New Molecular Techniques to Study the Skin Microbiota of Diabetic Foot Ulcers

The role of anaerobes in diabetic foot infections

“…Metagenomic studies have revealed that there is interplay among bacterial communities in specific environments, such as wounds, to produce specific clinical "syndromes" [16][17][18]. Certainly, various neurological, vascular and mechanical factors are known to affect the appearance and outcome of wounds.…”

Prevalence of TEM and SHV Genes among Extended Spectrum Beta-Lactamase (ESBL) Producing Escherichia coli Isolates from Infected Diabetic Foot Ulcers in a Tertiary Care Hospital

“…The culture based diagnostic techniques often underestimate the microbial load, diversity and the prevalence of fastidious and anaerobic bacteria. The molecular microbiological techniques once become widely available and affordable offer a promising tool in rapidly identifying pathogens causing infection, the resistant genes they possess and to determine the virulence factors in them (Lavigne et al, 2015;Lipsky et al, 2013;Spichler et al, 2015).…”

“…The increase in life expectancy and sedentary modern life style will certainly further increase the prevalence in the years to come (IDF Diabetes atlas, 2015) The foot ulcer and its subsequent aerobic, anaerobic bacterial and fungal infection is a debilitating complication of long standing diabetes, more so in poorly controlled diabetes (Lipsky et al, 2012;Chincholikar DA et al, 2002) The incidence of diabetic foot ulcer may be as high as 25% in diabetic patients during their lifetime (Singh et al, 2005). Prevention of foot ulcer is essential to reduce morbidity and mortality, but when foot ulcer develops due to altered mechanical load in a neuropathic foot, infection inevitably follows as an "epiphenomenon" in about 40-80% of patients (Singh et al, 2005;Uckay et al, 2015;Lavigne et al, 2015).…”

Understanding the Role of Fungi in Chronic Wounds

“…However, the use of swab samples from superficial tissue makes it difficult to ascertain whether any fungi identified merely resided on wound surfaces as colonizers or whether the fungi were invasive and involved deeper tissue (this may suggest a more pathogenic involvement) (5). …”