Diabetic Foot Infection

Paul Auwaerter, M.D.
Diabetic Foot Infection is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

  • Most diabetic foot infections (DFIs) are polymicrobial; however, if the patient hasn’t recently received abx therapy, often monomicrobial and due to either staphylococcal or streptococcal infection.
  • Frequent pathogens: most DFIs are polymicrobial.
  • Superficial, early infections (cellulitis, cellulitis involving blisters and shallow ulcers) are typically caused by S. aureus or beta-hemolytic streptococci.
  • Infections of ulcers that are chronic or previously treated with antibiotics may be caused by aerobic Gram-negative bacilli, S. aureus or Streptococci.
  • Deep soft tissue infections, osteomyelitis, and gangrene are more often polymicrobial, including aerobic Gram-negative bacilli and anaerobes (anaerobic streptococci, Bacteroides fragilis group, Clostridium species), but Staphyloccocus aureus is also common as single pathogen.
  • Multi-drug resistant Gram-negative organisms described in DFI especially ESBL, but most resistant organisms w/ reports from India and warmer climates.

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PATHOGENS

  • Most diabetic foot infections (DFIs) are polymicrobial; however, if the patient hasn’t recently received abx therapy, often monomicrobial and due to either staphylococcal or streptococcal infection.
  • Frequent pathogens: most DFIs are polymicrobial.
  • Superficial, early infections (cellulitis, cellulitis involving blisters and shallow ulcers) are typically caused by S. aureus or beta-hemolytic streptococci.
  • Infections of ulcers that are chronic or previously treated with antibiotics may be caused by aerobic Gram-negative bacilli, S. aureus or Streptococci.
  • Deep soft tissue infections, osteomyelitis, and gangrene are more often polymicrobial, including aerobic Gram-negative bacilli and anaerobes (anaerobic streptococci, Bacteroides fragilis group, Clostridium species), but Staphyloccocus aureus is also common as single pathogen.
  • Multi-drug resistant Gram-negative organisms described in DFI especially ESBL, but most resistant organisms w/ reports from India and warmer climates.

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Last updated: June 6, 2020