Clinical and microbiological profile of diabetic foot ulcer patients in a tertiary care hospital

Kateel, Ramya; Augustine, Alfred Joseph; Prabhu, Shivananda; Ullal, Sonali; Pai, M. M. Manohara; Adhikari, Prabha

doi:10.1016/j.dsx.2017.08.008

Cited by 31 publications

(24 citation statements)

References 16 publications

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“…In contrast of others' observation, our data showed that nephropathy, 8 peripheral arterial disease, 24 and osteomyelitis 25,26 were not risk factors for major amputation in diabetic hindfoot ulcers. A previous study suggested that nephropathy and high creatinine levels were risk factors for major amputation in diabetic hindfoot ulcers.…”

Section: Discussioncontrasting

confidence: 99%

Risk Factors for Major Amputation on Hindfoot Ulcers in Hospitalized Diabetic Patients

Moon

Kim

Han

et al. 2019

Advances in Wound Care

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The purpose of this study was to investigate the risk factors for major amputation in patients hospitalized with diabetic foot ulcers involving the hindfoot. Approach: Between January 2003 and October 2017, a total of 1,657 diabetic patients were admitted to the diabetic wound center of Korea University Guro Hospital, for the management of foot ulcers. Among the admitted patients, 117 diabetic patients with hindfoot ulcers were included in this study. One hundred and four patients (89%) healed without major amputation, while 13 patients (11%) healed with major amputation. Data related to 88 potential risk factors, including demographics, ulcer condition, vascularity, bioburden, neurology, and serology, were collected from patients in these two groups for comparison. Results: Among the 88 potential risk factors, 15 showed statistically significant differences between the two groups. In univariate analysis of 88 potential risk factors, nine showed statistically significant differences. In stepwise multiple logistic regression analysis, three of the nine risk factors remained statistically significant. Multivariate-adjusted odds ratios for pulmonary disorders, erythrocyte sedimentation rate (ESR) levels, and total iron-binding capacity (TIBC) levels were 38.525, 1.047, and 0.976, respectively. Innovation: Compared with forefoot and midfoot ulcers, diabetic foot ulcers involving the hindfoot are at increased risk of major amputation because infection may spread proximal to the ankle. However, large-scale cohort studies that specifically discuss the outcomes and characteristics of diabetic hindfoot ulcers are not widely available. Conclusion: Risk factors for major amputation in patients hospitalized with diabetic hindfoot ulcers include pulmonary disorders, high levels of ESR, and decreased TIBC levels.

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Section: Discussioncontrasting

confidence: 99%

Risk Factors for Major Amputation on Hindfoot Ulcers in Hospitalized Diabetic Patients

Moon

Kim

Han

et al. 2019

Advances in Wound Care

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“…The predominance is more in males compared to female patients [12]. DFIs occur mainly due to polymicrobial and monomicrobial infections [13]. Multidrug resistance and production of ESBL by microbes and their infections are associated with the increased length of hospital stay, with higher morbidity, mortality rate, and cost burden to the patients.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Gelatinase Activity and Pellicle Formation Among Extended-Spectrum Beta-Lactamase and Non-Extended-Spectrum Beta-Lactamase Producing Acinetobacter Baumannii From Diabetic Foot Ulcer Infections

Khan

Rao

Moosabba

2018

Asian J Pharm Clin Res

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Objective: The aim of the study was to assess and compare the gelatinase activity and pellicle formation in extended-spectrum beta-lactamase (ESBL) and non-ESBL producing Acinetobacter baumannii isolates from diabetic foot ulcer infection (DFI).Methods: A total of 42 isolates of A. baumannii recovered from patients of DFI from September 2016 to February 2018. Isolates were identified by the standard microbiological method and confirmed by the BD Phoenix 100 system. The antimicrobial susceptibility test was performed by the Kirby–Bauer disk diffusion method and ESBL was detected by double disk diffusion synergy test method. Gelatinase production was determined by the Luria Bertani agar supplemented with 30 g/L gelatin, and pellicle formation was determined by the Mueller-Hinton broth which is incubated at two different temperatures.Results: A total of 42 A. baumannii isolates were multidrug resistant. Among 21 isolates, each was ESBL and non-ESBL producers. Pellicle formation at 25°C in ESBL and non-ESBL producer isolates was 47.61% (10/21) and 28.57% (06/21). Pellicle formation at 37°C in ESBL and non-ESBL producer isolates was 57.14% (12/21) and 42.85% (09/21), respectively. Gelatinase production was present in 38.09% ESBL and 28.57% in non-ESBL producers. ESBL strains were more virulent compared to non-ESBL producers among patients of DFIs.Conclusion: This study showed that pellicle formation at 37°C was highly virulent due to ESBL producers. Gelatinase production was elevated in ESBL compared to non-ESBL producer isolates. This attribute of the isolates could render ESBL positive more pathogenic. Colistin and polymyxin B are the only choices of treatment for multidrug-resistant Acinetobacter baumannii infections.

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“…The treatment with chitosan favors secondary intention healing by stimulating fibroblast migration, which releases growth factors that favor the cicatricial process [42] Three of the patients treated with chitosan membranes have diabetes mellitus. Diabetic foot is one of the main complications associated with diabetes that causes morbidity, hospitalization and amputation, due to this the risk of developing an ulcer is 25% [43], as presented in Figure 3. Physiological failures such as venous, arterial or metabolic factors that occur in the human body, generate chronic ulcers on legs and feet that are usually hard to heal [40].…”

Section: Treatment Applicationmentioning

confidence: 99%

Characterization and efficacy of chitosan membranes in the treatment of skin ulcers

López‐Cervantes

Escárcega-Galaz

Sánchez‐Machado

et al. 2019

Egyptian Journal of Basic and Applied Sciences

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Chronic wounds aggravate the patient's indisposition by causing mobility, economic and social problems. Chitosan is a natural polymer that is considered a potent healing agent for skin lesions and has been used previously to manufacture dressings for wounds. The aim of this work was to evaluate the curative effect of chitosan membranes on cutaneous ulcers. The chitosan was characterized by measuring the degree of deacetylation and FTIR. The membranes were obtained by a solvent evaporation technique. Four patients with cutaneous ulcers were recruited to evaluate the effectiveness of the topical membranes. At the beginning of the in vivo assay, patients presented with infected wounds. By the end of treatment, the infection subsided, the granulation process was promoted and complete skin coverage was observed in most patients. The use of chitosan as a treatment for the healing of skin ulcers is considered highly promising for its medicinal properties, as well as for its affordability compared to traditional treatments.

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Clinical and microbiological profile of diabetic foot ulcer patients in a tertiary care hospital

Cited by 31 publications

References 16 publications

Risk Factors for Major Amputation on Hindfoot Ulcers in Hospitalized Diabetic Patients

Risk Factors for Major Amputation on Hindfoot Ulcers in Hospitalized Diabetic Patients

Comparative Study of Gelatinase Activity and Pellicle Formation Among Extended-Spectrum Beta-Lactamase and Non-Extended-Spectrum Beta-Lactamase Producing Acinetobacter Baumannii From Diabetic Foot Ulcer Infections

Characterization and efficacy of chitosan membranes in the treatment of skin ulcers

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