Diabetes and foot infection: More than double trouble

Abstract

Background: Infection of foot ulcers is a common, often severe and costly complication in diabetes. Many factors linked to the host, mainly immune defects, neuropathy and arteriopathy, as well as bacteria-related factors, interact in a complex way and account for the susceptibility of diabetic individuals to foot infections, the severity of such infections and difficulty to treat them. Methods: This article reviews these factors, in the light of data from the literature and from our own results. Results: DFIs are not as simple as previously suggested, and new concepts must be considered, especially the virulence potential of isolates and bacterial communications through biofilms. Conclusion: The development of new tools from molecular biology is a critical step to better understand and manage these infections. © 2012 John Wiley & Sons, Ltd.