scholarly journals An Alteration of Lymphocytes Subpopulations and Immunoglobulins Levels in Patients with Diabetic Foot Ulcers Infected Particularly by Resistant Pathogens

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Vladimíra Fejfarová ◽  
Alexandra Jirkovská ◽  
Michal Dubský ◽  
Frances Game ◽  
Jana Vydláková ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Antibiotic Sensitivity ◽  
Adaptive Immune System ◽  
Serum Levels ◽  
Study Groups ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Effector Cells ◽  
Immunoglobulin Subclasses ◽  
Causal Pathogen

The aim of our study was to analyse immune abnormalities in patients with chronic infected diabetic foot ulcers (DFUs) especially those infected by resistant microorganisms. Methods. 68 patients treated in our foot clinic for infected chronic DFUs with 34 matched diabetic controls were studied. Patients with infected DFUs were subdivided into two subgroups according to the antibiotic sensitivity of causal pathogen: subgroup S infected by sensitive (n=50) and subgroup R by resistant pathogens (n=18). Selected immunological markers were compared between the study groups and subgroups. Results. Patients with infected chronic DFUs had, in comparison with diabetic controls, significantly reduced percentages (p<0.01) and total numbers of lymphocytes (p<0.001) involving B lymphocytes (p<0.01), CD4+ (p<0.01), and CD8+ T cells (p<0.01) and their naive and memory effector cells. Higher levels of IgG (p<0.05) including IgG1 (p<0.001) and IgG3 (p<0.05) were found in patients with DFUs compared to diabetic controls. Serum levels of immunoglobulin subclasses IgG2 and IgG3 correlated negatively with metabolic control (p<0.05). A trend towards an increased frequency of IgG2 deficiency was found in patients with DFUs compared to diabetic controls (22% versus 15%; NS). Subgroup R revealed lower levels of immunoglobulins, especially of IgG4 (p<0.01) in contrast to patients infected by sensitive bacteria. The innate immunity did not differ significantly between the study groups. Conclusion. Our study showed changes mainly in the adaptive immune system represented by low levels of lymphocyte subpopulations and their memory effector cells, and also changes in humoral immunity in patients with DFUs, even those infected by resistant pathogens, in comparison with diabetic controls.

Elevated Serum Levels of Lp-PLA2 and IL-18 are Associated with Progression of Diabetic Foot Ulcers

2020 ◽  
Vol 66 (10/2020) ◽  
Author(s):  
Tian Chen ◽  
Jianhua Yu ◽  
Jing Wang ◽  
Qi Chang ◽  
Chao Qian
Keyword(s):  
Diabetic Foot ◽  
Elevated Serum ◽  
Serum Levels ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Benefits of Acidifying Agents in Local Therapy of Diabetic Foot Ulcers Infected by Pseudomonas sp: A Pilot Study

2019 ◽  
Vol 18 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Vladimíra Fejfarová ◽  
Hana Tibenská ◽  
Jitka Niklová ◽  
Robert Bém ◽  
Michal Dubský ◽  
...  
Keyword(s):  
Pilot Study ◽  
Diabetic Foot ◽  
Local Treatment ◽  
Local Therapy ◽  
Study Groups ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Pseudomonas Sp ◽  
Group 2 ◽  
Group 1

Infections caused by Pseudomonas sp are difficult to resolve by antibiotics (ATBs) and local therapy. The aim of our pilot study was to assess the effect of different local agents—particularly acidifying solutions—on the healing of diabetic foot ulcers (DFUs), eradication of pathogens, and economic costs related to DFU therapy. In this case study, we monitored 32 DFU patients infected by Pseudomonas species. Patients were divided into 2 groups according to the local therapy provided: group 1 (n = 15)—modern local treatment; group 2 (n = 17)—acidifying antiseptic solutions. The study groups differed only with regard to ATB usage prior to enrolment in the study ( P = .004), but did not differ with regard to age, diabetes control, peripheral arterial disease, or microcirculation status. During the follow-up period, DFUs healed in 20% of cases in group 1, but there were no cases of healing in group 2 (NS). The length of ATB therapy, the number of new osteomyelitis, lower limb amputations, and the changes of DFUs status/proportions did not differ significantly between study groups. Pseudomonas was eradicated in 67% of cases in group 1 and in 65% of cases in group 2. The local treatment given to group 2 patients was associated with lower costs ( P < .0001). Conclusion. Acidifying agents had the same effect as modern healing agents on wound healing, the number of amputations, and the eradication of Pseudomonas. Moreover, therapy performed using acidifying solutions proved in our pilot study markedly cheaper.

Common Pathogens and Antibiotic Sensitivity Profiles of Infected Diabetic Foot Ulcers in Saudi Arabia

2018 ◽  
Vol 17 (3) ◽  
pp. 161-168 ◽  
Author(s):  
Mousab Yousef Al Ayed ◽  
Mutasem Ababneh ◽  
Asirvatham Alwin Robert ◽  
Aus Alzaid ◽  
Rania Ahmed Ahmed ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Saudi Arabia ◽  
Diabetic Foot ◽  
Antibiotic Sensitivity ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Gram Positive ◽  
Gram Negative ◽  
Klebsiella Spp

We sought to define the type and antibiotic sensitivity response of pathogens isolated from diabetic foot ulcers based on ulcer location and Wagner classification. This retrospective analysis was done among 126 patients between 40 and 70 years of age at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia, using the swab culture method for microbiological assessment. Data on demographic variables, ulcer sites (location), and depth of ulcer (Wagner classification) were also collected. A total of 134 pathogens were isolated from 126 patients. The most common gram-negative pathogen identified was Pseudomonas aeruginosa (15.6%), followed by Klebsiella spp (6.7%). The most common gram-positive pathogen was Staphylococcus aureus (35%), followed by Streptococcus (8.9%). The most widely accepted antibiotic to which the gram-negative bacteria were sensitive was gentamycin (20.1%), followed by ciprofloxacin (19%). The most routinely used antibiotic in the treatment of the gram-positive bacteria was erythromycin (16%), with trimethoprim-sulfamethoxazole (14.1%) being the next most effective. In conclusion, Pseudomonas aeruginosa, Klebsiella spp, Staphylococcus aureus, and Streptococcus were the most common causes of diabetic foot infections. However, the frequency of encountered pathogens and respective sensitivity to antibiotic therapy may be influenced by the location site and severity of the ulceration.

scholarly journals A study on clinical grading and bacteriological profile of diabetic foot ulcers in tertiary care centre

2020 ◽  
Vol 7 (7) ◽  
pp. 2342 ◽  
Author(s):  
Mohammed Hamza ◽  
Thomas K. Thomas
Keyword(s):  
Treatment Outcome ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Antibiotic Sensitivity ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Tertiary Care Centre ◽  
Wagner’S Grade

Background: Diabetes is one of the commonest diseases worldwide and diabetic foot ulcer and its complications are associated with significant morbidity and even amputation. Early detection of colonizing agent of these ulcers help in reduced morbidity and hospital stay. We targeted this subgroup of patients to study Wagner’s grade, identify the bacterial agent and its antibiotic sensitivity and ankle-brachial pressure index (ABPI) assessment to detect PAD, for the best treatment outcome of diabetic foot ulcers.Methods: The present study was conducted in the Department of Surgery of SGMCRF, Venjaramoodu on 210 patients with diabetic foot ulcers between November 2017 and May 2019. Wagner’s grading of ulcer, culture and antibiotic sensitivity of microbe were done as well as ABPI was measured. Outcome of ulcers was compared to ABPI and ABPI was compared to time of healing.Results: Out of 210 patients 122 were males and 88 females, 62.9% had neuropathy and 66.7% had vasculopathy. Most patients presented with Wagner’s grade-II ulcers.  Most common microbe isolated was pseudomonas aeruginosa which was most sensitive to piperacillin and tazobactam combination. Majority of lesions 62.9% had ABPI in range of 0.5-0.89.Conclusions: Wagner’s grading and presence of neuropathy are predictors of major amputation. Piperacillin and tazobactam should be empirical choice of antibiotic. ABPI was inversely related to time of healing and has got significant association with treatment outcome.

scholarly journals Bacterial characteristics and their antibiotic sensitivity pattern in Sri Lankan diabetic foot ulcers

2013 ◽  
Vol 5 (1) ◽  
pp. 7
Author(s):  
WSMKJ Senanayake ◽  
LAK Samarasekera ◽  
Ranil Ferando ◽  
WA Kirthi Weerawardena
Keyword(s):  
Diabetic Foot ◽  
Antibiotic Sensitivity ◽  
Foot Ulcers ◽  
Sri Lankan ◽  
Diabetic Foot Ulcers ◽  
Sensitivity Pattern

scholarly journals Antibacterial activity of actinomycetes against bacterial pathogens of diabetic foot ulcers

2013 ◽  
Vol 5 (2) ◽  
pp. 335-337
Author(s):  
M. Saraswathi ◽  
N. Mallikarjuna
Keyword(s):  
Antibacterial Activity ◽  
Diabetic Foot ◽  
Bacterial Pathogens ◽  
Antibiotic Sensitivity ◽  
Public Health Problem ◽  
Major Complication ◽  
Foot Ulcers ◽  
Screening Methods ◽  
Diabetic Foot Ulcers ◽  
Test Organisms

Diabetes mellitus is a serious public health problem worldwide. Diabetic foot ulcers (DFU), a major complication in Type 2 diabetes are one of the major causes of morbidity and mortality around the world. To screen various bacterial pathogens present in diabetic foot ulcers and to determine their antibiotic sensitivity to actinomycetes isolated from various fields of Chandragiri, Tirupati, twenty four actinomycetes isolates were isolated and screened by primary and secondary screening methods to determine potent antibiotic producers by using test organisms. Among 24 isolates, 4 were more potent and they showed varied range of antibacterial activity of pathogens, isolated form diabetic foot ulcers. Four isolates were compared with lenezoid antibiotic. Enterococcus was resistant to lenezoid antibiotic but four actinomycetes inhibited the growth of Enterococi.

scholarly journals Antimicrobial Susceptibility Patterns ofPseudomonas aeruginosafrom Diabetes Patients with Foot Ulcers

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Tamil Selvi Sivanmaliappan ◽  
Murugan Sevanan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Susceptibility Patterns ◽  
Diabetes Patients

Pseudomonas aeruginosais an invasive organism that frequently causes severe tissue damage in diabetic foot ulcers. A major problem inP. aeruginosainfection may be that this pathogen exhibits a high degree of resistance to a broad spectrum of antibiotics. The study aimed to isolate and determine the antimicrobial susceptibility patterns of theP. aeruginosapopulation from diabetes patients with foot ulcers attending tertiary care hospitals in and around Coimbatore and their antimicrobial susceptibility pattern. The study was carried out at the Department of Microbiology, Dr. N.G.P. Arts and Science College, Coimbatore, for a period of one year (June 2006 to April 2007). The present study comprised 270 pus specimens collected from diabetic patients with foot ulcers. All pus samples were subjected to gram staining; bacterial culture and subsequently the antibiotic sensitivity to 15 different antibiotics for the confirmedP. aeruginosawere performed as per the standard procedures. Eighteen strains (14.28%) ofP. aeruginosafrom 270 diabetic foot ulcers were detected. Almost all the strains exhibited a varying degree of resistance to the antibiotics tested. Multidrug resistance for about 8 to 11 antibiotics was observed among the 55.5% of the isolates. Disk diffusion results show 100% resistance to ampicillin, cefoperazone, erythromycin, norfloxacin, and only cefotaxime, ciprofloxacin exhibited greater activity againstPseudomonas aeruginosa.

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