Vnitr Lek 2015, 61(4):328-334

Issues of infection related to diabetic foot syndrome

Milan Flekač
III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

Foot wounds are common problem in people with diabetes and now constitute the most frequent diabetes-related cause of hospitalization. Diabetic foot infections cause substantial morbidity and at least one in five results in a lower extremity amputation. They are are now the predominant proximate trigger for lower extremity amputations worldwide. One in five diabetic wounds present clinical signs of infection at primomanifestation. About 80 % of limb non-threating wounds can be succesfully healed using appropriate and comprehensive approach, including antimicrobial therapy, revascularisation and off-loading.

Keywords: antimicrobial therapy; diabetic foot infection; diabetic foot syndrome; microbiological diagnostics; osteomyelitis

Received: February 16, 2015; Accepted: March 13, 2015; Published: April 1, 2015  Show citation

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Flekač M. Issues of infection related to diabetic foot syndrome. Vnitr Lek. 2015;61(4):328-334.
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References

  1. Spichler A, Hurwitz BL, Armstrong DG et al. Microbiology of diabetic foot infections: from Louis Pasteur to "crime scene investigation". BMC Medicine 2015; 13: 2. Dostupné z DOI: <http://doi:10.1186/s12916-014-0232-0>. Go to original source... Go to PubMed...
  2. Lavery LA, Armstrong DG, Wunderlich RP et al. Risk factors for foot infections in individuals with diabetes. Diabetes Care 2006; 29(6): 1288-1293. Go to original source... Go to PubMed...
  3. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005; 293(2): 217-228. Go to original source... Go to PubMed...
  4. Prompers L, Schaper N, Apelqvist J et al. Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease: The EURODIALE Study. Diabetologia 2008; 51(5): 747-755. Go to original source... Go to PubMed...
  5. Lavery LA, Armstrong DG, Murdoch DP et al. Validation of the Infectious Diseases society of America's diabetic foot infection classification system. Clin Infect Dis 2007; 44(4): 562-565. Go to original source... Go to PubMed...
  6. Skrepnek GH, Armstrong DG, Mills JL. Open bypass and endovascular procedures among diabetic foot ulcer cases in the United States from 2001 to 2010. J Vasc Surg 2014; 60(5): 1255-1264. Go to original source... Go to PubMed...
  7. Richard JL, Lavigne JP, Sotto A. Diabetes and foot infection: more than double trouble. Diabetes Metab Res Rev 2012; 28(Suppl 1): S46-S53. Go to original source... Go to PubMed...
  8. Gardner SE, Frantz RA. Wound bioburden and infection-related complications in diabetic foot ulcers. Biol Res Nurs 2008; 10(1): 44-53. Go to original source... Go to PubMed...
  9. Lipsky BA, Berendt AR, Cornia PB et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2012; 54(12): e132-e173. Go to original source... Go to PubMed...
  10. Brem H, Tomic-Canic M. Cellular and molecular basis of wound healing in diabetes. J Clin Invest 2007; 117(5): 1219-1222. Go to original source... Go to PubMed...
  11. Richard JL, Sotto A, Lavigne JP. New insights in diabetic foot infection. World J Diabetes 2011; 2(2): 24-32. Go to original source... Go to PubMed...
  12. Cutting KF, White R. Defined and refined: criteria for identifying wound infection revisited. Br J Community Nurs 2004; 9(3): S6-S15. Go to original source... Go to PubMed...
  13. Gardner SE, Hillis SL, Frantz RA. Clinical signs of infection in diabetic foot ulcers with high microbial load. Biol Res Nurs 2009; 11(2): 119-128. Go to original source... Go to PubMed...
  14. Xu L, McLennan SV, Lo L et al. Bacterial load predicts healing rate in neuropathic diabetic foot ulcers. Diabetes Care 2007; 30(2): 378-380. Go to original source... Go to PubMed...
  15. Gardner SE, Haleem A, Jao YL et al. Cultures of diabetic foot ulcers without clinical signs of infection do not predict outcomes. Diabetes Care 2014; 37(10): 2693-2701. Go to original source... Go to PubMed...
  16. Roberts AD, Simon GL. Diabetic foot infections: the role of microbiology and antibiotic treatment. Semin Vasc Surg 2012; 25(2): 75-81. Go to original source... Go to PubMed...
  17. Uçkay I, Gariani K, Pataky Z et al. Diabetic foot infections: state-of the-art. Diabetes Obes Metab 2013; 16(4): 305-316. Go to original source...
  18. Armstrong DG, Lavery LA, Nixon BP et al. It's not what you put on, but what you take off: techniques for debriding and off-loading the diabetic foot wound. Clin Infect Dis 2004; 39(Suppl 2): S92-S99. Go to original source... Go to PubMed...
  19. Lavigne JP, Sotto A, Dunyach-Remy C et al. New Molecular Techniques to Study the Skin Microbiota of Diabetic Foot Ulcers. Adv Wound Care (New Rochelle) 2015; 4(1): 38-49. Go to original source... Go to PubMed...
  20. Sotto A, Lina G, Richard JL et al. Virulence potential of Staphylococcus aureus strains isolated from diabetic foot ulcers: a new paradigm. Diabetes Care 2008; 31(12): 2318-2324. Go to original source... Go to PubMed...
  21. Wolcott RD, Cox SB, Dowd SE. Healing and healing rates of chronic wounds in the age of molecular pathogen diagnostics. J Wound Care 2010; 19(7): 272-278. Go to original source... Go to PubMed...
  22. Lipsky BA, Richard JL, Lavigne JP. Diabetic foot ulcer microbiome: one small step for molecular microbiology. One giant leap for understanding diabetic foot ulcers? Diabetes 2013; 62(3): 679-681. Go to original source... Go to PubMed...
  23. Senneville E, Melliez H, Beltrand E et al. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis 2006; 42(1): 57-62. Go to original source... Go to PubMed...
  24. Senneville E, Morant H, Descamps D et al. Needle puncture and transcutaneous bone biopsy cultures are inconsistent in patients with diabetes and suspected osteomyelitis of the foot. Clin Infect Dis 2009; 48(7): 888-893. Go to original source... Go to PubMed...
  25. Armstrong DG, Lipsky BA. Diabetic foot infections: stepwise medical and surgical management. Int Wound J 2004; 1(2): 123-132. Go to original source... Go to PubMed...
  26. Lavery LA, Armstrong DG, Murdoch DP et al. Validation of the Infectious Diseases Society of America's diabetic foot infection classification system. Clin Infect Dis 2007; 44(4): 562-565. Go to original source... Go to PubMed...
  27. Jeandrot A, Richard JL, Combescure C et al. Serum procalcitonin and C-reactive protein concentrations to distinguish mildly infected from non-infected diabetic foot ulcers: a pilot study. Diabetologia 2008; 51(2): 347-352. Go to original source... Go to PubMed...
  28. Schaper NC, Apelqvist J, Bakker K. The international consensus and practical guidelines on the management and prevention of the diabetic foot. Curr Diab Rep 2003; 3(6): 475-479. Go to original source... Go to PubMed...
  29. Uzun G, Solmazgul E, Curuksulu H et al. Procalcitonin as a diagnostic aid in diabetic foot infections. Tohoku J Exp Med 2007; 213(4): 305-312. Go to original source... Go to PubMed...
  30. Lipsky BA, Sheehan P, Armstrong DG et al. Clinical predictors of treatment failure for diabetic foot infections: data from a prospective trial. Int Wound J 2007; 4(1): 30-38. Go to original source... Go to PubMed...
  31. Akinci B, Yener S, Yesil S et al. Acute phase reactants predict the risk of amputation in diabetic foot infection. J Am Podiatr Med Assoc 2011; 101(1): 1-6. Go to original source... Go to PubMed...
  32. Syndrom diabetické nohy : mezinárodní konsenzus vypracovaný Mezinárodní pracovní skupinou pro syndrom diabetické nohy. Galén: Praha 2000. ISBN 80-7262-051-7.
  33. Lipsky BA, Berendt AR, Deery HG et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2004; 39(7): 885-910. Go to original source... Go to PubMed...
  34. Lipsky BA, Rerendt AR, Embil J et al. Diagnosing and treating diabetic foot infections. Diabetes Metab Res Rev 2004; 20(Suppl 1): S56-S64. Go to original source... Go to PubMed...
  35. Mason J, Keeffet CO, Hutschinson A et al. A systematic review of foot ulcer in patients with type 2 diabetes mellitus. II: treatment. Diabet Med 1999; 16(11): 889-909. Go to original source... Go to PubMed...
  36. Caputo G, Cavanagh PR, Ulbrecht JS et al. Assessment and management of foot disease in patients with diabetes. N Eng J Med 1994; 331(13): 854-860. Go to original source... Go to PubMed...
  37. Grayson ML, Gibbons GW, Balogh K et al. Probing to bone in infected pedal ulcers. JAMA 1995; 273(9): 721-723. Go to original source... Go to PubMed...
  38. Dyet JF, Ettles DF, Nicholson AA et al. The role of radiology in the assesment and treatment of diabetic foot. In: Boulton AJM, Connor H, Cavanagh PR (eds). The foot in diabetes. 3rd ed. Wiley-Blackwell: Chichester 2000: 193-213. ISBN 978-0471489740. Go to original source...
  39. Lew DP, Waldvogel FA. Osteomyelitis. N Eng J Med 1997; 336(14): 999-1007. Go to original source... Go to PubMed...




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