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Diabetic foot infections

Shin-Yi Lin, Nai-Yu Lin, Yu-Yao Huang, Chi-Chun Hsieh, Yhu-Chering Huang
PURPOSE: To evaluate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in patients with diabetic foot ulcer (DFU) in Taiwan, and to assess the concordance between colonizing and clinical MRSA isolates from the patients. METHOD: A total of 354 nasal specimens were collected from 112 to 242 diabetic patients with and without foot ulcer, respectively. MRSA clinical isolates from DFU wound cultures were collected for comparison. RESULTS: Nasal carriage rate of S...
June 4, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Huihui Yang, Quan E Kan, Yong Su, Hua Man
It's known that long non-coding RNA CASC2 overexpression inhibit the JNK pathway in some disease models, while JNK pathway activation exacerbates diabetic nephropathy. Therefore we speculate that long non-coding RNA CASC2 can improve diabetic nephropathy by inhibiting JNK pathway. Thus, our study was carried out to investigate the involvement of CASC2 in diabetic nephropathy. We found that serum level of CASC2 was significantly lower in diabetic nephropathy patients than in normal people, and serum level of CASC2 showed no significant correlations with age, gender, alcohol consumption and smoking habits, but was correlated with course of disease...
June 11, 2018: Experimental and Clinical Endocrinology & Diabetes
Maria Demetriou, Nikolaos Papanas, Periklis Panagopoulos, Maria Panopoulou, Efstratios Maltezos
No abstract text is available yet for this article.
June 11, 2018: Experimental and Clinical Endocrinology & Diabetes
Grace Messenger, Richard Masoetsa, Imtiaz Hussain, Sriraman Devarajan, Mohamed Jahromi
Objective : This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods : Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first...
2018: Diabetic Foot & Ankle
Folusakin Ayoade, Pradeep Kumar Mada, Mohammad Alam
Raoultella ornithinolytica is a rare opportunistic aerobic gram-negative bacillus that naturally exists in soil, water and plants. The pathogen has been described in association with diabetic foot infections, biliary infections, bacteraemia and native and prosthetic joint infections. Fat necrosis and wound infection following breast reduction surgery or other plastic surgeries caused by this pathogen have not been previously described. We present a case of bilateral fat necrosis, wound infection and dehiscence in a 24-year-old woman with no significant past medical problems...
June 4, 2018: BMJ Case Reports
Steven L Percival, Matthew Malone, Dieter Mayer, Anne-Marie Salisbury, Gregory Schultz
Infected tissues in the feet of people with diabetes in the form of a diabetic foot ulcer (DFU) present a complex pathology for clinicians to manage. This is partly attributed to the multi-factorial nature of the disease, which may include; altered foot architecture leading to excessive plantar pressures and frictional forces peripheral arterial disease and loss of protective sensation. In addition, to the above co-morbid variables, it is understood that a delayed wound healing state may be perpetuated by the presence of microorganisms residing in the wound tissue...
June 4, 2018: International Wound Journal
Christopher W Farnsworth, Eric M Schott, Abigail Benvie, Stephen L Kates, Edward M Schwarz, Steven R Gill, Michael J Zuscik, Robert A Mooney
Obese patients with type 2 diabetes (T2D) are at an increased risk of foot infection, with impaired immune function believed to be a critical factor in the infectious process. In this study, we test the hypothesis that humoral immune defects contribute to exacerbated foot infection in a murine model of obesity/T2D. C57BL/6J mice were rendered obese and T2D by a high-fat diet for 3 mo and were compared with controls receiving a low-fat diet. Following injection of Staphylococcus aureus into the footpad, obese/T2D mice had greater foot swelling and reduced S...
June 1, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
Chun-Lin Su, Chang-Cheng Chang, Yun-Shing Peng, Mei-Yen Chen
OBJECTIVE: The aim of this study is to investigate the preexisting predictive factors associated with comorbidities for diabetic foot ulcer (DFU) in King classification III at an outpatient clinic. METHOD: This prospective study included 100 patients with DFU in King classification III treated at outpatient clinics in Chiayi Chang Gung Memorial Hospital from January 2011 to December 2011. The least follow-up time was 1 year. Medical documentations were in respect of patient's baseline characteristics, associated history, presence of comorbidities, follow-up time, and condition of wounds...
May 30, 2018: Annals of Plastic Surgery
Serhat Uysal, Anil Murat Ozturk, Meltem Tasbakan, Ilgin Yildirim Simsir, Aysegul Unver, Nevin Turgay, Husnu Pullukcu
BACKGROUND: Myiasis complication of diabetic foot ulcer has only been presented in a few case reports. Therefore, there is a need for additional data on this infestation. OBJECTIVE: Evaluate clinical characteristics of human myiasis in patients with diabetic foot. DESIGN: Case series. SETTINGS: A tertiary referral healthcare institution and a diabetic foot center. PATIENTS AND METHODS: Patients with diabetic foot infection com...
May 2018: Annals of Saudi Medicine
Lorena Tuchscherr, Èva Korpos, Hélène van de Vyver, Clais Findeisen, Salome Kherkheulidze, Anke Siegmund, Stefanie Deinhardt-Emmer, Olaf Bach, Martin Rindert, Alexander Mellmann, Cord Sunderkötter, Georg Peters, Lydia Sorokin, Bettina Löffler
Staphylococcus aureus is the most frequent pathogen causing diabetic foot infections. Here, we investigated the degree of bacterial virulence required to establish invasive tissue infections in diabetic organisms. Staphylococcal isolates from diabetic and non-diabetic foot ulcers were tested for their virulence in in vitro functional assays of host cell invasion and cytotoxicity. Isolates from diabetes mellitus type I/II patients exhibited less virulence than isolates from non-diabetic patients, but were nevertheless able to establish severe infections...
May 22, 2018: International Journal of Medical Microbiology: IJMM
Enrico Brocco, Sasa Ninkovic, Mariagrazia Marin, Christine Whisstock, Marino Bruseghin, Giovanni Boschetti, Raffaella Viti, William Forlini, Antonio Volpe
Diabetic foot is a complication of diabetes affecting 15% of diabetics in their lives. It is associated to diabetic neuropathy and peripheral vascular disease and its incidence has increased. The ulceration is the initial cause of a dramatic process leading, if not correctly treated, to amputations. Both neuropathy, neuro-ischemia and infections have a role in determining healing or worsening of the lesions and 85% of all amputations in diabetic patients are preceded by a foot ulceration deteriorating to a severe gangrene or infection...
May 29, 2018: Journal of Cardiovascular Surgery
Jennifer J Hurlow, Gavin J Humphreys, Frank L Bowling, Andrew J McBain
The number of people in the world with diabetes has nearly quadrupled in the past 40 years. Current data show that 25% of these diabetics will develop a foot ulcer in their lifetime and that the cost of care for a diabetic foot ulcer (DFU) is over twice that of any other chronic ulcer aetiology. Microbial biofilm has been linked to both wound chronicity and infection. Close to 1 in 2 diabetics with a DFU are predicted to go on to develop a diabetic foot infection (DFI). The majority of these DFIs have been found to evolve even before the diabetic individual has received an initial referral for expert DFU management...
May 28, 2018: International Wound Journal
Lei Gao, Shuo Wang, Lei Wang, Jiangning Wang
Objective: To evaluate the clinical value of skin stretching device in repair of diabetic foot wound. Methods: A retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device (trial group, n =24) and with the vacuum sealing drainage combined with skin graft (control group, n =24) respectively between October 2015 and July 2016. There was no significant difference in gender, age, side, course of disease, TEXAS stage between 2 groups ( P >0...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
M Libby Weaver, Caitlin W Hicks, Joseph K Canner, Ronald L Sherman, Kathryn F Hines, Nestoras Mathioudakis, Christopher J Abularrage
OBJECTIVE: Previous studies show conflicting results in wound healing outcomes based on angiosome direct perfusion (DP), but few have adjusted for wound characteristics in their analyses. We have previously shown that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing in diabetic foot ulcers (DFUs) treated by a multidisciplinary team. The aim of this study was to compare WIfI classification vs DP and pedal arch patency as predictors of wound healing in patients presenting with DFU and peripheral arterial disease...
May 23, 2018: Journal of Vascular Surgery
Lia Ferreira, André Carvalho, Rui Carvalho
BACKGROUND: Diabetic foot ulcers are the leading cause of non-traumatic lower extremity amputation. The aim of this study was to establish short-term predictors of lower extremity amputation (LEA) in patients with diabetic foot ulcers (DFU). METHODS: A retrospective observational study was performed. Patients observed for the first time in a multidisciplinary outpatient diabetic foot clinic during 1-year were reviewed. We examined demographic and clinical data and the occurrence of LEA within 180 days...
May 17, 2018: Diabetes & Metabolic Syndrome
Steven T W van Haelst, Martin Teraa, Frans L Moll, Gert J de Borst, Marianne C Verhaar, Michael S Conte
OBJECTIVE: The Wound, Ischemia, and foot Infection (WIfI) classification was developed to assess amputation risk and hence to aid in clinical decision-making in patients with chronic limb-threatening ischemia (CLTI). WIfI has been validated in multiple CLTI cohorts worldwide. In this study, we examined the relationship between WIfI stage and clinical outcomes in a well-defined subpopulation of CLTI patients considered not eligible for conventional revascularization. The aim of this study was to assess the prognostic value of the WIfI classification for clinical outcomes in a "no-option" CLTI population...
May 22, 2018: Journal of Vascular Surgery
Carina Matias, Isa Serrano, Sofia Van-Harten, Carla Mottola, João J Mendes, Luís Tavares, Manuela Oliveira
Diabetic foot ulcers are a major complication of diabetes and are often colonised by complex bacterial communities, where Staphylococcus aureus is frequently co-present with Pseudomonas aeruginosa. These bacteria interact through quorum sensing, encoded in S. aureus by the accessory gene regulator (agr). Typing and copy number of S. aureus agr were assessed here to give insights on strain variability and possible interspecies influence. As agr is classified in four genetic groups, agr-I, agr-II, agr-III and agr-IV, the agr type of 23 S...
May 23, 2018: Antonie Van Leeuwenhoek
P A Lazzarini, R E Pacella, D G Armstrong, J J van Netten
Globally ~435 million people have diabetes [1], and an estimated 19-34% (~83-148 million people) of those will be expected to develop foot ulcers in their lifetime [2]. Foot ulcers are typically precipitated by other diabetes-related lower-extremity complications, (DRLECs) including peripheral neuropathy and peripheral vascular disease [2,3]. Collectively, DRLECs are a leading cause of infection, hospitalization and amputation outcomes [2-5], yet, these outcomes are readily preventable with evidence-based care [6,7]...
May 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Khalid Johani, Blain G Fritz, T Bjarnsholt, Benjamin A Lipsky, Slade O Jensen, Mark Yang, Anastasia Dean, H Hu, Karen Vickery, Matthew Malone
OBJECTIVES: Rigorous visual evidence on whether or not biofilms are involved in diabetic foot osteomyelitis (DFO) is lacking. We employed a suite of molecular and microscopic approaches to investigate the microbiome, and phenotypic state of microorganisms involved in DFO. METHODS: In 20 consecutive subjects with suspected DFO, we collected intraoperative bone specimens. To explore the microbial diversity present in infected bone we performed next-generation DNA sequencing...
May 19, 2018: Clinical Microbiology and Infection
Ilker Uçkay, Benjamin Kressmann, Sébastien Di Tommaso, Marina Portela, Heba Alwan, Hubert Vuagnat, Sophie Maître, Christophe Paoli, Benjamin A Lipsky
Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin-collagen sponge with local care versus local care alone...
2018: SAGE Open Medicine
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