Risk Factors for Infection with Pseudomonas aeruginosa in Diabetic Foot Infections

Ertuğrul, Bülent M.; Lipsky, Benjamin A.; Türe, Mevlüt; Sakarya, Serhan

doi:10.7547/15-167

Cited by 27 publications

(31 citation statements)

References 19 publications

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“…The IDSA recommends empirically covering PsA in cases of high local prevalence (undefined in the guidance), warm climate, and frequent exposure of the feet to water [ 1 ]. Other reported risk factors include a history of amputation, wound dressings, and chronic kidney disease [ 5 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

Kim

Lydecker

Dave

et al. 2020

Open Forum Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

Kim

Lydecker

Dave

et al. 2020

Open Forum Infectious Diseases

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“…However, results were variable. Studies have found that Staphylococcus aureus is the main causative pathogen [16][17][18], but others have reported a predominance of Gram-negative aerobes [19,20]. These discrepancies could be related to various factors, such as the presence of different causative organisms at different times, geographical variations and ecologies, socio-economic conditions, hygiene, accessibility to effective health care services, the type and the severity of the infections, or depth of the wound and sampling technique [14,21].…”

Section: Introductionmentioning

confidence: 99%

Microbiological profile of diabetic foot ulcers in Kuwait

et al. 2020

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Introduction Diabetic foot ulcers (DFU) and infection (DFI) are a major diabetes-related problem around the world due to the high prevalence of diabetes in the population. The aim of our study was to determine the microbiological profile of infected ulcers in patients attending Dasman Diabetes Institute (DDI) clinics in Kuwait and to analyze the distribution of microbial isolates according to wound grade, sex, age and diabetes control. Methods We collected and analyzed clinical data and samples from 513 diabetic patients with foot ulcers referred to our podiatry clinic at DDI from Jan 2011 till Dec 2017. Results We show a higher prevalence of DFU in men than in women, and a greater percentage of DFU occurred in men at an earlier age (p<0.05). Only about half of the DFU were clinically infected (49.3%) but 92% of DFU showed bacterial growth in the microbiological lab analysis. In addition, we isolated more monomicrobial (57.3%) than polymicrobial (34.8%) DFI and representing an average of 1.30 pathogens per patient. The presence of Gram-positive and Gram-negative strains was comparable between men and women regardless their age or glucose levels. Interestingly, more Gram-positive strains are present in ulcers without ischemia while more Gram-negative strains are present in ulcers with ischemia (p<0.05). While Staphylococcus aureus was common in infected ulcers without ischemia, Pseudomonas aeruginosa was predominant in ulcers with infection and ischemia, regardless of ulcer depth. Finally, a higher percentage of women has controlled HbA1c levels (19.41% versus 11.95% in men) and more women in this group displayed non-infected wounds (60.6% and 43.90% for women and men, respectively). Conclusion Our results provide an updated picture of the DFI patterns and antibiotics resistance in patients attending Dasman Diabetes Institute (DDI) clinics in Kuwait which might help in adopting the appropriate treatment of infected foot and improving clinical outcomes.

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“…22,23 It has been suggested that high levels of moisture in the wound and a history of using active wound dressings facilitate the growth of P aeruginosa . 24 Additionally, wet dressings, excessive exudate, preference for autolytic debridement, particularly in the presence of necrosis instead of surgical debridement, or in cases where surgical debridement cannot be performed immediately, may play a role in this predisposition. It should be mentioned that it is also important to leave infections of the finger spaces as wet.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Microbiologic Profile of Foot Infections in Patients With Diabetic End-Stage Renal Disease

Körpınar

2020

The International Journal of Lower Extremity Wounds

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Objective Individuals with diabetes and end-stage renal disease (ESRD) are at increased risk of foot ulceration and lower extremity amputation. Although risk factors and microbiologic analysis of diabetic foot infections ( DFIs) have been extensively studied, there are limited data available for this characteristic group. Methods Clinical, demographic, laboratory, microbiological data, and foot examination information were collected retrospectively regarding 94 patients with ESRD who were referred for DFI between 2006 and 2016 to hyperbaric oxygen therapy. Results In 6 of 94 patients with ESRD (mean age 60 years; 65 males [69.1%], 29 women [30.8%]; 91 undergoing hemodialysis [96.8%], one peritoneal dialysis [1%], two [2%] recent renal transplants), the lesions were bilateral; therefore, the evaluations were made over 100 DFIs. The most common pathogens isolated in deep wound cultures were Staphylococcus aureus and Pseudomonas aeruginosa, respectively, contributing to 27 (21.2%) and 16 (12.5%) of all 127 isolates. When the distribution of the isolates according to different Wagner grades were analyzed, it was found that the proportion of Gramnegative isolates increased statistically significantly with the ascending Wagner grade (P = .004). Conclusion DFIs indicate a serious complication associated with a high risk of amputation, prolonged antibiotic treatment, increased hospital and procedure demands, and the cost of health care, on patients with ESRD. The familiarization of causative pathogens underlying DFIs can aid the clinicians in the choice of appropriate empirical antibiotic treatment. This study emphasizes the need for greater attention to risk factors and the microbiologic profile of DFIs in this characteristic group.

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Risk Factors for Infection with Pseudomonas aeruginosa in Diabetic Foot Infections

Abstract: This retrospective study provides some information on risk factors for infection with this difficult pathogen in patients with DFI. We need prospective studies in various parts of the world to better define this issue.

Cited by 27 publications

References 19 publications

Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

Microbiological profile of diabetic foot ulcers in Kuwait

A Retrospective Analysis of Microbiologic Profile of Foot Infections in Patients With Diabetic End-Stage Renal Disease

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