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Clinical Characteristics and Risk Factors of Diabetic Foot Ulcer With Multidrug- Resistant Organism Infection

Published on Mar 1, 2014in The International Journal of Lower Extremity Wounds 1.21
· DOI :10.1177/1534734614521236
Xiaoyan Ji3
Estimated H-index: 3
(Tianjin Medical University),
Peng Jin1
Estimated H-index: 1
(Tianjin Medical University)
+ 2 AuthorsPenghua Wang4
Estimated H-index: 4
(Tianjin Medical University)
Abstract
The objective was to determine multidrug-resistant organisms’ (MDROs) profile in diabetic foot ulcers (DFU), antibiotic resistance of MDROs, and to find the potential risk factors for infection with MDROs. In 157 patients with DFU admitted to Tianjin Metabolic Disease Hospital, China, from January 2011 to January 2012, microbiological specimens were taken on admission. The patients were divided into 2 groups according to the infection of MDROs. Potential risk factors for MDRO-positive specimens were examined using univariate and multivariate analyses. Seventy-eight MDRO strains were isolated from patients in the MDRO+ group, among which the top 3 were Staphylococcus aureus (16.7%), Enterobacter spp (16.7%), and Pseudomonas aeruginosa (15.4%). Most of the MDROs were resistant to at least 8 kinds of commonly used antibiotics. Gram-negative MDROs showed 23% to 50% resistance to third-generation cephalosporins. The resistant rates of Gram-positive MDROs to fluoroquinolone were more than 70%; penicillin and se...
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  • Citations (6)
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References47
Newest
Published on Apr 1, 2014in Diabetes, Obesity and Metabolism 5.98
Ilker Uckay28
Estimated H-index: 28
(Geneva College),
Karim Gariani15
Estimated H-index: 15
(Geneva College)
+ 1 AuthorsBenjamin A. Lipsky69
Estimated H-index: 69
(Geneva College)
Foot infections are frequent and potentially devastating complications of diabetes. Unchecked, infection can progress contiguously to involve the deeper soft tissues and ultimately the bone. Foot ulcers in people with diabetes are most often the consequence of one or more of the following: peripheral sensory neuropathy, motor neuropathy and gait disorders, peripheral arterial insufficiency or immunological impairments. Infection develops in over half of foot ulcers and is the factor that most of...
49 Citations Source Cite
Published on Nov 1, 2013in Diabetes Care 13.40
Dane K. Wukich30
Estimated H-index: 30
(University of Pittsburgh),
Kimberlee B. Hobizal6
Estimated H-index: 6
(University of Pittsburgh)
+ 1 AuthorsBedda L. Rosario15
Estimated H-index: 15
(University of Pittsburgh)
OBJECTIVE This retrospective, single-center study was designed to distinguish severe diabetic foot infection (DFI) from moderate DFI based on the presence or absence of systemic inflammatory response syndrome (SIRS). RESEARCH DESIGN AND METHODS The database of a single academic foot and ankle program was reviewed and 119 patients were identified. Severe DFI was defined as local infection associated with manifestation of two or more objective findings of systemic toxicity using SIRS criteria. RES...
16 Citations Source Cite
Maria Demetriou6
Estimated H-index: 6
(Democritus University of Thrace),
Nikolaos Papanas32
Estimated H-index: 32
(Democritus University of Thrace)
+ 3 AuthorsEfstratios Maltezos32
Estimated H-index: 32
(Democritus University of Thrace)
We evaluated the diagnostic performance of swabs versus tissue cultures in 28 diabetic patients with neuropathic (group A) and 22 diabetic patients with neuroischemic foot ulcer (group B) and the differences in bacterial isolates between the 2 groups. In group A, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of swab cultures for the diagnosis of infection were 100%, 40%, 88.5%, and 100%, respectively. In group B, the corresponding values were 100%...
16 Citations Source Cite
Marios Michail2
Estimated H-index: 2
(Athens State University),
Edward B. Jude37
Estimated H-index: 37
(University of Manchester)
+ 5 AuthorsNicholas Tentolouris23
Estimated H-index: 23
(Athens State University)
Serum inflammatory markers, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), and procalcitonin (PCT), have been used for the diagnosis of foot infections in patients with diabetes. However, little is known about their changes during treatment of patients with foot infections. The aim of this prospective study was to examine the performance of serum inflammatory markers for the diagnosis and follow-up of patients with osteomyelitis. A total of 61 patients (...
45 Citations Source Cite
Markus Loeffler77
Estimated H-index: 77
(University of Tübingen),
Heiko Schuster13
Estimated H-index: 13
(University of Tübingen)
+ 1 AuthorsStefan Beckert17
Estimated H-index: 17
(University of Tübingen)
Valid and reproducible sampling techniques as well as processing protocols are required for the assessment of biomarkers and mediators contained in wound exudate. Moreover, the ideal technique should be easy to use even in daily clinical routine. This is challenging since wound fluid represents an inhomogeneous mixture of different exogenous and endogenous sources. Analyzing wound fluid, however, may facilitate clinical decision making. Many techniques for obtaining wound fluid have been describ...
8 Citations Source Cite
Published on May 1, 2013in Clinical Infectious Diseases 9.12
James S. Molton6
Estimated H-index: 6
(National University of Singapore),
Paul A. Tambyah38
Estimated H-index: 38
(National University of Singapore)
+ 2 AuthorsDale Fisher31
Estimated H-index: 31
(National University of Singapore)
Since antibiotics were first used, each new introduced class has been followed by a global wave of emergent resistance, largely originating in Europe and North America where they were first used. Methicillin-resistant Staphylococcus aureus spread from the United Kingdom and North America across Europe and then Asia over more than a decade. Vancomycin-resistant enterococci and Klebsiella pneumoniae carbapenemase– producing K. pneumoniae followed a similar path some 20 years later. Recently howeve...
152 Citations Source Cite
Published on May 1, 2013in Lancet Infectious Diseases 25.15
Casper D. J. den Heijer8
Estimated H-index: 8
(Maastricht University Medical Centre),
Evelien M E van Bijnen4
Estimated H-index: 4
+ 5 AuthorsEllen E. Stobberingh55
Estimated H-index: 55
(Maastricht University Medical Centre)
Summary Background Information about the prevalence of Staphylococcus aureus resistance to antimicrobial drugs has mainly been obtained from invasive strains, although the commensal microbiota is thought to be an important reservoir of resistance. We aimed to compare the prevalence of nasal S aureus carriage and antibiotic resistance, including meticillin-resistant S aureus (MRSA), in healthy patients across nine European countries. Methods In this cross-sectional study, nasal swabs were obtaine...
111 Citations Source Cite
Published on Jan 1, 2013in Experimental and Therapeutic Medicine 1.41
Shanshan Zhang3
Estimated H-index: 3
(Shanghai Jiao Tong University),
Zheng-Yi Tang1
Estimated H-index: 1
(Shanghai Jiao Tong University)
+ 3 AuthorsGuang Ning1
Estimated H-index: 1
(Shanghai Jiao Tong University)
The prognosis for diabetic foot ulcers (DFUs) remains poor. Nutritional status has not been identified as one of the factors affecting the outcome of DFUs. Therefore, indicators correlated with nutritional status and outcome were analyzed to investigate their relationship. A total of 192 hospitalized patients with Wagner grade 1–5 ulcers and 60 patients with Wagner grade 0 ulcers (all had type 2 diabetes) were assessed by the following: subjective global assessment (SGA), anthropometric measurem...
17 Citations Source Cite
Published on Jan 1, 2013in Clinical Infectious Diseases 9.12
Catherine L. Passaretti4
Estimated H-index: 4
(Johns Hopkins University),
Jonathan A. Otter26
Estimated H-index: 26
+ 6 AuthorsTrish M. Perl62
Estimated H-index: 62
(Johns Hopkins University)
131 Citations Source Cite
Shanmugam P1
Estimated H-index: 1
,
Susan S L1
Estimated H-index: 1
Introduction: A diabetic foot infection is one of the most feared complications of Diabetes mellitus. Many studies have reported on the bacteriology of Diabetic Foot Infections (DFIs) over the past 25 years, but the results have been varied and often contradictory. Aims and Objectives: This study was carried out to determine the bacterial profiles of infected ulcers and the antibiotic resistance pattern of the isolates. Materials and Methods: Samples were collected from 50 patients with diabetic...
26 Citations Source Cite
Cited By6
Newest
Published on May 1, 2019in bioRxiv
Adeyemi Temitayo Adeyemo (Obafemi Awolowo University), Babatope Kolawole7
Estimated H-index: 7
(Obafemi Awolowo University)
+ 1 AuthorsAaron O. Aboderin8
Estimated H-index: 8
(Obafemi Awolowo University)
Background: Infected diabetic foot ulcer (IDFU) is a public health issue and a leading cause of non-traumatic limb amputation. Very few published data on IDFU is available in most West African countries. The objective of this study was to investigate the etiological agents of IDFU and the challenge of antibacterial drug resistance in the management of infections. Methods: This was a prospective cross-sectional hospital-based study involving three tertiary healthcare facilities. Consecutive eligi...
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Published on Aug 5, 2018in Experimental Diabetes Research
Mingxia Wu1
Estimated H-index: 1
(Third Military Medical University),
Hang Pan (Third Military Medical University)+ 3 AuthorsZiwen Liang5
Estimated H-index: 5
(Third Military Medical University)
Objective. To investigate the microbial distribution and drug susceptibility among diabetic foot ulcers (DFUs) with different Wagner grades and between acute and chronic DFUs. Methods. We enrolled 428 DFU patients who were hospitalized and treated in the Southwest Hospital. We collected deep ulcer secretion for microbial culture and drug susceptibility tests and analyzed the results. We reexamined 67 patients with poor anti-infection efficacy and analyzed microbial species. Results: The 354 posi...
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Published on Feb 1, 2018in International Journal of Infectious Diseases 3.20
Nese Saltoglu15
Estimated H-index: 15
(Istanbul University),
Onder Ergonul29
Estimated H-index: 29
(Koç University)
+ 34 AuthorsHaluk Eraksoy16
Estimated H-index: 16
(Istanbul University)
Abstract Objectives We described the clinical outcomes of the diabetic patients who had foot infections with multidrug resistant organisms. Methods We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. Results In total, 791 patients with DFI ...
4 Citations Source Cite
Yin Chen1
Estimated H-index: 1
,
Hui Ding1
Estimated H-index: 1
+ 1 AuthorsHong-Lin Chen1
Estimated H-index: 1
In this study, we aimed to investigate the relationship between osteomyelitis complications and drug-resistant infection risk in diabetic foot ulcer. Searches of MEDLINE and ISI databases were performed for the studies. Odds ratios (ORs) for drug-resistant infection incidence were calculated for diabetic foot ulcer patients with or without osteomyelitis complications. Eleven studies (12 cohorts) with 1526 patients were included in this study. Meta-analysis showed that the summary OR was 3.343 (9...
2 Citations Source Cite
Jinghang Zhang2
Estimated H-index: 2
(Tianjin Medical University),
Yuejie Chu3
Estimated H-index: 3
(Tianjin Medical University)
+ 4 AuthorsYue Peng1
Estimated H-index: 1
(Tianjin Medical University)
The objective was to analyze the clinical outcomes of multidrug resistant Pseudomonas aeruginosa (MDRPA) infection and determine the relationship between type III secretion system (TTSS) and MDRPA in diabetic foot (DF) patients. A total of 117 patients infected with P aeruginosa were recruited and grouped into MDRPA and non-MDRPA group according to antimicrobial susceptibility testing. TTSS genes were detected by polymerase chain reaction (PCR). Potential risk factors for MDRPA infection were ex...
6 Citations Source Cite