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Microbiology of Diabetic Foot Ulcer with Special Reference to ESBL Infections
American Journal of Clinical and Experimental Medicine
Volume 3, Issue 1, January 2015, Pages: 6-23
Received: Dec. 7, 2014; Accepted: Dec. 17, 2014; Published: Jan. 26, 2015
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Mohammad Zubair, Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh 202002, India
Abida Malik, Department of Microbiology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, India
Jamal Ahmad, Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh 202002, India
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Chronic foot wounds represent an increasing burden to healthcare systems as the age of the population increases. The deep dermal tissues of all chronic wounds harbor microorganisms, however, the precise interaction between microbes in the wounds and impaired healing is unknown. With regard to antibiotic therapy, there is a lack of evidence concerning its effectiveness, optimal regimens or clinical indications for treatment. Despite this lack of evidence, antibiotics are frequently a feature of the management of chronic wounds and these patients receive significantly more antibiotic prescriptions (both systemic and topical) than age and sex-matched patients. Current guidelines for antibiotic prescribing for such diabetic foot wounds are often based on expert opinion rather than scientific fact and may present difficulties in interpretation and implementation to the clinician. Although the increasing prevalence of antibiotic resistance is widely recognized, the relationships between antibiotic resistance, chronic wound microbiology and rationales for antibiotic therapy have yet to be determined. This review discusses the role of microbes in chronic diabetic foot wounds from a clinical perspective with particular focus on the occurrence of type bacteria and their impact on such wounds and resistance pattern, Extended Spectrum Beta Lactamases [ESBL] studies with special reference to Indian studies. The evidence and role of antibiotics in the treatment of such wounds are outlined and current practice of antibiotic usage for chronic wounds in the primary care setting described. The implications of antibiotic usage with regard to antibiotic resistance are also considered.
Diabetic Foot, India, ESBL
To cite this article
Mohammad Zubair, Abida Malik, Jamal Ahmad, Microbiology of Diabetic Foot Ulcer with Special Reference to ESBL Infections, American Journal of Clinical and Experimental Medicine. Vol. 3, No. 1, 2015, pp. 6-23. doi: 10.11648/j.ajcem.20150301.12
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