Release Date: 2023-09-14

Approach to Diabetic Foot Infections From the Perspective of an Infectious Disease Specialist

Sua Sumer (Author), Hatice Esranur Kiratli (Author), Nazlim Aktug Demir (Author)

Release Date: 2023-09-14

Approaching diabetic foot infections from the perspective of an infectious disease specialist involves a multidimensional strategy aimed at timely diagnosis, effective antimicrobial therapy, and surgical intervention when necessary. Given the predisposing factors such as neuropathy, vascular insufficiency, and impaired immune responses in diabetic patients, infections of the foot can progress rapidly and lead to severe [...]

Media Type

  • PDF

Buy from

Price may vary by retailers

Work TypeBook Chapter
Published inCurrent Perspective on Diabetes Mellitus in Clinical Sciences
First Page371
Last Page386
DOIhttps://doi.org/10.69860/nobel.9786053359111.35
ISBN978-605-335-911-1 (PDF)
LanguageENG
Page Count16
Copyright HolderNobel Tıp Kitabevleri
Licensehttps://nobelpub.com/publish-with-us/copyright-and-licensing

Approaching diabetic foot infections from the perspective of an infectious disease specialist involves a multidimensional strategy aimed at timely diagnosis, effective antimicrobial therapy, and surgical intervention when necessary. Given the predisposing factors such as neuropathy, vascular insufficiency, and impaired immune responses in diabetic patients, infections of the foot can progress rapidly and lead to severe complications like cellulitis, abscess formation, osteomyelitis, and even limb loss if not promptly addressed. The initial assessment includes thorough clinical evaluation, imaging studies like X-rays or MRI scans to assess for bone involvement, and microbiological sampling to identify the causative organisms. Treatment typically entails empirical broad-spectrum antibiotic therapy targeting common pathogens such as Staphylococcus aureus and Streptococcus species, while adjusting therapy based on culture results and sensitivities. Surgical intervention, ranging from drainage of abscesses to debridement of necrotic tissue or even amputation in severe cases, may be necessary to control the infection and preserve limb function. Close monitoring for response to therapy, glycemic control, and wound care are essential to achieve optimal outcomes and prevent the recurrence in diabetic foot infections. Collaborative care involving infectious disease specialists, podiatrists, vascular surgeons, and endocrinologists is crucial for comprehensive management tailored to the individual patient’s needs.

Sua Sumer (Author)
Professor, Selcuk University
https://orcid.org/0000-0003-3508-7516

Hatice Esranur Kiratli (Author)
Selcuk University
https://orcid.org/0000-0001-5094-1026

Nazlim Aktug Demir (Author)
Professor, Selcuk University
https://orcid.org/0000-0002-4703-0827

  • McDermott K, Fang M, Boulton AJ, Selvin E, Hicks CW. Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers. Diabetes care 2023;46:209-21.

  • Lipsky BA, Senneville É, Abbas ZG, et al. Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes/metabolism research and reviews 2020;36:e3280.

  • Salman SÖ, Didem; Satman, İlhan; Adaş, Mine; Pekkolay, Zafer. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu 2022: Türkiye Endokrinoloji ve Metaabolizma Derneği Çalışma Grubu; 2022 [cited 2022]. Available from: https://fi le.temd.org.tr/Uploads/publications/guides/documents/diabetes- mellitus_2022.pdf.

  • Saltoğlu N, Kılıçoğlu Ö, Baktıroğlu S, et al. Diyabetik ayak yarası ve infeksiyonunun tanısı, tedavisi ve önlenmesi: ulusal uzlaşı raporu. 2015.

  • Sotto A, Richard JL, Jourdan N, Combescure C, Bouziges N, Lavigne JP. Miniaturized oligonucleotide arrays: a new tool for discriminating colonization from infection due to Staphylococcus aureus in diabetic foot ulcers. Diabetes Care 2007;30:2051-6.

  • Lipsky BA, Berendt AR, Cornia PB, et al. 2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infectionsa. Clinical Infectious Diseases 2012;54:e132-e73.

  • Weintrob ACS, Daniel J Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities 2023 [updated 07.03.2023]. Available from: https://www.uptodate.com/contents/clinical- manifestations-diagnosis-and-management-of-diabetic-infections-of-the-lower-extremities/print.

  • Eleftheriadou I, Tentolouris N, Argiana V, Jude E, Boulton AJ. Methicillin-resistant Staphylococcus aureus in diabetic foot infections. Drugs 2010;70:1785-97.

  • Aragón-Sánchez J, Lipsky BA, Lázaro-Martínez JL. Diagnosing diabetic foot osteomyelitis: is the combination of probe-to-bone test and plain radiography suffi cient for high-risk inpatients? Diabet Med 2011;28:191-4.

  • Shone A, Burnside J, Chipchase S, Game F, Jeffcoate W. Probing the validity of the probe-to-bone test in the diagnosis of osteomyelitis of the foot in diabetes. Diabetes Care 2006;29:945.

  • Hartemann-Heurtier A, Senneville E. Diabetic foot osteomyelitis. Diabetes Metab 2008;34:87-95.

  • Sharma H, Sharma S, Krishnan A, et al. The effi cacy of infl ammatory markers in diagnosing infected diabetic foot ulcers and diabetic foot osteomyelitis: Systematic review and meta-analysis. PloS one 2022;17:e0267412.

  • Lavery LA, Ahn J, Ryan EC, et al. What are the Optimal Cutoff Values for ESR and CRP to Diagnose Osteomyelitis in Patients with Diabetes-related Foot Infections? Clin Orthop Relat Res 2019;477:1594-602.

  • Kaleta JL, Fleischli JW, Reilly CH. The diagnosis of osteomyelitis in diabetes using erythrocyte sedimentation rate: a pilot study. J Am Podiatr Med Assoc 2001;91:445-50.

  • Mutluoglu M, Uzun G, Turhan V, Gorenek L, Ay H, Lipsky BA. How reliable are cultures of specimens from superfi cial swabs compared with those of deep tissue in patients with diabetic foot ulcers? J Diabetes Complications 2012;26:225-9.

  • Ertugrul MB, Baktiroglu S, Salman S, et al. The diagnosis of osteomyelitis of the foot in diabetes: microbiological examination vs. magnetic resonance imaging and labelled leucocyte scanning. Diabet Med 2006;23:649-53.

  • Aragón-Sánchez FJ, Cabrera-Galván JJ, Quintana-Marrero Y, et al. Outcomes of surgical treatment of diabetic foot osteomyelitis: a series of 185 patients with histopathological confi rmation of bone involvement. Diabetologia 2008;51:1962-70.

  • Charles PG, Uçkay I, Kressmann B, Emonet S, Lipsky BA. The role of anaerobes in diabetic foot infections. Anaerobe 2015;34:8-13.

  • Eckmann C, Dryden M. Treatment of complicated skin and soft-tissue infections caused by resistant bacteria: value of linezolid, tigecycline, daptomycin and vancomycin. Eur J Med Res 2010;15:554-63.

  • Vatan A, Saltoglu N, Yemisen M, et al. Association between biofi lm and multi/extensive drug resistance in diabetic foot infection. Int J Clin Pract 2018;72:e13060.

  • Lebeaux D, Ghigo JM, Beloin C. Biofi lm-related infections: bridging the gap between clinical management and fundamental aspects of recalcitrance toward antibiotics. Microbiol Mol Biol Rev 2014;78:510-43.

  • Hartemann-Heurtier A, Robert J, Jacqueminet S, et al. Diabetic foot ulcer and multidrug-resistant organisms: risk factors and impact. Diabet Med 2004;21:710-5.

  • Lipsky BA, Dryden M, Gottrup F, Nathwani D, Seaton RA, Stryja J. Antimicrobial stewardship in wound care: a Position Paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association. J Antimicrob Chemother 2016;71:3026-35.

  • Uçkay I, Berli M, Sendi P, Lipsky BA. Principles and practice of antibiotic stewardship in the management of diabetic foot infections. Curr Opin Infect Dis 2019;32:95-101.

  • Senneville E, Robineau O. Treatment options for diabetic foot osteomyelitis. Expert Opin Pharmacother 2017;18:759-65.

  • 12. Retinopathy, Neuropathy, and Foot Care: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022;45:S185-s94.

onix_3.0::thothThoth ONIX 3.0
onix_3.0::project_museProject MUSE ONIX 3.0
onix_3.0::oapenOAPEN ONIX 3.0
onix_3.0::jstorJSTOR ONIX 3.0
onix_3.0::google_booksGoogle Books ONIX 3.0
onix_3.0::overdriveOverDrive ONIX 3.0
onix_2.1::ebsco_hostEBSCO Host ONIX 2.1
csv::thothThoth CSV
json::thothThoth JSON
kbart::oclcOCLC KBART
bibtex::thothThoth BibTeX
doideposit::crossrefCrossRef DOI deposit
onix_2.1::proquest_ebraryProQuest Ebrary ONIX 2.1
marc21record::thothThoth MARC 21 Record
marc21markup::thothThoth MARC 21 Markup
marc21xml::thothThoth MARC 21 XML

Share This Chapter!