Association between biofilm and multi/extensive drug resistance in diabetic foot infection

Vatan, Aslı; Saltoğlu, Neşe; Yemişen, Mücahit; Balkan, İ̇lker İnanç; Sürme, Serkan; Demiray, Tayfur; Mete, Bilgül; Tabak, Fehmı

doi:10.1111/ijcp.13060

Cited by 33 publications

(33 citation statements)

References 34 publications

(47 reference statements)

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“…Recent studies suggest that many (perhaps most) DFIs are caused by bacteria in a biofilm mode, although biofilm infection is difficult to diagnose clinically . Pathogens in biofilm, compared with planktonic, infections are more difficult to treat, but some antibiotics (eg, rifampicin, daptomycin, and fosfomycin) appear to be more effective for biofilm infection than others . With appropriately selected antibiotic therapy (combined with any necessary surgery and proper metabolic control and wound care), most DFIs can be treated successfully with limited harms.…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)

Lipsky

Senneville

Abbas

et al. 2020

Diabetes Metabolism Res

494

692

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The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the diagnosis and treatment of foot infection in persons with diabetes and updates the 2015 IWGDF infection guideline. On the basis of patient, intervention, comparison, outcomes (PICOs) developed by the infection committee, in conjunction with internal and external reviewers and consultants, and on systematic reviews the committee conducted on the diagnosis of infection (new) and treatment of infection (updated from 2015), we offer 27 recommendations. These cover various aspects of diagnosing soft tissue and bone infection, including the classification scheme for diagnosing infection and its severity. Of note, we have updated this scheme for the first time since we developed it 15 years ago. We also review the microbiology of diabetic foot infections, including how to collect samples and to process them to identify causative pathogens. Finally, we discuss the approach to treating diabetic foot infections, including selecting appropriate empiric and definitive antimicrobial therapy for soft tissue and for bone infections, when and how to approach surgical treatment, and which adjunctive treatments we think are or are not useful for the infectious aspects of diabetic foot problems. For this version of the guideline, we also updated four tables and one figure from the 2016 guideline. We think that following the principles of diagnosing and treating diabetic foot infections outlined in this guideline can help clinicians to provide better care for these patients.

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Section: Treatmentmentioning

confidence: 99%

“…135,136 Pathogens in biofilm, compared with planktonic, infections are more difficult to treat, but some antibiotics (eg, rifampicin, daptomycin, and fosfomycin) appear to be more effective for biofilm infection than others. 137,138 With appropri-…”

Section: Rationalementioning

confidence: 99%

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)

Lipsky

Senneville

Abbas

et al. 2020

Diabetes Metabolism Res

494

692

View full text Add to dashboard Cite

show abstract

“…When surgery is not necessary for various reasons, a strictly conservative antibiotic therapy is very reasonable. Of note, the proportion of antibiotic-related side effects in randomized-controlled DFO trials may compromise up to 20-30% of all systemic antibiotic DFO regimens [49][50][51][52][53][54][55].…”

Section: Antibiotic Therapymentioning

confidence: 99%

Diabetic Foot Osteomyelitis: Frequent Pathogens and Conservative Antibiotic Therapy

Vogel¹,

Huber²,

Uçkay³

2021

Infections and Sepsis Development

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Chronic diabetic foot osteomyelitis (DFO) is a frequent complication in adult polyneuropathy patients with long-standing diabetes mellitus. Regarding the conservative therapy, there are several crucial steps in adequate diagnosing and approaches. The management should be performed in a multidisciplinary approach following the findings of recent research, general principles of antibiotic therapy for bone; and according to (inter-)national guidance. In this chapter we emphasize the overview on the state-of-the-art management regarding the diagnosis and antibiotic therapy in DFO. In contrast, in this general narrative review and clinical recommendation, we skip the surgical, vascular and psychological aspects.

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“…Drug resistance (Table 2) and biofilm formation (Table 3) of gram-positive and gram-negative bacteria are found to colonize in diabetic wounds. Multidrug/extensive drug-resistant microbes have also been isolated from foot ulcer regions, and it also shows signs of resistance against various antimicrobials, 45 which include MRSA. 46 Majority of chronic wound-forming bacteria, 47 Pseudomonas, Klebsiella, and E coli, are also found to form biofilm.…”

Section: Drug Resistance and Biofilm Formation Of Pseudomonas Speciesmentioning

confidence: 99%

Combinatorial Drug Therapy for Controlling Pseudomonas aeruginosa and Its Association With Chronic Condition of Diabetic Foot Ulcer

Srivastava

Karthikeyan

2019

The International Journal of Lower Extremity Wounds

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Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, major observations of DFU cases have reported on amputation of foot region, and microbial bioburden during DFU is a major cause that affects healing of the wound regions. Pathogenic microbes are routinely isolated from these wound regions, especially Staphylococcus, Pseudomonas, Klebsiella, and Escherichia coli have been reported, whereas higher prevalence of Pseudomonas species during chronic condition in the deeper part of the wound, when left untreated, leads to gangrene. Multiple drug-resistant Pseudomonas strains are a new threat because of their biofilm-forming ability, making it more potent and incurable. Acyl homoserine lactones (AHL) are a group of signaling molecules that can regulate biofilm growth, and Las and Rhl operon generally work in tandem to initiate biofilm formation by Pseudomonas species. These signaling molecules also initiate virulence factors that correlates upregulation of inflammatory responses, and AHL can be a therapeutic target in order to prevent the efficacy of multiple drug-resistant strains that form biofilm and also can be an alternative solution against control of multiple drug-resistant strains.

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Association between biofilm and multi/extensive drug resistance in diabetic foot infection

Abstract: Multi/extensive drug resistance and previous recurrent DFIs were significantly associated with biofilm formation in patients with diabetic foot.

Cited by 33 publications

References 34 publications

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)

Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)

Diabetic Foot Osteomyelitis: Frequent Pathogens and Conservative Antibiotic Therapy

Combinatorial Drug Therapy for Controlling Pseudomonas aeruginosa and Its Association With Chronic Condition of Diabetic Foot Ulcer

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