Microbiology and treatment of diabetic foot infections

Abstract

Foot infections in diabetic patients are a major source of morbidity and an important proximate cause of amputations. These infections can be categorized clinically as limb threatening or non-limb threatening. The former are often caused by Staphylococcus aureus (often methicillin-resistant) and group B streptococci while the latter by these organisms and gramnegative bacilli and anaerobes. Multidrug-resistant pathogens are found in chronic infections, especially after exposure to health care and antibiotics. Effective treatment combines appropriate antimicrobial therapy with wound management and, if needed, surgical debridement. Osteomyelitis is common, often requiring surgical debridement for effective therapy. Although aspects of care could be refined by additional study, current evidence is sufficient to prevent or effectively treat most of these infections.