Review of microbiological sampling in diabetic foot disease

Authors

  • Hannah C Travers Russell’s Hall Hospital, Black Country Vascular Network, UK Birmingham Vascular Unit, University Hospitals Birmingham, UK https://orcid.org/0000-0002-6822-6466
  • Jonathon Dawson Russell’s Hall Hospital, Black Country Vascular Network, UK
  • Anitha Muthusami Russell’s Hall Hospital, Black Country Vascular Network, UK
  • Michael L Wall Russell’s Hall Hospital, Black Country Vascular Network, UK

DOI:

https://doi.org/10.15277/bjd.2021.310

Keywords:

diabetic foot, microbiology sampling, osteomyelitis

Abstract

Introduction: Diabetes mellitus is a significant cause of morbidity and mortality. Foot-related complications affect 2–2.5% of people with diabetes. There is significant variation in outcomes for patients with diabetic foot disease within the UK. The multidisciplinary approach to diabetic foot disease is well publicised and protocols, guidance and consensus approaches exist for most components of the management of diabetic foot disease. Antimicrobial therapy to treat diabetic foot infections based on microbiological sampling and culture is well documented, but no consensus exists on how these samples should be obtained, processed and reported.

Methods: A literature review was undertaken to establish the reporting of techniques used in obtaining and processing microbiological samples in diabetic foot disease to establish if consensus exists in the methodologies used with a view to develop best practice guidelines.

Results: Six out of 102 papers reported all processes in obtaining and processing microbiological samples.

Conclusion: No gold standard consensus exists for microbiological sampling of diabetic foot infections, preventing optimisation of this aspect of management of diabetic foot disease and ultimately potentially adversely affecting the outcomes of this growing patient cohort.

Author Biography

Hannah C Travers, Russell’s Hall Hospital, Black Country Vascular Network, UK Birmingham Vascular Unit, University Hospitals Birmingham, UK

Vascular Surgery Registrar (ST6)

Birmingham Vascular Unit

References

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Lipsky BA, Berendt AR, Cornia PB, et al. Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. J Am Podiatr Med Assoc 2013;103(1):2–7. https://doi.org/10.7547/1030002

Tone A, Nguyen S, Devemy F, et al. Six-week versus twelve-week antibiotic therapy for nonsurgically treated diabetic foot osteomyelitis: a multicenter open-label controlled randomized study. Diabetes Care 2015;38(2):302–7. https://doi.org/10.2337/dc14-1514

National Institute for Health and Care Excellence. Diabetic foot infection: antimicrobial prescribing. Evidence review. 2019. Available at: https://www.nice.org.uk/guidance/ng19/evidence/evidence-review-pdf-6953995118 (accessed 10 March 2021)

Dawson J, Travers HC, Wall ML. Level of training in microbiological sampling for toe amputations in diabetic foot disease: a survey of UK vascular trainees. Diabetic Foot J 2021 (accepted for publication).

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Published

2021-10-20

Issue

Section

Reviews