A Microbiological Study of Diabetic Foot Lesions

Jones, E W; Edwards, Rebecca; Finch, Roger; Jeffcoate, William

doi:10.1111/j.1464-5491.1985.tb00640.x

Cited by 48 publications

(14 citation statements)

References 10 publications

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“…Severe and moderate DFIs are usually polymicrobial in nature, whereas mild DFI are mostly monomicrobial [2,4,[9][10][11]. In our study, 20.2% of the patients had mild infection.…”

Section: Discussionmentioning

confidence: 86%

“…First culture results were monomicrobial in 78% of cases with mild DFI, while they were polymicrobial in 73% of cases with moderate to severe infections. Studies from western countries show that Gram-positive aerobes are the predominant organisms isolated from DFI [4][5][6][7][8][9][10][11]. In contrast, two recent Indian studies have shown a preponderance of Gram-negative aerobes.…”

Section: Discussionmentioning

confidence: 99%

“…Therapy directed at known causative organisms can significantly improve the outcome and reduce infection-related morbidities. Reports from western countries have found that Staphylococcus aureus and β-haemolytic streptococci are the main causative pathogens [4][5][6][7][8][9][10][11]. In India, the choice of empirical antimicrobials is extrapolated from data available from western countries, which may or may not be appropriate for Indian patients [7][8][9]12].…”

Section: Introductionmentioning

confidence: 99%

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Changing microbiological profile of pathogenic bacteria in diabetic foot infections: time for a rethink on which empirical therapy to choose?

et al. 2010

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Aims/hypothesis We studied the bacterial aetiology and antibiotic sensitivity pattern of diabetic foot ulcers in India. Methods Records of 447 hospitalised patients between 1991 and 2008 were retrospectively analysed between two time periods (before and after 1999) to compare bacterial aetiology and antimicrobial sensitivity patterns. The first three consecutive cultures from the same wound during treatment were evaluated. Results Of 1,632 cultures, 66% were polymicrobial, 23% monomicrobial and 11% sterile. In the monomicrobial group, 14% (n=228) of cultures were Gram-negative, whereas 9% (n=147) were Gram-positive. The most common pathogens in the first culture were Pseudomonas aeruginosa (20.1%), Staphylococcus aureus (17.2%) and Escherichia coli (16.3%). Results for the third cultures showed persistence of P. aeruginosa (15.3%) and E. coli (14.2%). Gramnegative isolates dominated over Gram-positive ones (25.3% vs 15.1%, p<0.05). Antibiotic sensitivity patterns before and after 1999 were: piperacillin-tazobactam 74% vs 66% (p<0.005), imipenem 77% vs 85% (NS), cefoperazone-sulbactam 47% vs 44% (p<0.005), amikacin 62% vs 78% (NS), ceftriaxone 41% vs 36% (p<0.005), amoxicillinclavulanate 51% vs 43% (p<0.05) and clindamycin 43% vs 36% (p<0.005), respectively.

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“…Severe and moderate DFIs are usually polymicrobial in nature, whereas mild DFI are mostly monomicrobial [2,4,[9][10][11]. In our study, 20.2% of the patients had mild infection.…”

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changing microbiological profile of pathogenic bacteria in diabetic foot infections: time for a rethink on which empirical therapy to choose?

et al. 2010

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“…Often in association with lack of sensation, stiffened arteries, compromised host immune response, and recurrence of ulcers especially harbored by multidrug-resistant organisms places diabetic foot patients at higher risk of non-healing ulcers. Earlier studies have shown that most diabetic foot infections are polymicrobial with a predominance of Gram-positive cocci especially S. aureus , and Streptococci (Sapico et al, 1984; Jones et al, 1985). However, recent studies indicate the dominance of Gram-negative pathogens in the monomicrobial state, particularly members of family Enterobacteriace and Pseudomonas (Tiwari et al, 2011; Turhan et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Culture-Based Screening of Aerobic Microbiome in Diabetic Foot Subjects and Developing Non-healing Ulcers

et al. 2016

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The study was carried on diabetic foot patients to deduce clinical attributes, the occurrence of the range of aerobic microbial flora and to assess their comparative in vitro susceptibility to the customarily used antimicrobials. We also studied the potential risk factors involved in the development of non-healing ulcers. A total of 87 organisms were isolated from 70 specimens, including Escherichia coli (19.5%) among the Gram-negative and Staphylococcus aureus (18.4%) among the Gram-positive as the predominant aerobes explored. Pseudomonas aeruginosa and E. coli were predominant isolates of non-healing ulcers. The antimicrobial sensitivity pattern revealed that vancomycin (100%) and amikacin (90.4%) exhibited highest sensitivity to Gram-positive cocci, while all strains of P. aeruginosa were sensitive toward imipenem (100%). The prevalent uncontrolled glycemic status, altered lipid spectra, the existence of neuropathy, and peripheral vascular disease, suggested predisposition toward the development of non-healing lesions. The study has underlined the need for continuous surveillance of bacteria and their antimicrobial sensitivity blueprints to provide the basis for empirical therapy and to minimize the risk of complications. Further, stringent clinical evaluation, and medical history will help in revealing the risk of developing non-healing status in diabetic foot ulcers.

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“…Aerobic Streptococci may be isolated in one‐third of cases and usually are found in a polymicrobial infection. Non‐limb‐threatening infections average about 2.1 microbial species per ulcer; however, many are monomicrobial 22–24 …”

Section: Microbiologymentioning

confidence: 99%