Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China

Xuemei Li,1,2 Qingfeng Cheng,3 Zhipeng Du,3 Shenyin Zhu,2 Chao Cheng4 1Department of Pharmacy, Chongqing Health Center for Women and Children, Chongqing, People’s Republic of China; 2Department of Pharmacy, First Affiliated Hospital of Chongqing Medical University, Chongqing, People&rs...

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Autores principales:	Li X, Cheng Q, Du Z, Zhu S, Cheng C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic foot osteomyelitis ulcer swabbing microbiological concordance antimicrobial susceptibility test targeted antibiotic therapy Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/1fee3b4dbbfb467e900edb6cabaae035
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spelling	oai:doaj.org-article:1fee3b4dbbfb467e900edb6cabaae0352021-12-02T18:18:27ZMicrobiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China1178-7007https://doaj.org/article/1fee3b4dbbfb467e900edb6cabaae0352021-04-01T00:00:00Zhttps://www.dovepress.com/microbiological-concordance-in-the-management-of-diabetic-foot-ulcer-i-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Xuemei Li,1,2 Qingfeng Cheng,3 Zhipeng Du,3 Shenyin Zhu,2 Chao Cheng4 1Department of Pharmacy, Chongqing Health Center for Women and Children, Chongqing, People’s Republic of China; 2Department of Pharmacy, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Department of Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Hubei, People’s Republic of ChinaCorrespondence: Chao ChengDepartment of Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangcheng District, Hubei, 441021, People’s Republic of ChinaTel +86 23 8901 2401Fax +86 23 68811793Email chengchao11c0@163.comShenyin ZhuDepartment of Pharmacy, First Affiliated Hospital of Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People’s Republic of ChinaTel +86 23 8901 2401 Fax +86 23 68811793 Email zhushenyin0486@sina.comObjective: This study aimed to assess the microbiological concordance between swab and soft tissue cultures, and corresponding bone specimen cultures from patients with diabetic foot osteomyelitis (DFO). We aimed to analyze the bone specimens’ antimicrobial susceptibilities, and to improve clinical management of diabetic foot ulcer infections by using proper antibiotics.Methods: The microbial culture results of ulcer swabs, and soft tissue and bone tissue specimens, and the antimicrobial susceptibility tests of bone specimens from patients with DFO were analyzed in a single diabetic foot center.Results: A total of 60 patients with results from three specimens were included. Staphylococcus aureus was the most common bacterium isolated from the three specimens. The microbiological results for the three specimens were identical in 12 cases, the culture results from swabs and bone tissue specimens were identical in 14 cases, and the results from soft tissue and bone tissue were identical in 46 cases. The concordance of the results of pathogens isolated between soft tissue and bone specimen cultures was higher than that between the swab and bone cultures. Gram-positive bacteria were more sensitive to moxifloxacin, linezolid, and vancomycin, while Gram-negative bacteria were more sensitive to piperacillin/tazobactam, cefoperazone/sulbactam, and carbapenems.Conclusion: Soft tissue culture results have more reliable microbiological concordance to identify DFO bacteria than swab culture results and targeted antibiotic therapy for DFO should be based on antimicrobial susceptibility testing in bone tissue specimen cultures.Keywords: diabetic foot osteomyelitis, ulcer swabbing, microbiological concordance, antimicrobial susceptibility test, targeted antibiotic therapyLi XCheng QDu ZZhu SCheng CDove Medical Pressarticlediabetic foot osteomyelitisulcer swabbingmicrobiological concordanceantimicrobial susceptibility testtargeted antibiotic therapySpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 14, Pp 1493-1503 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic foot osteomyelitis ulcer swabbing microbiological concordance antimicrobial susceptibility test targeted antibiotic therapy Specialties of internal medicine RC581-951
spellingShingle	diabetic foot osteomyelitis ulcer swabbing microbiological concordance antimicrobial susceptibility test targeted antibiotic therapy Specialties of internal medicine RC581-951 Li X Cheng Q Du Z Zhu S Cheng C Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China
description	Xuemei Li,1,2 Qingfeng Cheng,3 Zhipeng Du,3 Shenyin Zhu,2 Chao Cheng4 1Department of Pharmacy, Chongqing Health Center for Women and Children, Chongqing, People’s Republic of China; 2Department of Pharmacy, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Department of Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Hubei, People’s Republic of ChinaCorrespondence: Chao ChengDepartment of Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangcheng District, Hubei, 441021, People’s Republic of ChinaTel +86 23 8901 2401Fax +86 23 68811793Email chengchao11c0@163.comShenyin ZhuDepartment of Pharmacy, First Affiliated Hospital of Chongqing Medical University, No. 1, Yixueyuan Road, Yuzhong District, Chongqing, 400016, People’s Republic of ChinaTel +86 23 8901 2401 Fax +86 23 68811793 Email zhushenyin0486@sina.comObjective: This study aimed to assess the microbiological concordance between swab and soft tissue cultures, and corresponding bone specimen cultures from patients with diabetic foot osteomyelitis (DFO). We aimed to analyze the bone specimens’ antimicrobial susceptibilities, and to improve clinical management of diabetic foot ulcer infections by using proper antibiotics.Methods: The microbial culture results of ulcer swabs, and soft tissue and bone tissue specimens, and the antimicrobial susceptibility tests of bone specimens from patients with DFO were analyzed in a single diabetic foot center.Results: A total of 60 patients with results from three specimens were included. Staphylococcus aureus was the most common bacterium isolated from the three specimens. The microbiological results for the three specimens were identical in 12 cases, the culture results from swabs and bone tissue specimens were identical in 14 cases, and the results from soft tissue and bone tissue were identical in 46 cases. The concordance of the results of pathogens isolated between soft tissue and bone specimen cultures was higher than that between the swab and bone cultures. Gram-positive bacteria were more sensitive to moxifloxacin, linezolid, and vancomycin, while Gram-negative bacteria were more sensitive to piperacillin/tazobactam, cefoperazone/sulbactam, and carbapenems.Conclusion: Soft tissue culture results have more reliable microbiological concordance to identify DFO bacteria than swab culture results and targeted antibiotic therapy for DFO should be based on antimicrobial susceptibility testing in bone tissue specimen cultures.Keywords: diabetic foot osteomyelitis, ulcer swabbing, microbiological concordance, antimicrobial susceptibility test, targeted antibiotic therapy
format	article
author	Li X Cheng Q Du Z Zhu S Cheng C
author_facet	Li X Cheng Q Du Z Zhu S Cheng C
author_sort	Li X
title	Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China
title_short	Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China
title_full	Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China
title_fullStr	Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China
title_full_unstemmed	Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China
title_sort	microbiological concordance in the management of diabetic foot ulcer infections with osteomyelitis, on the basis of cultures of different specimens at a diabetic foot center in china
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/1fee3b4dbbfb467e900edb6cabaae035
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Microbiological Concordance in the Management of Diabetic Foot Ulcer Infections with Osteomyelitis, on the Basis of Cultures of Different Specimens at a Diabetic Foot Center in China

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