Diabetes-associated infections: development of antimicrobial resistance and possible treatment strategies

Akash, Muhammad Sajid Hamid; Rehman, Kanwal; Fiayyaz, Fareeha; Sabir, Shakila; Khurshid, Mohsin

doi:10.1007/s00203-020-01818-x

Cited by 110 publications

(81 citation statements)

References 123 publications

(101 reference statements)

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“…Among all listed comorbidities, DM was independently associated with increased antimicrobial usage. DM is a pre-infectious condition and previous studies suggest people admitted at hospitals with DM end up receiving more antibiotics than patients without DM, largely due to the presence of antibiotic resistance gene in the diabetic population [ 13 ]. This finding may have compelled physicians to prescribe multiple antibiotics to make sure the patient's condition does not worsen.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Molla¹,

Yeasmin²,

Islam

et al. 2021

Infection Prevention in Practice

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Background: As evidence is mounting regarding irrational and often unnecessary use of antibiotics during the COVID-19 pandemic a cross-sectional Point Prevalence Survey (PPS) (in accordance with WHO guideline) was conducted across COVID-19 dedicated wards in Dhaka Medical College and Hospital (DMCH). Methodology: Antibiotic usage data were collected from 193 patients at different COVID-19 dedicated wards at DMCH on 11 June 2020. Comparisons in antibiotic usage were made between different groups using Pearson chi-square and Fisher’s exact test. Result: Findings reveal all surveyed patients (100%) were receiving at least one antibiotic with 133 patients (68.91%) receiving multiple antibiotics. Overall, patients presenting with the severe disease received more antibiotics. Third-generation cephalosporins (i.e. ceftriaxone) (53.8%), meropenem (40.9%), moxifloxacin (29.5%), and doxycycline (25.4%) were the four most prescribed antibiotics among surveyed patients. Diabetes mellitus (DM) was independently associated with multiple antibiotic prescribing. Abnormal C-reactive protein (CRP) and serum d-dimer were linked with higher odds of multiple antibiotic prescribing among study patients. Conclusion: Prevalence of multiple antibiotic prescriptions was high among severely ill patients and those with abnormal CRP and d-dimer levels. Data regarding the quality of antibiotic prescribing were lacking.

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Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Molla¹,

Yeasmin²,

Islam

et al. 2021

Infection Prevention in Practice

View full text Add to dashboard Cite

show abstract

“…Infections in DFU are capturing the attention of the clinicians because often related to severe discomfort, increased request of medical cares and high risk of healing failure, which may rapidly lead to hospitalization and lower extremities amputation [5] . The development of diabetic foot infection (DFI) is strictly associated with an open wound [6] , but other risk factors include peripheral neuropathy and arteriopathy, diabetes-related immune dysfunction, renal impairment and the chronic course of the wound itself [6] , [7] . DFI still remains a clinical challenge due to the complexity of medical and surgical treatments and the associated negative outcome.…”

Section: Introductionmentioning

confidence: 99%

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

Caruso

Maiorino

Macera

et al. 2021

Diabetes Research and Clinical Practice

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Aim To investigate the rate of antibiotic resistance and its main risk factors in a population of patients with diabetic foot infection (DFI) during the COVID-19 pandemic, in comparison with the population of 2019. Methods Two hundred and twenty-five patients with DFI were admitted in a tertiary care center from January 2019 to December 2020. Antibiotic resistance was evaluated by microbiological examination of soft tissues’ or bone’s biopsy. Results Compared with 2019 group (n = 105), 2020 group (n = 120) had a significantly higher prevalence of antibiotic resistance [2019 vs 2020, 36% vs 63%, P <0.001] and more often was admitted with recent or current antibiotic therapy (18% vs 52%, P <0.001), which was frequently self-administered (5% vs 30%, P = 0.032). The risk of antibiotic resistance was also higher in 2020 group [OR 95% CI, 2.90 (1.68 to 4.99)]. Prior hospitalization, antibiotic self-administration and antibiotic prescription by general practitioners resulted as independent predictors of antibiotic resistance. Conclusions In a population of people with DFI admitted in a tertiary care center during the COVID-19 pandemic the prevalence of antibiotic resistance was higher than 2019. Previous hospitalization, antibiotic self-administration /prescription by general practitioners were related to higher risk of antibiotic resistant infections.

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“…It has been reported that reduced levels of IgA in the saliva increase the risk of upper respiratory tract infections (URTI), and vice versa [9,10]. Elderly people, children, and patients with diabetes who have poor immune function are at increased risk of URTI infection [11][12][13]. Therefore, increasing pIgR expression and salivary IgA levels in patients with low immunity are important for URTI prevention.…”

Section: Introductionmentioning

confidence: 99%

Faster Short-Chain Fatty Acid Absorption from the Cecum Following Polydextrose Ingestion Increases the Salivary Immunoglobulin A Flow Rate in Rats

et al. 2020

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Salivary immunoglobulin A (IgA) plays a vital role in preventing upper respiratory tract infections (URTI). In our previous study, we showed that the intake of carbohydrates increases the intestinal levels of short-chain fatty acids (SCFAs), which in turn increase salivary IgA levels. However, the mechanism underlying this phenomenon has not been fully elucidated. In this study, we investigated in rats the effect of polydextrose (PDX) ingestion on salivary IgA level and SCFA concentration in cecal digesta and the portal vein. Five-week-old rats were fed with a fiber-free diet (control) or with 40 g/kg of PDX for 28 days. Compared to the control, ingestion of PDX led to a higher salivary IgA flow rate (p = 0.0013) and a higher concentration of SCFAs in the portal vein (p = 0.004). These two data were positively correlated (rs = 0.88, p = 0.0002, n = 12). In contrast, the concentration of SCFAs in cecal digesta and cecal digesta viscosity were significantly lower following PDX ingestion, compared to the control (p = 0.008 and 0.05, respectively). These findings suggest that the ingestion of PDX increases the absorption rate of SCFAs in the intestine through PDX-induced fermentation, which is accompanied by an increase in SCFA levels in the blood, and ultimately leads to increased salivary IgA levels.

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Diabetes-associated infections: development of antimicrobial resistance and possible treatment strategies

Cited by 110 publications

References 123 publications

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

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

Faster Short-Chain Fatty Acid Absorption from the Cecum Following Polydextrose Ingestion Increases the Salivary Immunoglobulin A Flow Rate in Rats

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