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BackgroundDiabetic foot infection represents a significant complication of diabetes mellitus, contributing substantially to morbidity, mortality, and healthcare expenditure worldwide. Accurate diagnosis relies on a comprehensive assessment integrating clinical evaluation, imaging studies, and microbiological analysis. Management necessitates a multidisciplinary approach, encompassing surgical intervention, antimicrobial therapy, and advanced wound care strategies. Preventive measures are paramount in reducing the incidence and severity, emphasizing patient education, regular foot screenings, and early intervention.MethodsThe researchers performed a systematic review of literature using PUBMED MESH keywords. Additionally, the study was registered in the International Prospective Register of Systematic Reviews at the Center for Reviews and Dissemination, University of York (CRD42021277788). This review provides a comprehensive overview of the microbial spectrum and antibiotic susceptibility patterns observed in diabetic foot infections.ResultsThe search through the databases finally identified 13 articles with 2545 patients from 2021 to 2023. Overall, the predominant Gram-positive microbial species isolated were Staphylococcus aureus, Enterococcus fecalis, Streptococcus pyogenes, Streptococcus agalactiae, and Staphylococcus epidermidis. Whereas the predominant Gram-negative included Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa.ConclusionDiabetic foot infections represent a complex and multifaceted clinical entity, necessitating a holistic approach to diagnosis, management, and prevention. Limited high-quality research data on outcomes and the effectiveness of guideline recommendations pose challenges in updating and refining existing DFI management guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021277788, identifier CRD42021277788.
BackgroundDiabetic foot infection represents a significant complication of diabetes mellitus, contributing substantially to morbidity, mortality, and healthcare expenditure worldwide. Accurate diagnosis relies on a comprehensive assessment integrating clinical evaluation, imaging studies, and microbiological analysis. Management necessitates a multidisciplinary approach, encompassing surgical intervention, antimicrobial therapy, and advanced wound care strategies. Preventive measures are paramount in reducing the incidence and severity, emphasizing patient education, regular foot screenings, and early intervention.MethodsThe researchers performed a systematic review of literature using PUBMED MESH keywords. Additionally, the study was registered in the International Prospective Register of Systematic Reviews at the Center for Reviews and Dissemination, University of York (CRD42021277788). This review provides a comprehensive overview of the microbial spectrum and antibiotic susceptibility patterns observed in diabetic foot infections.ResultsThe search through the databases finally identified 13 articles with 2545 patients from 2021 to 2023. Overall, the predominant Gram-positive microbial species isolated were Staphylococcus aureus, Enterococcus fecalis, Streptococcus pyogenes, Streptococcus agalactiae, and Staphylococcus epidermidis. Whereas the predominant Gram-negative included Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa.ConclusionDiabetic foot infections represent a complex and multifaceted clinical entity, necessitating a holistic approach to diagnosis, management, and prevention. Limited high-quality research data on outcomes and the effectiveness of guideline recommendations pose challenges in updating and refining existing DFI management guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021277788, identifier CRD42021277788.
Wound infection is one of the most important factors affecting wound healing, so its effective control is critical to promote the process of wound healing. However, with the increasing prevalence of multi-drug-resistant (MDR) bacterial strains, the prevention and treatment of wound infections are now more challenging, imposing heavy medical and financial burdens on patients. Furthermore, the diminishing effectiveness of conventional antimicrobials and the declining research on new antibiotics necessitate the urgent exploration of alternative treatments for wound infections. Recently, phage therapy has been revitalized as a promising strategy to address the challenges posed by bacterial infections in the era of antibiotic resistance. The use of phage therapy in treating infectious diseases has demonstrated positive results. This review provides an overview of the mechanisms, characteristics, and delivery methods of phage therapy for combating pathogenic bacteria. Then, we focus on the clinical application of various phage therapies in managing refractory wound infections, such as diabetic foot infections, as well as traumatic, surgical, and burn wound infections. Additionally, an analysis of the potential obstacles and challenges of phage therapy in clinical practice is presented, along with corresponding strategies for addressing these issues. This review serves to enhance our understanding of phage therapy and provides innovative avenues for addressing refractory infections in wound healing.
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