Swab cultures accurately identify bacterial pathogens in diabetic foot wounds not involving bone

Slater, Robert A.; Lazarovitch, Tsilia; Boldur, I; Ramot, Yoram; Buchs, Andreas; Weiss, Michael E.; Hindi, A. Al; Rapoport, Micha J.

doi:10.1111/j.1464-5491.2004.01221.x

Cited by 123 publications

(107 citation statements)

References 23 publications

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“…Indeed, the French National Observatory for Epidemiology of Bacterial Resistance to Antimicrobials and the European Antimicrobial Resistance Surveillance System reported a decrease in the prevalence of MRSA in France [22,23], and MRSA strains responsible for bacteraemia decreased from 33% in 2001 to 26% in 2007. This trend could be explained by a change in the major epidemic clone of MRSA detected in French hospitals (replacing the Iberic clone with the pandemic clone V) [24,25]. Moreover, we cannot exclude a possible effect of national campaigns promoted by the French health authorities on a more sound use of antibiotic agents (1999) and on the usefulness of hydro-alcoholic solution for handwashing (2001)(2002) [26], as these measures have been associated with a reduction in MRSA development and transmission [27,28].…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers

et al. 2010

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Moreover, prevalence of pathogens considered as colonisers dramatically fell from 23.1% to 5.8% of all isolates (p<0.001). In parallel, implementation of guidelines was associated with a saving of €14,914 (US $20,046) related to a reduced microbiology laboratory workload and €109,305 (US$147,536) due to reduced prescription of extended-spectrum antibiotic agents. Conclusions/interpretation Implementation of guidelines for obtaining specimens for culture from patients with DFI is cost-saving and provides interesting quality indicators in the global management of DFI.

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Section: Discussionmentioning

confidence: 99%

Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers

et al. 2010

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“…Our method used quantitative aerobic and anaerobic swab cultures as an alternative method when the HCP believed an invasive procedure would place the patient at risk. While this decision was based on the microbiological experimental [28,29], while others believe that superficial swab cultures of DFIs only complicate patient evaluation by sampling the superficial wound compartment, which may contain colonizing organisms rather than true pathogens. These divergent conclusions may be explained by different and non-standardized protocols.…”

Section: Discussionmentioning

confidence: 99%

Clinical and bacteriological survey of diabetic foot infections in Lisbon

Mendes

Marques-Costa

Vilela³

et al. 2012

Diabetes Research and Clinical Practice

127

101

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Infection Microbiology Portugal a b s t r a c tAims: An epidemiological survey of diabetic foot infections (DFIs) in Lisbon, stratifying the bacterial profile based on patient demographical data, diabetic foot characteristics (PEDIS classification), ulcer duration and antibiotic therapy.Methods: A transversal observational multicenter study, with clinical data collection using a structured questionnaire and microbiological products (aspirates, biopsies or swabs collected using the Levine method) of clinically infected foot ulcers of patients with diabetes mellitus (DM).Results: Forty-nine hospitalized and ambulatory patients were enrolled in this study, and 147 microbial isolates were cultured. Staphylococcus was the main genus identified, and methicillin-resistant Staphylococcus aureus (MRSA) was present in 24.5% of total cases. In the clinical samples collected from patients undergoing antibiotic therapy, 93% of the antibiotic regimens were considered inadequate based on the antibiotic susceptibility test results. The average duration of an ulcer with any isolated multi-drug resistant (MDR) organism was 29 days, and previous treatment with fluoroquinolones was statistically associated with multidrug resistance.Conclusions: Staphylococcus aureus was the most common cause of DFIs in our area. Prevalence and precocity of MDR organisms, namely MRSA, were high and were probably related to previous indiscriminate antibiotic use. Clinicians should avoid fluoroquinolones and more frequently consider the use of empirical anti-MRSA therapy.

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“…A culture of swabs collected from ulcers and other foot lesions in diabetic patients often yields several pathogens that can be difficult to distinguish from colonising organisms, especially in chronic or previously treated wounds [73]. Evidence suggests that the culture results do not reliably identify the pathogens present unless the involved bone is cultured [74]. The role of antibiotics for the treatment of foot ulcers in diabetic patients without clinical signs of infection remains unclear [75].…”

Section: Skin Nail Mucous Membrane and Soft Tissue Infectionsmentioning

confidence: 99%

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

Peleg

Weerarathna

McCarthy

et al. 2006

Diabetes Metabolism Res

506

406

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SummarySpecific defects in innate and adaptive immune function have been identified in diabetic patients in a range of in vitro studies. However, the relevance of these findings to the integrated response to infection in vivo remains unclear, especially in patients with good glycaemic control. Vaccine efficacy seems adequate in most diabetic patients, but those with type 1 diabetes and high glycosylated haemoglobin levels are most likely to exhibit hyporesponsiveness. While particular infections are closely associated with diabetes, this is usually in the context of extreme metabolic disturbances such as ketoacidosis. The link between glycaemic control and the risk of common community-acquired infections is less well established but could be clarified if infection data from large community-based observational or intervention studies were available. The relationship between hospital-acquired infections and diabetes is well recognized, particularly among post-operative cardiac and critically ill surgical patients in whom intensive insulin therapy improves clinical outcome independent of glycaemia. Nevertheless, further research is needed to improve our understanding of the role of diabetes and glycaemic control in the pathogenesis and management of community-and hospitalacquired infections.

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Swab cultures accurately identify bacterial pathogens in diabetic foot wounds not involving bone

Abstract: Swab cultures are valuable in identifying pathogens in diabetic foot wounds when bone is not involved. When surgical debridement is contraindicated or delayed, swab cultures can be used to select appropriate antibiotic therapy.

Cited by 123 publications

References 23 publications

Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers

Beneficial effects of implementing guidelines on microbiology and costs of infected diabetic foot ulcers

Clinical and bacteriological survey of diabetic foot infections in Lisbon

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

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