Antibiotic resistance in diabetic foot infection: how it changed with COVID-19 pandemic in a tertiary care center

Caruso, Paola; Maiorino, Maria Ida; Macera, Margherita; Signoriello, Giuseppe; Castellano, L.; Scappaticcio, Lorenzo; Longo, Miriam; Gicchino, Maurizio; Campitiello, Ferdinando; Bellastella, Giuseppe; Coppola, Nicola; Esposito, Katherine

doi:10.1016/j.diabres.2021.108797

Cited by 36 publications

(32 citation statements)

References 32 publications

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“…29,30 Therefore, microbiological cultures need to be confirmed by radiological exams (X-ray or MRI). 31,32 However, X-ray signs for OM are often late, not specific, and appear when 40%-70% of the bone has already been resorbed. 18 On the other hand, MRI alterations can be detected earlier, but they do not distinguish between pathological bone marrow replacement or infiltration.…”

Section: Discussionmentioning

confidence: 99%

“…A bone biopsy is considered the gold standard for diagnosis, although it is not frequently performed based on the invasiveness of the procedure and the risk of false positive or negative results 29,30 . Therefore, microbiological cultures need to be confirmed by radiological exams (X‐ray or MRI) 31,32 . However, X‐ray signs for OM are often late, not specific, and appear when 40%–70% of the bone has already been resorbed 18 .…”

Section: Discussionmentioning

confidence: 99%

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Biochemical predictors of diabetic foot osteomyelitis: A potential diagnostic role for parathormone

Caruso

Maiorino

Scappaticcio

et al. 2022

Diabetes Metabolism Res

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Aims The aims of this study were to evaluate parathormone (PTH) levels in people with diabetic foot ulcers (DFU) and investigate the relationship between PTH levels and osteomyelitis (OM) in this population. Materials and Methods Eighty‐eight patients were admitted for DFU in a tertiary‐care centre from October 2021 to May 2022. OM was diagnosed by clinical, laboratory, and radiological evaluations. Laboratory measurements and clinical parameters were collected from medical records. Participants in the study were divided into two groups according to the diagnosis of OM (patients with OM, group 1 [n = 54] and patients without OM, group 2 [n = 34]). Results Compared with group 2, patients in group 1 were younger and had a longer duration of diabetes. Erythrocyte sedimentation rate and fibrinogen were significantly higher in group 1 compared with group 2. PTH levels were significantly lower (group 1 vs. group 2, median [interquartile range] 16.2 (11.6, 31.0) vs. 23.7 (17.0, 38.1), p = 0.008) and alkaline phosphatase was significantly higher (97.0 (79.0, 112.0) vs. 88.0 (63.0, 107.0), p = 0.031) in group 1. In multiple linear regression analysis, the only independent predictors of PTH concentrations were alkaline phosphatase levels (β‐coefficient 0.441, p < 0.001) and the presence of OM (β‐coefficient −0.290, p = 0.038). Conclusions In a population of patients with diabetes and OM admitted to a tertiary university centre, PTH levels were lower as compared with diabetic individuals without OM. The OM and alkaline phosphatase levels were independent predictors of PTH levels in this selected population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Biochemical predictors of diabetic foot osteomyelitis: A potential diagnostic role for parathormone

Caruso

Maiorino

Scappaticcio

et al. 2022

Diabetes Metabolism Res

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“…An individual's quality of life may be jeopardised if they undergo therapy that is excessively strenuous and leads to functional imbalance. This is the precarious balance that defines diabetes care for this population 16 . The strategy must be tailored to the resident's level of functioning.…”

Section: Frailtymentioning

confidence: 99%

Individualized Approaches to Diabetes Care in Nursing Homes

Majeed¹,

Sultana²,

Shakeel³

et al. 2022

PJMHS

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Although diabetes care has been widely established as a single entity, data in older, frail individuals with numerous comorbidities and have limited polymedication. This group accounts for a sizable number of nursing home residents (NHs). We came together as a group of experts with multidisciplinary (endocrinologists, geriatricians, Nurses staff, general practitioners and diabetologists) with real-world practice in this field, which is becoming more and more important globally, to compile practical, straightforward guidance on the managing of senior, fragile patients of diabetes. An Individual Care Plan (ICP), which is presented in layman's terms, is the cornerstone of a patient's diabetes treatment. This is due to the demands placed on personnel of NH (medical coordinator, manager, nurses, and caregiver working at the front lines, and the other caregiver worker which is under training). The actual purpose of this document, which is released when the patient is admitted, is to made prescriptions ensure that given at and followed after admission. It details the need for proper treatment, regular monitoring, and dates and times for essential examinations and testing. This entails keeping tabs on the patient's HbA1c, as well as their blood and urine glucose levels and any complications that may arise from the condition (hypoglycemia, cardiovascular disease, foot disorders, ocular problems, malnutrition, kidney failure and peripheral neuropathy). Consequentially, staff education on the unique challenges of care for an elderly person with diabetes, emergency procedures, and maintaining an up-to-date ICP for use by medical professionals is essential. Keywords: Diabetes care, nursing home, staff nurses

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“…The ineffective use of antibiotics will hinder wound healing in patients with diabetic foot infections, and increase the length of stay in hospitals as well as hospital costs. Therefore, timely identification of bacteria and drug resistance is the key in the appropriate treatment of diabetic foot infections (Caruso et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

MALDI-TOF MS Based Bacterial Antibiotics Resistance Finger Print for Diabetic Pedopathy

Sun

Lai

et al. 2022

Front. Chem.

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Diabetes mellitus has become a major global health issue. Currently, the use of antibiotics remains the best foundational strategy in the control of diabetic foot infections. However, the lack of accurate identification of pathogens and the empirical use of antibiotics at early stages of infection represents a non-targeted treatment approach with a poor curative effect that may increase the of bacterial drug resistance. Therefore, the timely identification of drug resistant bacteria is the key to increasing the efficacy of treatments for diabetic foot infections. The traditional identification method is based on bacterial morphology, cell physiology, and biochemistry. Despite the simplicity and low costs associated with this method, it is time-consuming and has limited clinical value, which delays early diagnosis and treatment. In the recent years, MALDI-TOF MS has emerged as a promising new technology in the field of clinical microbial identification. In this study, we developed a strategy for the identification of drug resistance in the diagnosis of diabetic foot infections using a combination of macro-proteomics and MALDI MS analysis. The macro-proteomics result was utilized to determine the differential proteins in the resistance group and the corresponding peptide fragments were used as the finger print in a MALDI MS analysis. This strategy was successfully used in the research of drug resistance in patients with diabetic foot infections and achieved several biomarkers that could be used as a finger print for 4 different drugs, including ceftazidime, piperacillin, levofloxacin, and tetracycline. This method can quickly confirm the drug resistance of clinical diabetic foot infections, which can help aid in the early treatment of patients.

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Antibiotic resistance in diabetic foot infection: how it changed with COVID-19 pandemic in a tertiary care center

Cited by 36 publications

References 32 publications

Biochemical predictors of diabetic foot osteomyelitis: A potential diagnostic role for parathormone

Biochemical predictors of diabetic foot osteomyelitis: A potential diagnostic role for parathormone

Individualized Approaches to Diabetes Care in Nursing Homes

MALDI-TOF MS Based Bacterial Antibiotics Resistance Finger Print for Diabetic Pedopathy

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