The Distribution of Causative Microorganisms in Diabetic Foot Infection: Has There Been Any Alterations?

Ertuğrul, Mustafa Bülent; Uyar-Güleç, G.; Baktiroğlu, Selçuk; Çörekli, Esra; Türe, Mevlüt

doi:10.5152/kd.2017.05

Cited by 7 publications

(5 citation statements)

References 12 publications

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“…This study aimed to investigate the local causative microorganisms of DFIs in a regional centre located in a subtropical setting. A retrospective analysis of 256 microorganisms identified S. aureus as the predominant microorganism regardless of infection severity or acuity, which is consistent with previous research [3,11,12]. However, only 10% of the S. aureus samples were methicillin-resistant, which is lower than the published literature [3,13].…”

Section: Discussionsupporting

confidence: 86%

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Staphylococcus aureus Is the Predominant Pathogen in Hospitalised Patients with Diabetes-Related Foot Infections: An Australian Perspective

Morton,

Coghill

2024

Antibiotics

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Diabetes prevalence continues to increase worldwide, which has led to a rising incidence of diabetes-related foot infections (DFIs). There is significant local variation in the microbiology of DFIs, and Pseudomonas spp. is suggested to be more prevalent in subtropical climates. The aim of this study was to investigate the local microbiological findings in patients admitted to the hospital with DFIs. This retrospective study analysed data from all adult patients diagnosed with diabetes and admitted to the hospital for the treatment of a DFI between 1 January 2021 and 31 December 2022. Both superficial wound swabs and tissue cultures were included. The Infectious Diseases Society of America classification system was used to categorise the severity of the DFI. Patient characteristics and demographics were analysed using descriptive statistics. One hundred fifty-one episodes of care were included. Most of the DFIs were classified as moderate infections 101/151 (67%). The most commonly isolated microorganism was Staphylococcus aureus (33%) followed by normal skin flora (11%) and β-haemolytic streptococci (7%). P. aeruginosa was isolated more commonly in those with chronic DFIs (10%) compared to those with acute DFIs (2%). Despite the frequent identification of S. aureus, 83% of patients received an antipseudomonal antibiotic. The introduction of multidisciplinary DFI rounds should be considered.

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Section: Discussionsupporting

confidence: 86%

“…In addition, 97 patients (64%) received antibiotics prior to admission, and 127 (84%) received an antipseudomonal antibiotic during the hospital admission. The median duration of antibiotics was 15 days (IQR [11][12][13][14][15][16][17][18][19][20]. The median duration of antibiotics post-amputation was 10 days (IQR 7-13 days).…”

Section: Resultsmentioning

confidence: 99%

Staphylococcus aureus Is the Predominant Pathogen in Hospitalised Patients with Diabetes-Related Foot Infections: An Australian Perspective

Morton,

Coghill

2024

Antibiotics

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“…4,6,10-13 In Turkey, a few systematic reviews revealed that our profile was intermediate between those reported from Asian versus Western countries. 14,15 The high incidence of P aeruginosa as a causative pathogen was also highlighted in the National Consensus Report for the Diagnosis, Treatment and Prevention of Diabetic Foot Wounds and Infections, and these data were reported to be taken into consideration in the empirical treatment of patients presenting with DFI. 16 The results of our study, where 51.9% of the isolated bacteria were gram negative and P aeruginosa was the most common gram-negative isolate, also seem to be parallel with this knowledge.…”

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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“… Staphylococcus aureus is among the most common pathogens associated with DFU and the cause of DFI [5, 7, 8]. S.…”

Section: Introductionmentioning

confidence: 99%

“…Staphylococcus aureus is among the most common pathogens associated with DFU and the cause of DFI [5,7,8]. S. aureus has a known ability to infect bone and survive intracellularly within different bone cell types (both osteoblasts and osteocytes) [9,10].…”

Section: Introductionmentioning

confidence: 99%

The bacteriology of diabetic foot ulcers and infections and incidence of Staphylococcus aureus Small Colony Variants

Lee

Mashayamombe

Walsh

et al. 2023

Journal of Medical Microbiology

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Introduction. Uninfected diabetes-related foot ulcer (DFU) progression to diabetes-related foot infection (DFI) is a prevalent complication for patients with diabetes. DFI often progresses to osteomyelitis (DFI-OM). Active (growing) Staphylococcus aureus is the most common pathogen in these infections. There is relapse in 40–60 % of cases even when the initial treatment at the DFI stage apparently clears infection. Hypothesis. S. aureus adopts the quasi-dormant Small Colony Variant (SCV) state during DFU and consequently infection, and when present in DFI cases also permits survival in non-diseased tissues as a reservoir to cause relapse. Aim. The aim of this study was to investigate the bacterial factors that facilitate persistent infections. Methodology. People with diabetes were recruited from two tertiary hospitals. Clinical and bacterial data was taken from 153 patients with diabetes (51 from a control group with no ulcer or infection) and samples taken from 102 patients with foot complications to identify bacterial species and their variant colony types, and then compare the bacterial composition in those with uninfected DFU, DFI and those with DFI-OM, of whom samples were taken both from wounds (DFI-OM/W) and bone (DFI-OM/B). Intracellular, extracellular and proximal ‘healthy’ bone were examined. Results. S. aureus was identified as the most prevalent pathogen in diabetes-related foot pathologies (25 % of all samples). For patients where disease progressed from DFU to DFI-OM, S. aureus was isolated as a diversity of colony types, with increasing numbers of SCVs present. Intracellular (bone) SCVs were found, and even within uninfected bone SCVs were present. Wounds of 24 % of patients with uninfected DFU contained active S. aureus . All patients with a DFI with a wound but not bone infection had previously had S. aureus isolated from an infection (including amputation), representing a relapse. Conclusion. The presence of S. aureus SCVs in recalcitrant pathologies highlights their importance in persistent infections through the colonization of reservoirs, such as bone. The survival of these cells in intracellular bone is an important clinical finding supporting in vitro data. Also, there seems to be a link between the genetics of S. aureus found in deeper infections compared to those only found in DFU.

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The Distribution of Causative Microorganisms in Diabetic Foot Infection: Has There Been Any Alterations?

Cited by 7 publications

References 12 publications

Staphylococcus aureus Is the Predominant Pathogen in Hospitalised Patients with Diabetes-Related Foot Infections: An Australian Perspective

Staphylococcus aureus Is the Predominant Pathogen in Hospitalised Patients with Diabetes-Related Foot Infections: An Australian Perspective

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

The bacteriology of diabetic foot ulcers and infections and incidence of Staphylococcus aureus Small Colony Variants

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