Antibiotic Resistance Poses Challenges for Treatment of Diabetic Foot Ulcers
The number of bacteria showing marked resistance to antibiotic therapy in patients with diabetic foot ulcers is on the rise, according to the results of a recent study conducted by researchers in Peru. The study results were presented this spring at the ENDO 2017 conference in Florida.
In their study, the researchers isolated bacteria from 88 patients with diabetic foot ulcers who were treated with early ambulatory surgical debridement from 2010 to 2014, identifying the types of bacteria present in the ulcers as well as evaluating the germs’ responses to treatment with antibiotics. Cultures were removed from the base of the ulcer following the debridement procedure.
After examining the cultures and exposing them to an array of antibiotic agents, the researchers found high levels of positive extended-spectrum beta-lactamase (ESBL) Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (MRSA) as well as high resistance to both broad- and narrow-spectrum antibiotics including ciprofloxacin, ceftriaxone and clindamycin.
In their evaluations of antibiotic agents, the researchers found Gram-negative ESBL-positive Enterobacteriaceae (comprising about a third of the Gram-negative strains) had no resistance to carbapenem antibiotics with the exception of P aeruginosa which demonstrated 80% to 100% resistance. In ESBL-positive Enterobacteriaceae, 56% were resistant to ceftriaxone and 69% of patients were resistant to ciprofloxacin. Although Acinetobacter baumannii was rare, occurring in only 2.3% of cases, it demonstrated 100% resistance to all of the evaluated antibiotics.
In Gram-positive cultures, MRSA accounted for 70.5% and showed 89% resistance to clindamycin and 100% resistance to ciprofloxacin. No resistance was observed for vancomycin.
Resistance to antibiotics has made international headlines during the past decade as widespread use of antibiotics has resulted in adaptations in many bacteria strains, rendering medicines far less effective in controlling the pathogens’ spread. According to the CDC, more than 2 million people are infected with antibiotic-resistant bacteria every year in the U.S., and more than 23,000 people die as a result of those infections.
Diabetic Foot Care in Los Angeles
Diabetic foot ulcer treatment is complicated by several factors, including circulation and nerve deficits that interfere with normal healing responses. The rise of resistant bacteria poses an even more serious challenge to healthcare providers charged with treating ulcers. That means to be effective, ulcer treatment needs to be carefully planned and monitored to ensure the best possible results.
Dr. Felix Sigal is a leader in diabetic foot ulcer treatment with active involvement in ongoing clinical trials. At the Foot & Ankle Clinic, Dr. Sigal and his team offer the most advanced, innovative treatment options for optimal outcomes in patients throughout the Greater Los Angeles region. If you have diabetes, regular podiatric checkups are essential for preventing ulcers and other complications. Call the Foot & Ankle Clinic at 213-365-0793 to learn more about the treatment options we offer and to schedule an office visit today.