scholarly journals Bacterial Diversity of Diabetic Foot Ulcers: Current Status and Future Prospectives

2019 ◽  
Vol 8 (11) ◽  
pp. 1935 ◽  
Author(s):  
Fatemah Sadeghpour Heravi ◽  
Martha Zakrzewski ◽  
Karen Vickery ◽  
David G. Armstrong ◽  
Honghua Hu
Keyword(s):  
Diabetic Foot ◽  
Bacterial Communities ◽  
High Sensitivity ◽  
Current Status ◽  
Foot Ulcers ◽  
High Morbidity ◽  
Diabetic Foot Ulcers ◽  
Bacterial Identification ◽  
Molecular Approaches ◽  
The Impact

Diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) are associated with reduced patient quality of life, lower-extremity amputation, hospitalization, and high morbidity and mortality. Diverse bacterial communities have been identified in DFUs/DFIs, playing a significant role in infection prognosis. However, due to the high heterogeneity of bacterial communities colonized in DFUs/DFIs, culture-based methods may not isolate all of the bacterial population or unexpected microorganisms. Recently, high sensitivity and specificity of DNA (metagenomics) and RNA (metatranscriptomics) technologies have addressed limitations of culture-based methods and have taken a step beyond bacterial identification. As a consequence, new advances obtained from DNA- and RNA-based techniques for bacterial identification can improve therapeutic approaches. This review evaluated the current state of play in aetiology of DFUs/DFIs on culture and molecular approaches, and discussed the impact of metagenomic and metatranscriptomic methods in bacterial identification approaches.

scholarly journals A Bibliometric Analysis of the Top-Cited Articles on Diabetic Foot Ulcers

2021 ◽  
Author(s):  
Jiasheng You ◽  
Chao Liu ◽  
Yixin Chen ◽  
Weifen Zhu ◽  
Shunwu Fan ◽  
...  
Keyword(s):  
Bibliometric Analysis ◽  
Diabetic Foot ◽  
Median Number ◽  
Scientific Discipline ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Level Of Evidence ◽  
Bibliometric Method ◽  
Academic Publications ◽  
The Impact

Abstract Background: Citation analysis is a bibliometric method for appraising the impact of academic publications in any given scientific discipline. There is a paucity of literature concerning influential works on diabetic foot ulcers (DFUs). Aims: To determine the top-cited articles in the field of DFU research.Methods: A bibliometric analysis of citations indexed in the Scopus and the Web of Science databases was conducted in January 2021 to determine all publications related to DFU. The 50 top-cited articles that met the inclusion criteria were ranked. Articles were evaluated for several characteristics including year of publication, country of origin, authorship, publishing journal, topic categories, publishing type and level of evidence.Results: The median number of citations per article in the list was 442 (interquartile range [IQR], 320-520), with a median of 21.8 citations (IQR, 16.5-34.5) per year since publication. The publication years ranged from 1986 to 2017, with 1998 accounting for the greatest number of studies (n = 7). The citation classics were published in 20 journals and originated from institutions in nine countries. The majority of the studies were clinical, of which expert-opinion/review with Level V evidence and clinical studies with Levels I and II evidence comprised the greater proportion in the list.Conclusions: This study identified the top-cited articles and provides useful insights into the history and development of DFU research. Our findings may serve as a quick reference for education curriculums and clinical practice, in addition to providing a foundation for further studies on this topic.

scholarly journals Predictors of intra-hospital mortality in patients with diabetic foot ulcers in Nigeria: data from the MEDFUN Study.

2020 ◽  
Author(s):  
Olufunmilayo O Adeleye ◽  
Ejiofor T Ugwu ◽  
Ibrahim D Gezawa ◽  
Innocent Okpe ◽  
Ignatius Ezeani ◽  
...  
Keyword(s):  
Renal Impairment ◽  
Hospital Mortality ◽  
Cardiac Failure ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Diabetic Foot Ulcers ◽  
Grade 3

Abstract Background: Diabetic foot ulcers (DFU) are associated with high morbidity and mortality globally. Mortality in patients hospitalized for DFU in Nigeria is unacceptably high. This study was undertaken to determine factors that predict mortality in patients hospitalized for DFU in Nigeria.Methods:The current study was part of Multi-centre Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN), an observational study conducted in six tertiary healthcare institutions across the 6 geopolitical zones of Nigeria. Consecutive type 1 or 2 diabetic patients hospitalized for DFU who consented to participate were recruited and subjected to relevant clinical, biochemical and radiological assessments and multidisciplinary care until discharge or death. Data for type 1 diabetes mellitus (DM) patients were expunged from current mortality analysis due to their small number.Results: Three hundred and twenty three type 2 DM subjects with mean age and mean duration of DM of 57.2 11.4 years and 8.7± 5.8 years respectively participated in this study. The median duration of ulcers was 39 days with a range of 28 to 54 days and majority (79.9%) presented with advanced ulcers of at least Wagner grade 3. Mortality of 21.4% was recorded in the study, with the highest mortality observed among subjects with Wagner grade 5. Variables significantly associated with mortality with their respective p values were DM duration more than 120 months (p 0.005), ulcer duration > one month (p 0.020), ulcer severity of Wagner grade 3 and above (p 0.001), peripheral arterial disease (p 0.005), proteinuria (p <0.001), positive blood cultures (p<0.001), low HDL (p <0.001), shock at presentation (p<0.001), cardiac failure (p 0.027),and renal impairment (p <0.001). On Multivariate regression analysis, presence of bacteraemia (OR 5.053; 95% CI 2.572-9.428) and renal impairment (OR 2.838; 95% CI 1.349 – 5.971) were significantly predictive of mortality independent of other variables.Conclusions: This study showed high intra-hospital mortality among patients with DFU, with majority of deaths occurring among those with advanced ulcers, bacteremia, cardiac failure and renal impairment. Prompt attention to these factors might be helpful in improving survival from DFU in Nigeria.

scholarly journals Understanding the relationship between depression and diabetic foot ulcers

2016 ◽  
Vol 04 (01) ◽  
pp. 017-024 ◽  
Author(s):  
Andrew Steel ◽  
John Reece ◽  
Anne-Marie Daw
Keyword(s):  
Depressive Symptoms ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Biological Relationship ◽  
The Cost ◽  
The Impact ◽  
Concept Review ◽  
The Relationship

AbstractThe prevalence of diabetes is increasing, as is the cost of managing its comorbidities. Diabetic foot ulcers (DFUs) and their complications place a considerable cost burden on the health system, and lead to a significant level of disability. The relationship between depression and diabetes is well-established. The relationship between depression and foot ulcers in diabetic patients is less well-established. The purpose of this article is to provide a current concept review of the literature from 1988 to 2013, linking DFUs and depressive symptoms, with an emphasis on the impact depressive symptoms have on healing rates of DFUs. Articles specifically focusing on the biological relationship, depression′s impact on self-care, screening for depressive symptoms, causes and cost of treating DFUs, and measuring depression were reviewed. A deeper understanding of this relationship is needed to identify causal relationships, improve treatment outcomes, and reduce healing times of DFUs.

scholarly journals Microbial Community Distribution and Core Microbiome in Successive Wound Grades of Individuals with Diabetic Foot Ulcers

2020 ◽  
Vol 86 (6) ◽  
Author(s):  
Apoorva Jnana ◽  
Vigneshwaran Muthuraman ◽  
Vinay Koshy Varghese ◽  
Sanjiban Chakrabarty ◽  
Thokur Sreepathy Murali ◽  
...  
Keyword(s):  
Community Structure ◽  
Microbial Community ◽  
Diabetic Foot ◽  
Antibiotic Susceptibility ◽  
Morbidity And Mortality ◽  
Wound Management ◽  
Foot Ulcers ◽  
High Morbidity ◽  
Diabetic Foot Ulcers ◽  
Core Microbiome

ABSTRACT Diabetic foot ulcer (DFU) is a major complication of diabetes with high morbidity and mortality rates. The pathogenesis of DFUs is governed by a complex milieu of environmental and host factors. The empirical treatment is initially based on wound severity since culturing and profiling the antibiotic sensitivity of wound-associated microbes is time-consuming. Hence, a thorough and rapid analysis of the microbial landscape is a major requirement toward devising evidence-based interventions. Toward this, 122 wound (100 diabetic and 22 nondiabetic) samples were sampled for their bacterial community structure using both culture-based and next-generation 16S rRNA-based metagenomics approach. Both the approaches showed that the Gram-negative microbes were more abundant in the wound microbiome. The core microbiome consisted of bacterial genera, including Alcaligenes, Pseudomonas, Burkholderia, and Corynebacterium in decreasing order of average relative abundance. Despite the heterogenous nature and extensive sharing of microbes, an inherent community structure was apparent, as revealed by a cluster analysis based on Euclidean distances. Facultative anaerobes (26.5%) were predominant in Wagner grade 5, while strict anaerobes were abundant in Wagner grade 1 (26%). A nonmetric dimensional scaling analysis could not clearly discriminate samples based on HbA1c levels. Sequencing approach revealed the presence of major culturable species even in samples with no bacterial growth in culture-based approach. Our study indicates that (i) the composition of core microbial community varies with wound severity, (ii) polymicrobial species distribution is individual specific, and (iii) antibiotic susceptibility varies with individuals. Our study suggests the need to evolve better-personalized care for better wound management therapies. IMPORTANCE Chronic nonhealing diabetic foot ulcers (DFUs) are a serious complication of diabetes and are further exacerbated by bacterial colonization. The microbial burden in the wound of each individual displays diverse morphological and physiological characteristics with unique patterns of host-pathogen interactions, antibiotic resistance, and virulence. Treatment involves empirical decisions until definitive results on the causative wound pathogens and their antibiotic susceptibility profiles are available. Hence, there is a need for rapid and accurate detection of these polymicrobial communities for effective wound management. Deciphering microbial communities will aid clinicians to tailor their treatment specifically to the microbes prevalent in the DFU at the time of assessment. This may reduce DFUs associated morbidity and mortality while impeding the rise of multidrug-resistant microbes.

scholarly journals The Impact of the Micro-Lightguide O2C for the Quantification of Tissue Ischemia in Diabetic Foot Ulcers

Diabetes Care ◽  
2004 ◽  
Vol 27 (12) ◽  
pp. 2863-2867 ◽  
Author(s):  
S. Beckert ◽  
M. B. Witte ◽  
A. Konigsrainer ◽  
S. Coerper
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Tissue Ischemia ◽  
The Impact
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