Diagnosis and Management of Diabetic Foot Infections

Yeola

et al. 2020

J Family Med Prim Care

Aim: This study was carried out on patients with diabetic foot ulcer (DFU) to assess the clinical characteristics, spectrum of microbial flora, antibiotic sensitivity, and devise an empiric antimicrobial therapy. Material Methods: Clinical data and tissue samples were collected from 105 diabetic foot ulcer patients between December 2018 and November 2019. The collected samples were processed as per Clinical and Laboratory Standards Institute guidelines and clinical and microbiological data was analyzed. Results: In this study of 105 patients, DFU was most common in males in 5 th and 6 th decade of life. Majority of patients had poor glycemic control and neuropathy. Of 110 bacterial isolates obtained from 97 samples, 73.7% were Gram-negative bacteria, and 27.3% were Gram-positive. Most of samples (48.6%) showed growth of single bacteria, growth of two bacteria and polymicrobial growth was seen in 28.6% and 15.2% of tissue samples respectively of which. Pseudomonas was predominant isolate (27.3%) sensitive to imipenem (90%), amikacin (86.6%), gentamicin (83.3%), and cefotaxime (80%) followed by Staphylococcus aureus (19.1%) sensitive to amikacin and gentamicin (100%), and ofloxacin (90%). Pseudomonas, E. coli, Proteus and Klebsiella were highly resistant to ampicillin and amoxicillin-clavulanic acid. Conclusion: This study showed DFU are common in 5 th and 6 th decades of life. Gram-negative bacteria are predominant infective organism. Most of both Gram-negative and Gram-positive bacteria are resistant to variable degrees to commonly used antibiotics and sensitive to aminoglycosides. Amikacin and gentamicin can be used as empiric antibiotics for treatment of DFU infections.

Section: Discussionsupporting

confidence: 91%

“…Diabetic foot infections in India are commonly caused by gram-negative bacilli. [ 30 ] There are many studies from West like Mendes et al . [ 25 ] which have reported predominance of Gram positive organisms in diabetic foot ulcers.…”

Section: Discussionmentioning

confidence: 99%

A study on diabetic foot ulcers in Central rural India to formulate empiric antimicrobial therapy

Yeola

et al. 2020

J Family Med Prim Care

Oxidative Medicine and Cellular Longevity

“…A balanced redox state is likely critical for prompt healing. Diabetic skin appears to be infiltrated with more inflammatory cells, edema, and less granulation tissue formation than the normal skin, suggesting a deterioration in diabetic ulcer healing reserve [ 2 , 7 ].Additionally, the periwound and central wound tissue in people with diabetes appears to also be more likely to be prone to excessive oxidative stress and damage, which results in poor healing [ 12 , 13 ]. Kim et al suggested that both high oxidative stress levels and bacteria set the wound up for chronic wound development [ 14 ].…”

Section: Oxidative Stress State In the Development And Healing Of mentioning

confidence: 99%

“…The mechanism of diabetic wound chronicity has not been well understood. It is currently believed that oxidative stress plays a vital role in the occurrence and development of diabetic wound [ 2 , 3 ]. Oxidative stress is caused by overproduction of reactive oxygen species and insufficient antioxidant systems.…”

Section: Introductionmentioning

confidence: 99%

The Role of Oxidative Stress and Antioxidants in Diabetic Wound Healing

Deng

Song

et al. 2021

350

215

Foot ulcers are one of the most common and severe complication of diabetes mellitus with significant resultant morbidity and mortality. Multiple factors impair wound healing include skin injury, diabetic neuropathy, ischemia, infection, inadequate glycemic control, poor nutritional status, and severe morbidity. It is currently believed that oxidative stress plays a vital role in diabetic wound healing. An imbalance of free radicals and antioxidants in the body results in overproduction of reactive oxygen species which lead to cell, tissue damage, and delayed wound healing. Therefore, decreasing ROS levels through antioxidative systems may reduce oxidative stress-induced damage to improve healing. In this context, we provide an update on the role of oxidative stress and antioxidants in diabetic wound healing through following four perspectives. We then discuss several therapeutic strategies especially dietary bioactive compounds by targeting oxidative stress to improve wounds healing.

Wound Repair Regeneration

“…Along with monobacterial infections, polybacterial colonization of DFUs is also frequently reported 11,12 . The majority of these polybacterial infections show co‐existence of S. aureus and P. aeruginosa 13 .…”

Section: The Landscapementioning

confidence: 99%

Bacterial chatter in chronic wound infections

Buch

Chai

Goluch

2020

One of the hallmark characteristics of chronic diabetic wounds is the presence of biofilm‐forming bacteria. Bacteria encapsulated in a biofilm may coexist as a polymicrobial community and communicate with each other through a phenomenon termed quorum sensing (QS). Here, we describe the QS circuits of bacterial species commonly found in chronic diabetic wounds. QS relies on diffusion of signaling molecules and the local concentration changes of these molecules that bacteria experience in wounds. These biochemical signaling pathways play a role not only in biofilm formation and virulence but also in wound healing. They are, therefore, key to understanding the distinctive nature of these infections. While several in vivo and in vitro models exist to study QS in wounds, there has been limited progress in understanding the interplay between QS molecules and host factors that contribute to wound healing. Lastly, we examine the potential of targeting QS for both diagnosis and therapeutic intervention purposes.