scholarly journals MON-626 Frequency and Associated Factors with Multidrug-Resistant Organism Infection in Diabetic Foot Ulcers in a Peruvian Public Hospital

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marlon Augusto Yovera-Aldana ◽  
Liset Paola Sifuentes ◽  
Delia Cruz-Estacio ◽  
Diana Consuelo Flores ◽  
Lucy Nelly Damas-Casani
Keyword(s):  
Clinical Practice ◽  
Diabetic Foot ◽  
Associated Factors ◽  
Public Hospital ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Bivariate Analysis ◽  
Resistant Organism ◽  
Diabetic Foot Ulcers ◽  
International Expert

Abstract Objective: To determine the frequency and associated factors with multidrug-resistant organism (MDRO) infection among patients with diabetic foot ulcers in a Peruvian Public Hospital. Materials and methods. Cross-sectional survey was conducted from January 2017 -December 2018 at National Hospital in Lima Perú. Ulcers with clinical signs of infection (erythema, edema, pain, purulent exudate) according Infectious Diseases Society of America clinical practice guideline were included1. Wounds with only skin involvement were excluded. On admission, specimens for culture were obtained after cleansing and debriding of the wound. Samples were promptly sent to the microbiology laboratory for culture using appropriate transport media. Bacterial identification and antibiotic susceptibility testing were performed using the VITEK® 2 automated system (BioMérieux Laboratory, Argentina). Multidrug-resistant organisms were identified according to the recommendations of International Expert Proposal2. Prevalence ratios derived from bivariate analysis are given with their 95% CI, which was performed to study factors associated with the presence of multidrug-resistant bacteria; and a multivariate analysis with a lineal model to associated variables found in the bivariate analysis. This study has the approval of the Research Ethics Committee of the María Auxiliadora Hospital. Results Among 153 selected subjects, 75% were male, with an average age of 59 yo, 70% had ≥10 years of diabetes duration and only 16% had HbA1C <7%. A frequency of 85% of patients with MDRO infection was found and was associated with minor amputation RP 1.18 (95% CI 1.01-1.44) and with hospitalization time of ≥ 28 days RP 1.21 (95% CI 1.03-1.30). Conclusion. 6 of 7 patients have MDRO infection among patients with diabetic foot ulcers and are associated with the occurrence of minor amputation and hospitalization time ≥ 28 days. References 1. Lipsky BA, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54(12):e132-73. 2. Magiorakos AP, et al. Multidrug-resistant, extensively drug-resistant and pandrugresistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268-81.

scholarly journals The Influence of Multidrug-Resistant Bacteria on Clinical Outcomes of Diabetic Foot Ulcers: A Systematic Review

2021 ◽  
Vol 10 (9) ◽  
pp. 1948
Author(s):  
Gianmarco Matta-Gutiérrez ◽  
Esther García-Morales ◽  
Yolanda García-Álvarez ◽  
Francisco Javier Álvaro-Afonso ◽  
Raúl Juan Molines-Barroso ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Mortality Rates ◽  
Multidrug Resistant ◽  
Healing Time ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Resistant Organism ◽  
Diabetic Foot Ulcers ◽  
Multidrug Resistant Organisms

Multidrug-resistant organism infections have become important in recent years due to the increased prevalence of diabetic foot ulcers and their possible consequences. This study aimed to systematically review and evaluate ulcer duration, healing time, hospital stay, amputation, and mortality rates in patients with diabetic foot ulcers caused by infection with multidrug-resistant organisms. PubMed, the Cochrane Library, and Web of Science were searched in May 2020 to find observational studies in English about the clinical outcomes of multidrug-resistant organism infection in diabetic foot ulcers. Eight studies met the inclusion criteria, and these studies included 923 patients. The overall methodological quality of the study was moderate. Ulcer duration was described in six studies, and there was no practical association with multidrug-resistant organisms. Two out of three studies reported a longer healing time in multidrug-resistant organism infections than in non-multidrug-resistant organism infections. Clinical outcomes included the duration of hospitalisation, surgeries, amputations, and deaths. Lower limb amputation was the most reported clinical outcome in the included studies, and was more prevalent in the multidrug-resistant organism infections. We concluded that there was not enough evidence that multidrug-resistant organisms hindered the healing of diabetic foot ulcers. In contrast to the clinical outcomes, multidrug-resistant organisms affect both amputation rates and mortality rates.

scholarly journals Alternative Approaches for the Management of Diabetic Foot Ulcers

2021 ◽  
Vol 12 ◽  
Author(s):  
Cassandra Pouget ◽  
Catherine Dunyach-Remy ◽  
Alix Pantel ◽  
Adeline Boutet-Dubois ◽  
Sophie Schuldiner ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Current Knowledge ◽  
Healing Process ◽  
Public Health Problem ◽  
Skin Surface ◽  
Multidrug Resistant ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Alternative Approaches

Diabetic foot ulcers (DFU) represent a growing public health problem. The emergence of multidrug-resistant (MDR) bacteria is a complication due to the difficulties in distinguishing between infection and colonization in DFU. Another problem lies in biofilm formation on the skin surface of DFU. Biofilm is an important pathophysiology step in DFU and may contribute to healing delays. Both MDR bacteria and biofilm producing microorganism create hostile conditions to antibiotic action that lead to chronicity of the wound, followed by infection and, in the worst scenario, lower limb amputation. In this context, alternative approaches to antibiotics for the management of DFU would be very welcome. In this review, we discuss current knowledge on biofilm in DFU and we focus on some new alternative solutions for the management of these wounds, such as antibiofilm approaches that could prevent the establishment of microbial biofilms and wound chronicity. These innovative therapeutic strategies could replace or complement the classical strategy for the management of DFU to improve the healing process.

Insight into multidrug-resistant microorganisms from microbial infected diabetic foot ulcers

2019 ◽  
Vol 13 (2) ◽  
pp. 1261-1270 ◽  
Author(s):  
Mohamed A. Hassan ◽  
Tamer M. Tamer ◽  
Asmaa A. Rageh ◽  
Alaa M. Abou-Zeid ◽  
Eman H.F. Abd El-Zaher ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Insight Into

Prevalence Of Diabetic Foot Ulcers And Their Associated Factors In Patients From Public Hospitals In Manaus-Am

2021 ◽  
Author(s):  
Nariani Souza Galvão ◽  
Mariana Alves Bandeira ◽  
Evely Oliveira de Carvalho ◽  
Kevin Woo ◽  
Paula Cristina Nogueira ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Associated Factors ◽  
Public Hospitals ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Leczenie miodem owrzodzeń cukrzycowych stóp

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Bogdan Kędzia ◽  
Elżbieta Hołderna-Kędzia
Keyword(s):  
Clinical Practice ◽  
Diabetic Foot ◽  
Clinical Studies ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Stages Of Development ◽  
Health Threat ◽  
Beneficial Effects ◽  
Neurogenic Origin

Diabetic foot ulcers are of neurogenic or angiogenic origin. In both cases they pose a serious health threat because their treatment is difficult and in many cases is ineffective. A serious complications in the treatment of this disease are caused by microorganism infections that are resistant to antibiotics. Hence the search for other effective healings of diabetic foot ulcers. One solution is to use bee honey for this purpose. The clinical studies presented in the work prove that the use of honey dressings in diabetic foot ulcers provide very beneficial effects, better and faster achievable than in the case of preparations generally used in clinical practice. For this reason, bee honey can be successfully applied in the treatment of diabetic foot ulcers, both of angiogenic and neurogenic origin, at different stages of development, including gangrenous processes.

Risk factors and healing impact of multidrug-resistant bacteria in diabetic foot ulcers

2008 ◽  
Vol 34 (4) ◽  
pp. 363-369 ◽  
Author(s):  
J.-L. Richard ◽  
A. Sotto ◽  
N. Jourdan ◽  
C. Combescure ◽  
D. Vannereau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Resistant Bacteria ◽  
Diabetic Foot Ulcers ◽  
Multidrug Resistant Bacteria

scholarly journals Identification of biofilm-producing microorganism’s and drug susceptibility pattern from diabetic foot ulcer patients at Puducherry

2020 ◽  
Vol 11 (4) ◽  
pp. 7353-7357
Author(s):  
Jayarani Manikandan ◽  
Jaikumar S ◽  
Sandhya Rani T
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Isolation And Identification ◽  
Diabetic Ulcer ◽  
Biofilm Production

Diabetes mellitus is a significant health problem worldwide that affects approximately 171 million people; severe complications lead to the development of diabetic foot ulcers. Diabetic ulcer infections are mainly polymicrobial in nature and multidrug-resistant (MDR), which is capable of forming a biofilm, which is the important virulence factor results in treatment failure. The main objectives of this study to investigate the etiologic agents of diabetic foot infections, their antimicrobial resistance and biofilm formation. A total of 200 patient samples were taken from diabetic foot ulcer patients between September 2015 and February 2016. Isolation and identification of microorganism were made according to standard microbiological procedures. Antibiotic Susceptibility testing performed by Kirby Bauer disc diffusion method and the biofilm production was performed by the tube method and Congo Red Method. Out of 200 samples processed,  110 (55%) were polymicrobial, 50 (25%) monomicrobial and 40(20 %)culture Sterile. The most common organism isolated were 82(39%) Pseudomonas aeruginosa,45(21%) Staphylococcus aureus, 48(23%) Candida sp followed by others. Biofilm production was seen in 112 (53%) of the isolates. Antimicrobial drug  resistance was higher among 92(82%) biofilm producers than non-biofilm 20(18%) producing microorganisms. Organisms isolated from chronic diabetic foot ulcers cases were multidrug-resistant and biofilm producers. Our study shows the importance of biofilm screening with the usual antibiogram, as a routine technique in diabetic foot ulcers patients for effective treatment.

scholarly journals Wound care using metronidazole in a patient with diabetic foot ulcer: a case report

2020 ◽  
Vol 1 ◽  
pp. 172-175
Author(s):  
Agus Santosa ◽  
Okta Fajar Silviana ◽  
Neneng Khasanah
Keyword(s):  
Diabetic Foot ◽  
Public Hospital ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Medical Intervention ◽  
Infection Process ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Area

The control of infection in diabetic foot ulcers is essential to prevent injuries from getting worse. Infection in diabetic foot ulcers is generally caused by bacteria existence in the wound. Antibiotics may not be orally able to exterminate bacteria rapidly in the wound area, so antibiotics are needed directly and topically to the wound to reduce the infection process. This case describes wound care intervention using gauze added by antibiotic metronidazole as a wound compress in a 46-year-old male patient with diabetic foot ulcers treated at Cempaka Ward Banyumas Regional Public Hospital. This case is interesting because the medical intervention given to patients is rarely implemented in clinical practice. The conclusion is that a metronidazole antibiotic used to compress wounds in patients with diabetic foot ulcers can reduce the wound infection process.

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