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Diabetic Foot Infection: Causative Pathogens and Empiric Antibiotherapy Considerations-The Experience of a Tertiary Center

2019-06Journal article Open access
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dc.contributor.authorNeves, JM
dc.contributor.authorDuarte, B
dc.contributor.authorPinto, M
dc.contributor.authorFormiga, A
dc.contributor.authorNeves, J
dc.date.accessioned2021-04-15T14:13:51Z
dc.date.available2021-04-15T14:13:51Z
dc.date.issued2019-06
dc.description.abstractMost moderate-to-severe diabetic foot infections (DFIs) require hospitalization with urgent surgical approach and administration of empiric antibiotherapy. To ensure optimal antibiotic coverage, regular microbiological background updates are imperative. The purpose is to characterize the microbiological profile and the antibiotic sensitivity pattern of the DFI causative pathogens isolated within a specialized DFI unit of a tertiary hospital, in order to establish evidence-based policies regarding empirical antibiotic use. A cross-sectional study was conducted. Microbiological cultures and corresponding antibiotic sensitivity tests collected from moderate-to-severe DFIs as a first approach to the hospitalized patient were retrieved and analyzed during a 12-month period. Two groups were analyzed: inpatients that had been previously followed at the diabetic foot clinic of the hospital and inpatients without a previous contact with the hospital services. A total of 125 isolates obtained from 87 patients were deemed for analysis. Globally, a predominance of Gram-positive bacteria was observed (60%). Staphylococcus aureus was the most common pathogen. The global ratio of methicillin-sensitive S aureus to methicillin-resistant S aureus (MRSA) was 1.3:1, with similar findings in both groups. According to the antibiotic sensitivity test results, and within the recommended empiric antibiotic regimens for DFI, piperacillin/tazobactam seems to be the most suitable option. Gram-positive bacteria prevail as the main isolates in DFIs. Screening for MRSA-specific risk factors is mandatory. When going for a first empiric therapy, piperacillin/tazobactam is recommended in this institution, and an anti-MRSA agent should be added early, if necessary. We encourage continuous monitoring for the bacterial prevalence in Portuguese diabetic foot centers as it is paramount for the decision making regarding DFI protocols.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Low Extrem Wounds. 2019 Jun;18(2):122-128.pt_PT
dc.identifier.doi10.1177/1534734619839815pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3657
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGEpt_PT
dc.subjectAdultpt_PT
dc.subjectAnti-Bacterial Agentspt_PT
dc.subjectCross-Sectional Studiespt_PT
dc.subjectDatabases, Factualpt_PT
dc.subjectDiabetes Mellituspt_PT
dc.subjectDiabetic Footpt_PT
dc.subjectDrug Resistance, Microbialpt_PT
dc.subjectFemalept_PT
dc.subjectGram-Negative Bacterial Infectionspt_PT
dc.subjectGram-Positive Bacterial Infectionspt_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectMalept_PT
dc.subjectMicrobial Sensitivity Testspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectTertiary Care Centerspt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectHSAC DERpt_PT
dc.subjectCHLC PAT CLINpt_PT
dc.subjectCHLC CIRpt_PT
dc.titleDiabetic Foot Infection: Causative Pathogens and Empiric Antibiotherapy Considerations-The Experience of a Tertiary Centerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage128pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage122pt_PT
oaire.citation.titleThe International Journal of Lower Extremity Woundspt_PT
oaire.citation.volume18pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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