scholarly journals Intracardiac Abscess and Pacemaker Lead Infection Secondary to Hematogenous Dissemination of Methicillin-Sensitive Staphylococcus Aureus from a Prior Diabetic Foot Ulcer and Osteomyelitis

2018 ◽  
Vol 19 ◽  
pp. 224-228 ◽  
Author(s):  
Kristopher S. Pfirman ◽  
Robel Haile
2017 ◽  
Vol 16 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Wen-xia Wu ◽  
Dan Liu ◽  
Yi-wen Wang ◽  
Chuan Wang ◽  
Chuan Yang ◽  
...  

Diabetic foot and subsequent diabetic ulcer infections are the most devastating complication of diabetes. This study was conducted to explore the bacterial spectrum, sensitivity of microbials, and analysis of the empirical antibiotic regimens in our health center. The study included patients with diabetic foot ulcer infection (DFI) seen from 2009 to 2014. The patients included had all information covering the physical examination, laboratory tests, and image examinations. We sent appropriately obtained specimens for culture prior to starting empirical antibiotic therapy in all participants. A total of 312 patients were included: 52, 112, 95 and 53 patients within uninfected, mild, moderate, and severe infection groups. The total percentages of Gram-positive cocci (GPCs) and Gram-negative rods (GNRs) were 54% and 48.8% ( P = 0.63). The most common GPC was Staphylococcus aureus (22.4%) and GNR was Pseudomonas aeruginosa (11.9%). Methicillin-resistant Staphylococcus aureus was isolated from 21 patients (6.7%). Even in the mild infection group, there was no significant difference between GPC and GNR infection, irrespective of recent antibiotic use ( P = 0.053). The most frequently used empirical antibiotics in our center were second-/third-generation cephalosporin ± clindamycin, both in the mild and moderate/severe infection groups. In our center, the amoxicillin/clavulanate or ampicillin/sulbactam (β-L-ase 1) and second-/third-generation cephalosporins were highly resistant to the common GNR (30%-60%). The ticarcillin/clavulanate, piperacillin/tazuobactam (β-L-ase 2), fluoroquinolone, and group 2 carbapenem had good sensitivity. This study presents a comprehensive microbiological survey of diabetic foot ulcers in inpatients and provides reliable evidence of the local microbial epidemiology and sensitivity of antibiotics, which may help us improve clinical outcomes in DFI patients.


2019 ◽  
Vol 10 (1) ◽  
pp. 50-55
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening diabetic infections are usually polymicrobial involving multiple aerobic and anaerobic organisms. Methodology: The present study was a cross sectional study, conducted in the department of surgery and microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September' 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is 'any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus'. Results: Majority 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillin-clavulanic acid, amikacin, piperacillin-tazobactam. In Coagulasenegative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem. Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Escherichia coli and Citrobacter spp. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 50-55


2016 ◽  
Vol 214 (10) ◽  
pp. 1605-1608 ◽  
Author(s):  
Jean-Philippe Rasigade ◽  
Catherine Dunyach-Rémy ◽  
Anaïs Sapin ◽  
Nourredine Messad ◽  
Sophie Trouillet-Assant ◽  
...  

2020 ◽  
Vol 7 (8) ◽  
pp. 2512
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian ◽  
Sudha Selvam

Background: Diabetic foot ulcer is one of the major surgical problem leading to hospital admission. Diabetic foot ulcer patients with uncontrolled diabetes may end up in forefoot amputation. Early aggressive debridement, control of blood sugar and empirical antibiotic therapy would reduce the morbidities in patients with diabetic foot ulcer. Further the knowledge of commonly isolated microbes and their antibiotic sensitivity pattern would be helpful to start empirical therapy. The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents.Methods: This cross-sectional study was conducted in 115 patients admitted with diabetic foot ulcer over a period of 9 months from October 2015 to June 2016 at the department of general surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Tissue scrapping samples were collected and processed as per standard guidelines.Results: 167 organisms were isolated from 115 patients. 52% of culture showed polymicrobial growth. There was increased prevalence of gram-negative organisms 53% compared to gram positive organisms 47%. When comes to individual isolate, Staphylococcus aureus was the most common organism isolated 24.6% followed by Pseudomonas aeruginosa 21%. All gram-positive aerobes were sensitive to vancomycin and gram-negative isolates were sensitive to amikacin, piperacillin-tazobactum, gentamycin and cefotaxime.Conclusions: Staphylococcus aureus and Pseudomonas were the common pathogens isolated. This study recommends use of vancomycin along with piperacillin-tazobactum as an empirical therapy along with adequate blood sugar control and early debridement of devitalized tissues in patients with diabetic foot infections.


2018 ◽  
Vol 108 (6) ◽  
pp. 528-531 ◽  
Author(s):  
Andrew J. Hale ◽  
Emily Vicks ◽  
Mary T. LaSalvia ◽  
John M. Giurini ◽  
Adolf W. Karchmer

Diabetic foot infections are a common cause of morbidity and mortality in the United States, and successful treatment often requires an aggressive and prolonged approach. Recent work has elucidated the importance of appropriate therapy for a given severity of diabetic foot infection, and highlighted the ongoing risk such patients have for subsequent invasive life-threatening infection should diabetic foot ulcers fail to heal. The authors describe the case of a man with diabetes who had prolonged, delayed healing of a diabetic foot ulcer. The ulcer subsequently became infected by methicillin-resistant Staphylococcus aureus (MRSA). The infection was treated conservatively with oral therapy and minimal debridement. Several months later, he experienced MRSA bloodstream infection and complicating endocarditis. The case highlights the ongoing risk faced by patients when diabetic foot ulcers do not heal promptly, and emphasizes the need for aggressive therapy to promote rapid healing and eradication of MRSA.


2018 ◽  
Vol 8 (3) ◽  
pp. 251-256
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening infection in diabetic patients are usually polymicrobial involving both multiple aerobic and anaerobic organisms.Methods: The present study was a cross sectional study, conducted in the Department of Surgery and Microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September’ 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is ‘any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus’.Results: 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillinclavulanic acid, amikacin, piperacillin-tazobactam. In Coagulase-negative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem.Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Citrobacter spp.Birdem Med J 2018; 8(3): 251-256


2019 ◽  
Vol 18 (3) ◽  
pp. 269-278 ◽  
Author(s):  
José Luis Lázaro-Martínez ◽  
Francisco Javier Álvaro-Afonso ◽  
David Sevillano-Fernández ◽  
Raúl Juan Molines-Barroso ◽  
Yolanda García-Álvarez ◽  
...  

The use of an antimicrobial dressing instead of a non-antimicrobial dressing may increase the number of diabetic foot ulcers healed over a medium-term follow-up period. The study aim was to evaluate the clinical and microbiological efficacy of a silver foam dressing in the management of diabetic foot ulcers. We conducted a single-center, prospective, open, noncontrolled study involving 21 outpatients with diabetic foot ulcers with mild infection. All patients received standard of care for their wounds and a silver foam dressing with silicone adhesive was applied twice per week for wound management during a 6-week treatment period. Soft tissue punch biopsies were taken every second week for qualitative and quantitative microbiological analysis. Wounds were assessed at patient admission, and wound bed tissue was evaluated for presence, quality, and consistency of granulation tissue. Clinical evaluation revealed improvements in wound conditions as a result of treatment with the silver dressing. Wollina wound scores improved significantly, from a mean score of 3.9 ± 1.6 points at inclusion to 6.1 ± 1.3 points at the end of the study (n = 19, P < .001). Treatment with the silver dressing resulted in significant decreases in the bioburden of classically considered diabetic foot ulcer pathogenic organisms such as Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus, Enterobacteriaceae species, Pseudomonas aeruginosa, and other nonfermenting gram-negative bacilli. Findings revealed that the use of silver foam dressing significantly reduced the pathogenic bacterial load and markedly improved the clinical outcome in patients with diabetic foot ulcer with mild infection over a 6-week treatment period.


Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Afshan Zia

Objectives: To identify the common bacterial pathogens responsible for infection in diabetic foot ulcer and their sensitivity pattern to different antibiotics. Methods: This prospective observational study was conducted from 24th June 2019 to 27th December 2019 at Services Institute of Medical Sciences Lahore. Specimens of discharge from diabetic foot ulcers (DFU) were received from Diabetes Management Centre (DMC). Cultures were put up and bacteria isolated were identified by standard methods. Antibiotic sensitivity was determined by Kirby-Bauer disc diffusion method. Results: Samples from DFU of 50 patients were processed. Thirty-six (72%) samples were from males and 14(28%) were from females; mean age of patients was 53±9.5 years. Forty-nine (98%) patients had unsatisfactory glycemic control. Forty three (86%) samples were growth positive while 07(14%) were bacteriologically sterile. Monomicrobial infection was observed in 38 (76%) cases while polymicrobial infection was seen in 12 cases (24%). The most common isolates were Staphylococcus aureus 14(28%), Pseudomonas species 11 (22%) and Proteus species 10 (20%). Forty three percent of Staphylococcus aureus, were methicillin resistant (MRSA). All MRSA remained sensitive to vancomycin and linezolid. In Pseudomonas species, resistance to third generation cephalosporins, ceftazidime , was 27%, while resistance to imipenem was seen in 3 (9%) of isolates. In Proteus species, resistance to third generation cephalosporins was 90% while to imipenem resistance was 60%. Resistance to commonly prescribed quinolones was more than 70% among all the bacterial isolates. Conclusions: Common Gram positive and Gram negative organisms responsible for infection in DFU were Staphylococcus aureus, Pseudomonas species and Proteus species. The isolates were multi-drug resistant (MDR). Resistance to antibiotics used as empiric therapy was high. Keywords: Diabetic foot ulcer, antibiotic resistance, empiric therapy


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