Version 1
: Received: 20 December 2022 / Approved: 21 December 2022 / Online: 21 December 2022 (09:23:20 CET)
Version 2
: Received: 19 January 2023 / Approved: 20 January 2023 / Online: 20 January 2023 (15:13:51 CET)
Uçkay, I.; Lebowitz, D.; Kressmann, B.; Lipsky, B.A.; Gariani, K. Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections—A Large Retrospective Comparative Study. Antibiotics2023, 12, 316.
Uçkay, I.; Lebowitz, D.; Kressmann, B.; Lipsky, B.A.; Gariani, K. Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections—A Large Retrospective Comparative Study. Antibiotics 2023, 12, 316.
Uçkay, I.; Lebowitz, D.; Kressmann, B.; Lipsky, B.A.; Gariani, K. Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections—A Large Retrospective Comparative Study. Antibiotics2023, 12, 316.
Uçkay, I.; Lebowitz, D.; Kressmann, B.; Lipsky, B.A.; Gariani, K. Influence of Skin Commensals on Therapeutic Outcomes of Surgically Debrided Diabetic Foot Infections—A Large Retrospective Comparative Study. Antibiotics 2023, 12, 316.
Abstract
In diabetic foot infections (DFI), the clinically virulence of skin commensals are generally presumed to be of low virulence. In this single-center study, we divided the wound isolates into two groups: skin commensals (coagulase-negative staphylococci, micrococci, corynebacteria, cutibacteria); and, pyogenic pathogens, and followed the patients for ≥ 6 months. In 1,018 DFI episodes (392 [39%] with osteomyelitis), we identified skin commensals as the sole culture isolates (without accompanying pyogenic pathogens) in 54 cases (5%). After treatment (antibiotic therapy [median of 20 days], hyperbaric oxygen in 98 cases [10%]), 251 episodes (25%) were clinical failures. Group comparisons between those growing only skin commensals and controls found no difference in clinical failure (17% vs 24 %, p=0.23) or microbiological recurrence (11% vs 17 %, p=0.23). The skin commensals were mostly treated with non-beta-lactam oral antibiotics. In multivariate logistic regression analysis, isolation of only skin commensals was not associated with failure (odds ratio 0.4, 95% confidence interval 0.1-3.8). Clinicians might wish to consider these isolates as potential pathogens when selecting a targeted antibiotic regimen, which may equally base on oral non-beta-lactam antibiotic agents susceptible to the corresponding skin pathogens.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
