anne-Marie Daw
Keyword(s):  
Depressive Symptoms ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Biological Relationship ◽  
The Cost ◽  
The Impact ◽  
Concept Review ◽  
The Relationship

AbstractThe prevalence of diabetes is increasing, as is the cost of managing its comorbidities. Diabetic foot ulcers (DFUs) and their complications place a considerable cost burden on the health system, and lead to a significant level of disability. The relationship between depression and diabetes is well-established. The relationship between depression and foot ulcers in diabetic patients is less well-established. The purpose of this article is to provide a current concept review of the literature from 1988 to 2013, linking DFUs and depressive symptoms, with an emphasis on the impact depressive symptoms have on healing rates of DFUs. Articles specifically focusing on the biological relationship, depression′s impact on self-care, screening for depressive symptoms, causes and cost of treating DFUs, and measuring depression were reviewed. A deeper understanding of this relationship is needed to identify causal relationships, improve treatment outcomes, and reduce healing times of DFUs.

scholarly journals FGF23 and Klotho Levels are Independently Associated with Diabetic Foot Syndrome in Type 2 Diabetes Mellitus

2019 ◽  
Vol 8 (4) ◽  
pp. 448 ◽  
Author(s):  
Javier Donate-Correa ◽  
Ernesto Martín-Núñez ◽  
Carla Ferri ◽  
Carolina Hernández-Carballo ◽  
Víctor Tagua ◽  
...  
Keyword(s):  
Gene Expression ◽  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
Limb Amputation ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Inverse Association ◽  
Expression Levels ◽  
Cadaveric Organ ◽  
Gene Expression Levels

Background: Diabetic foot syndrome (DFS) is a prevalent complication in the diabetic population and a major cause of hospitalizations. Diverse clinical studies have related alterations in the system formed by fibroblast growth factor (FGF)-23 and Klotho (KL) with vascular damage. In this proof-of-concept study, we hypothesize that the levels of FGF23 and Klotho are altered in DFS patients. Methods: Twenty patients with limb amputation due to DFS, 37 diabetic patients without DFS, and 12 non-diabetic cadaveric organ donors were included in the study. Serum FGF23/Klotho and inflammatory markers were measured by enzyme-linked immunosorbent assay (ELISA). Protein and gene expression levels in the vascular samples were determined by immunohistochemistry and quantitative real-time PCR, respectively. Results: Serum Klotho is significantly reduced and FGF23 is significantly increased in patients with DFS (p < 0.01). Vascular immunoreactivity and gene expression levels for Klotho were decreased in patients with DFS (p < 0.01). Soluble Klotho was inversely related to serum C-reactive protein (r = −0.30, p < 0.05). Vascular immunoreactivities for Klotho and IL6 showed an inverse association (r = −0.29, p < 0.04). Similarly, vascular gene expression of KL and IL6 were inversely associated (r = −0.31, p < 0.05). Logistic regression analysis showed that higher Klotho serum concentrations and vascular gene expression levels were related to a lower risk of DFS, while higher serum FGF23 was associated with a higher risk for this complication. Conclusion: FGF23/Klotho system is associated with DFS, pointing to a new pathophysiological pathway involved in the development and progression of this complication.

The impact of Syme amputation in surgical treatment of patients with diabetic foot syndrome and Charcot-neuro-osteoarthropathy

2004 ◽  
Vol 124 (3) ◽  
pp. 145-150 ◽  
Author(s):  
A. Eckardt ◽  
C. Sch�llner ◽  
J. Decking ◽  
S. Ritter ◽  
S. Schadmand-Fischer ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
The Impact ◽  
Syme Amputation

Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections

2014 ◽  
Vol 63 (10) ◽  
pp. 1377-1385 ◽  
Author(s):  
Thokur S. Murali ◽  
Shettigar Kavitha ◽  
Jain Spoorthi ◽  
Deepika V. Bhat ◽  
Alevoor S. Bharath Prasad ◽  
...  
Keyword(s):  
Immune Response ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Diabetic Patients ◽  
Bacterial Strains ◽  
Microbial Drug Resistance

While virulence factors and the biofilm-forming capabilities of microbes are the key regulators of the wound healing process, the host immune response may also contribute in the events following wound closure or exacerbation of non-closure. We examined samples from diabetic and non-diabetic foot ulcers/wounds for microbial association and tested the microbes for their antibiotic susceptibility and ability to produce biofilms. A total of 1074 bacterial strains were obtained with staphylococci, Pseudomonas, Citrobacter and enterococci as major colonizers in diabetic samples. Though non-diabetic samples had a similar assemblage, the frequency of occurrence of different groups of bacteria was different. Gram-negative bacteria were found to be more prevalent in the diabetic wound environment while Gram-positive bacteria were predominant in non-diabetic ulcers. A higher frequency of monomicrobial infection was observed in samples from non-diabetic individuals when compared to samples from diabetic patients. The prevalence of different groups of bacteria varied when the samples were stratified according to age and sex of the individuals. Several multidrug-resistant strains were observed among the samples tested and most of these strains produced moderate to high levels of biofilms. The weakened immune response in diabetic individuals and synergism among pathogenic micro-organisms may be the critical factors that determine the delicate balance of the wound healing process.

scholarly journals The analysis for time of referral to a medical center among patients with diabetic foot infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Cheng-Wei Lin ◽  
Hui-Mei Yang ◽  
Shih-Yuan Hung ◽  
I-Wen Chen ◽  
Yu-Yao Huang
Keyword(s):  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Poor Prognosis ◽  
Medical Center ◽  
Comprehensive Treatment ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Diabetic Foot Infection ◽  
The Impact

Abstract Background Diabetic foot infection (DFI) is a limb- and life-threatening complication for diabetic patients needing immediate and comprehensive treatment. Early referral of DFI patients to a diabetic foot center is recommended but there appears limited validated evidence, with the association between referral time and clinical outcomes of limb- preservation or in-hospital mortality still lacking. Methods This retrospective research studied consecutive type 2 diabetic patients with DFI treated at the major diabetic foot center in Taiwan from 2014 to 2017. Six hundred and sixty-eight patients presented with limb-threatening DFI. After stratifying their referral days into quartiles, the demographic information and clinical outcomes were analyzed. Results One hundred and seventy-two patients were placed in the first quartile (Q1) with less than 9 days of referral time; 164 in the second quartile (Q2) with 9-21 days; 167 in the third quartile (Q3) with 21-59 days; and 165 in the fourth quartile (Q4) with >59 days. End-stage renal disease (ESRD), major adverse cardiac events (MACE) and peripheral arterial disease (PAD) were noted as being higher in the Q4 group compared with the Q1 group (25.45% vs 20.35% in ESRD, 47.27% vs 26.16% in MACE and 78.79% vs 52.33% in PAD respectively). The Q1 group had more patients presenting with systemic inflammatory responsive syndrome (SIRS) (29.07% in Q1 vs 25.45% in Q4 respectively, P=0.019). Regarding poor outcome (major lower-extremity amputation (LEA) or in-hospital mortality), the Q4 group had 21.21% of patients in this category and the Q1 group had 10.47%. The odds ratio of each increased referral day on poor prognosis was 1.006 with 95% confidence interval 1.003–1.010 (P=<0.001). In subgroups, the impact on poor prognosis by day was most obvious in patients with SIRS (OR 1.011, 95% CI 1.004–1.018, P=0.003) and those with PAD (OR 1.004, 95% CI 1.001–1.008, P=0.028). Conclusions The deferred referral of DFI patients to the diabetic foot center might be associated with poor treatment outcome either in major LEA or mortality, particularly in patients with SIRS or PAD. Both physician and patient awareness of disease severity and overcoming the referral barrier is suggested. Trial registration Not applicable.

scholarly journals Study the antibiotics sensitivity and beta- lactamase productivity of some Staphylococcus spp. Isolates from different sources of the Al Jamhoree Teaching Hospital in Mosul City

2019 ◽  
Vol 24 (7) ◽  
pp. 27
Author(s):  
Ayman Mohammed Khaleel1 ◽  
Adeeba Younis Shareef ◽  
, Shakeeba Younis Shareef
Keyword(s):  
Staphylococcus Aureus ◽  
Teaching Hospital ◽  
Clinical Laboratory ◽  
Bacterial Species ◽  
Age Groups ◽  
National Committee ◽  
Beta Lactamase ◽  
Bacterial Isolates ◽  
Bacterial Strains ◽  
Staphylococcus Spp

The study includes the isolation of certain types of Gram-positive bacteria Staphylococcus spp..The sample materials (blood, wounds, burns) were collected from both genders of all age groups of inpatients in Al Jamhoree Teaching Hospital in the Mosul during June till end of November 2018. Staphylococcus aureus was the most common among the isolates with 7 isolates(38.9%) followed by Staphylococcus epidermidis, Staphylococcus scriuri Staphylococcus lentus (Staphylococcus simulans) with 2 isolates each with 11.1% followed by Staphylococcus chromogenase, Staphylococcu scapilis and  Staphylococcus xylosus with one isolate for each one 5.5%. The number of isolates was 9 isolates and 50%, followed by wound samples. The isolates were 6 isolated by 33% and the samples of burns were 3 isolates. 17% were isolated and Staphylococcus aureus was the most dominant species. The sensitivity of bacterial isolates was  studied for 15 antibiotics for different antibiotic groups. The results showed that a difference in the resistance ratio of the isolates to these antagonists, as they were resistant to the Ceftrixone, Cloxacillin 100%. The Ciprofloxacillin, Gentamycin, Pipracillin, and Amikacin resistance were  reduced. The Ciprofloxacillin antagonist was the most affected on the bacterial isolates studied, followed by the Rifampin. The results showed that the beta-lactamase enzyme was not produced by any of the Iodic methods by 4 bacterial strains, while the rest of the species varied in the susceptibility of production to the enzyme. The Iodine tube is one of the best methods to detect the production of these enzymes. The susceptibility of bacterial species to the production of large-spectrum beta-lactase enzymes was also tested using the National Committee for Clinical Laboratory Standards (NCCL) and the double-disc method. Staphylococcus lentus, Staphylococcus capilis, Staphylococcus chromanogenes The first NCCL has shown a single isolation of Staphylococcus capilis ability to produce it.   http://dx.doi.org/10.25130/tjps.24.2019.125

Sign in / Sign up

Export Citation Format

Share Document