scholarly journals Bacterial Diversity with Emerging Antimicrobial Resistance of Diabetic Foot Ulceration and Current Detection Techniques: A Review

2021 ◽  
Vol 18 (6) ◽  
pp. em323
Author(s):  
Ishrat Binte Aftab ◽  
Akash Ahmed ◽  
Sayeed Akhtar Alvi ◽  
Fahmina Akhtar
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Diversity ◽  
Diabetic Foot ◽  
Foot Ulceration ◽  
Detection Techniques ◽  
Current Detection

Bacterial Diversity, Antibiotic Resistance, and the Risk of Lower Limb Amputation in Younger and Older Individuals With Diabetic Foot Infection

2021 ◽  
pp. 153473462199229
Author(s):  
Stefan Dörr ◽  
Ann-Kathrin Holland-Letz ◽  
Gregor Weisser ◽  
Apostolos Chatzitomaris ◽  
Ralf Lobmann
Keyword(s):  
Bacterial Diversity ◽  
Diabetic Foot ◽  
Care Center ◽  
Bacterial Load ◽  
Limb Amputation ◽  
Older Individuals ◽  
Foot Care ◽  
Gram Positive ◽  
Gram Negative ◽  
Diabetic Foot Infection

Introduction A diabetic foot infection (DFI) contributes to high mortality and morbidity in diabetics due to its often rapid progressive and intricately treatable infection. DFIs are usually a polymicrobial infection and characterizing the entire bacterial load is still challenging. Prompt and effective treatment of DFI is nevertheless mandatory to safe limbs and lives. It is therefore crucial to know the local pathogen spectrum and its antibiotic susceptibility. Methods and Material For a 12-month period, we investigated 353 individuals with infected diabetic foot ulcer, their bacterial diversity, and antimicrobial susceptibility at fist-time visit in a Diabetic Foot Care Center in southern Germany. Results Cultures yielded 888 species, most of them gram-positive cocci (primary Staphylococcus aureus). The gram-negative sector was mainly formed by Pseudomonas aeruginosa and Enterobacteriacae. Because the prevalence of multiresistant species was surprisingly low (0.9% of isolated strains), we suggest penicillins with β-lactamase inhibitor in case of gram-positive–dominated infection or piperacillin/tazobactam or rather carbapenems with equal efficacy when gram-negative species are involved.

The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection

2021 ◽  
pp. 153473462110041
Author(s):  
Nese Saltoglu ◽  
Serkan Surme ◽  
Elif Ezirmik ◽  
Ayten Kadanali ◽  
Ahmet Furkan Kurt ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Antimicrobial Resistance ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Initial Treatment ◽  
Methicillin Resistance ◽  
Major Amputation ◽  
Diabetic Foot Infection ◽  
Vascular Insufficiency ◽  
Klebsiella Spp

We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 ± 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection ( p = .043) and vancomycin treatment ( p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency ( p = .004), hospital readmission ( p = .009), C-reactive protein > 130 mg/dL ( p = .007), and receiving carbapenems ( p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials.

scholarly journals Importance of Time Spent Standing for Those at Risk of Diabetic Foot Ulceration

Diabetes Care ◽  
2010 ◽  
Vol 33 (11) ◽  
pp. 2448-2450 ◽  
Author(s):  
B. Najafi ◽  
R. T. Crews ◽  
J. S. Wrobel
Keyword(s):  
At Risk ◽  
Diabetic Foot ◽  
Foot Ulceration

Increased forefoot to rearfoot plantar pressure ratio in South Indian patients with diabetic foot ulceration

2004 ◽  
Vol 21 (4) ◽  
pp. 396-397 ◽  
Author(s):  
V. Viswanathan ◽  
M. Sivagami ◽  
R. Seena ◽  
C. Snehalatha ◽  
A. Ramachandran ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Plantar Pressure ◽  
Pressure Ratio ◽  
Foot Ulceration ◽  
Indian Patients ◽  
South Indian

scholarly journals Diabetic Foot Care Plan

2000 ◽  
Vol 11 (suppl d) ◽  
pp. 15D-21D
Author(s):  
Gordon Dow ◽  
The Diabetic Foot Care Plan Working Group
Keyword(s):  
Diabetes Mellitus ◽  
Antibiotic Therapy ◽  
Diabetic Foot ◽  
Economic Loss ◽  
Care Plan ◽  
Foot Care ◽  
Foot Ulceration ◽  
General Management ◽  
Clinical Scenarios ◽  
Therapeutic Guidelines

Diabetes mellitus is the number one cause of limb loss in North America, and is associated with growing, unacceptable rates of morbidity, mortality and economic loss. Approximately 80% of these amputations are preceded by the development of foot ulceration. Various disciplines have studied the prevention and management of foot ulceration in those with diabetes. The present care plan was constructed to incorporate the important contributions from these disciplines into practical therapeutic guidelines. The care plan has been divided into three basic sections: assessment, general management and antibiotic therapy. Each of these sections is described in detail and borrows heavily from previous Canadian position papers. Application of the care plan is illustrated by multiple diabetic foot clinical scenarios, which have been categorized according to the Wagner classification.

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