Bacterial genus is a risk factor for major amputation in patients with diabetic foot

Cardoso, Natália Anício; Cisneiros, Lígia De Loiola; Machado, Carla Jorge; Cenedezi, Juliana Merlin; Procópio, Ricardo Jayme; Navarro, Túlio Pinho

doi:10.1590/0100-69912017002007

Cited by 10 publications

(14 citation statements)

References 17 publications

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“…Prior studies too mentioned Pseudomonas as the most frequently occurring gram-negative bacteria in DFU. 18,19 Earlier findings reported that Escherichia coli was most commonly found pathogen on the dorsum of the foot, concurring with the current study. 14 However, no study has been found on antibiotic sensitivity with respect to the different locations of the DFU.…”

Section: Discussionsupporting

confidence: 92%

Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

Ayed

Ababneh

Robert

et al. 2018

The International Journal of Lower Extremity Wounds

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We sought to define the type and antibiotic sensitivity response of pathogens isolated from diabetic foot ulcers based on ulcer location and Wagner classification. This retrospective analysis was done among 126 patients between 40 and 70 years of age at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia, using the swab culture method for microbiological assessment. Data on demographic variables, ulcer sites (location), and depth of ulcer (Wagner classification) were also collected. A total of 134 pathogens were isolated from 126 patients. The most common gram-negative pathogen identified was Pseudomonas aeruginosa (15.6%), followed by Klebsiella spp (6.7%). The most common gram-positive pathogen was Staphylococcus aureus (35%), followed by Streptococcus (8.9%). The most widely accepted antibiotic to which the gram-negative bacteria were sensitive was gentamycin (20.1%), followed by ciprofloxacin (19%). The most routinely used antibiotic in the treatment of the gram-positive bacteria was erythromycin (16%), with trimethoprim-sulfamethoxazole (14.1%) being the next most effective. In conclusion, Pseudomonas aeruginosa, Klebsiella spp, Staphylococcus aureus, and Streptococcus were the most common causes of diabetic foot infections. However, the frequency of encountered pathogens and respective sensitivity to antibiotic therapy may be influenced by the location site and severity of the ulceration.

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Section: Discussionsupporting

confidence: 92%

Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

Ayed

Ababneh

Robert

et al. 2018

The International Journal of Lower Extremity Wounds

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“…The search in the databases resulted in 507 studies; and, after sorting by title, abstract, and application of the inclusion and exclusion criteria, 43 articles were selected. Then, all of them were submitted to full and critical reading, culminating in the selection of 28 studies of which 16 (57.1%) were found in the Medline database (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) ; 6 (21.4%), in the BVS database (25)(26)(27)(28)(29)(30) , of which 66.7% (n = 4) in the LILACS database (26)(27)(28)30) and 33.3% (n = 2) in the IBECS databases (25,29) ; and 6 articles (21.4%) found at CINAHL (31)(32)(33)(34)(35)(36) .…”

Section: Resultsmentioning

confidence: 99%

“…As for the year of publication, 7.1% matched 2009 (9,25) ; 10.7%, 2010 (10)(11)31) ; 3.6%, 2012 (26) ; 3.6%, 2013 (12) ; 7.1%, 2014 (13,27) ; 10.7%, 2015 (14,(28)(29) ; 3.6%, 2016 (15) ; 25%, 2017 (16)(17)(18)(19)(20)30,32) ; 25% , 2018 (21)(22)(23)(24)(33)(34)(35) ; and 3.6%, 2019 (36) . Regarding the country of the study, 21.4% were done in India (12,15,18,(22)(23)(24) ; 21.4%, in Brazil (13,20,(26)(27)(28)30) ; 10.7%, in China (11,21,32) ; 7.1%, in Turkey (16,35) ; 10.7%, in Spain (25,29,36) ; and 7.1%, in Mexico (14,…”

Section: Resultsmentioning

confidence: 99%

Microbiological profile of leg ulcer infections: review study

et al. 2021

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Objectives: to analyze the microbiological profile of leg ulcers of patients treated at outpatient clinics and hospitals regarding the type of microorganism, microbiological selection of antibiotics, and techniques for the collection of culture material. Methods: literature review performed on LILACS, IBECS, MEDLINE, and CINAHL databases, resulting in a descriptive analysis of 27 studies. Results: 35.7% of the studies occurred in an outpatient care scenario; and 64.2% in hospitals. There was a predominance of swab (100%) in outpatient care and biopsy (55.5%) in the hospital. Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were more common at both levels of assistance. Methicillin-resistant Staphylococcus aureus was isolated in both. Conclusions: the microbiological profile of infections was similar, with the presence of resistant bacteria in both environments. This fact causes concern and raises the need for research to elucidate it. The studies did not compare the effectiveness between biopsy and swab.

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“…and Klebsiella spp. identified in the infected ulcers of DFU patients were associated with a much higher risk of major amputation . Baumfeld et al found that risk factors for major amputations were ischaemia and previous amputations history, and antibiotic therapy before operations appeared to be a protective factor .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with lower‐extremity amputation in patients with diabetic foot ulcers in a Chinese tertiary care hospital

Guo

Yue

Qian

et al. 2019

International Wound Journal

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Providing a better understanding of the risk factors for amputation in this particular region, Hunan province, in China might help patients with diabetic foot ulcers receive timely and appropriate medical care and help prevent amputation. Diabetic foot ulcer patients referred to the Third Xiangya Hospital during the period between December 2014 and September 2018 were enrolled. Participants who underwent amputations and received conservative treatments were compared using univariate and multivariate analyses to identify the independent predictors of amputation. Those who required amputation presented significantly higher levels of white blood cell counts, platelet counts, erythrocyte sedimentation rate, C‐reactive protein, and glycated haemoglobin (HbA1c) levels. However, levels of haemoglobin, postprandial plasma C‐peptide, triglyceride, high‐density lipoprotein cholesterol, albumin, and uric acid were decreased in patients with amputations. Patients with more advanced Wagner grades had much higher rates of amputation. Multivariable‐adjusted odds ratios in stepwise logistic regression model was 1.317 for HbA1c (95% CI: 1.015‐1.709), 0.255 for triglyceride (95% CI: 0.067‐0.975), and 20.947 for Wagner grades (95% CI: 4.216‐104.080). Independent risk factors for amputation in these Chinese diabetic foot ulcer patients included an elevated HbA1c level, lower triglyceride level, and higher Wagner grades.

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Bacterial genus is a risk factor for major amputation in patients with diabetic foot

Abstract: os gêneros bacterianos Acinetobacter spp. e Klebsiella spp. identificados nas úlceras infectadas dos pacientes com pé diabético associaram-se a maior incidência de amputação maior.

Cited by 10 publications

References 17 publications

Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

Microbiological profile of leg ulcer infections: review study

Factors associated with lower‐extremity amputation in patients with diabetic foot ulcers in a Chinese tertiary care hospital

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