Characteristics of patients in group 1 and 2
| Clinical data | Group 1 (n = 115) | Group 2 (n = 22) | ||
|---|---|---|---|---|
| n | % | n | % | |
| Type 1 diabetes | 13 | 11.3 | 2 | 9.1 |
| Type 2 diabetes | 91 | 79.1 | 20 | 90.9 |
| Other specific types of diabetes | 9 | 7.8 | 0 | - |
| No data on the type of diabetes | 2 | 1.7 | 0 | - |
| Male | 87 | 75.7 | 16 | 72.7 |
| Female | 28 | 24.3 | 6 | 27.3 |
| Neuropathic foot ulcers | 52 | 45.2 | 14 | 63.6 |
| Neuro-ischemic foot ulcers | 50 | 43.5 | 7 | 31.8 |
| Ischemic foot ulcers | 11 | 9.6 | 1 | 4.5 |
| Indeterminate type | 2 | 1.7 | 0 | - |
| Obesity | 46 | 40.0 | 14 | 63.6 |
| Overweight | 16 | 13.9 | 4 | 18.9 |
| Normal weight | 25 | 21.7 | 3 | 13.6 |
| Lack of body weight data | 28 | 24.4 | 1 | 4.5 |
| Age in years ± SD | 59.7±10.02 | 58.5±9.68 | ||
| Duration of diabetes in years ± SD | 17.03±10.36 | 16.9±12.09 | ||
Results of microbiological cultures in terms of the number of microorganisms isolated in the culture in group 1 and 2
| Results of cultures (n = 200) | Group 1 (n = 137) | Group 2 (n = 63) |
|---|---|---|
| no growth | 16 (11.7%) | 1 (1.6%) |
| one microorganism | 49 (35.8%) | 21 (33.3%) |
| two microorganisms | 33 (24.0%) | 17 (27.0%) |
| three microorganisms | 13 (9.5%) | 13 (20.6%) |
| more than three microorganisms | 26 (19.0%) | 11 (17.5%) |
Percentage of HbA1c values of patients in the group 1 and 2
| Hba1c % | <6.0 | 6.0–6.9 | 7.0–7.9 | 8.0–8.9 | 9.0–9.9 | 10.0–10.9 | 11.0–11.9 | >12 |
| Group 1 | 7.8% | 34.3% | 23.5% | 20.6% | 7.8% | 2.0% | 2.9% | 1.0% |
| Group 2 | 2.1% | 25.0% | 29.2% | 20.8% | 20.8% | 0.0% | 0.0% | 2.1% |
Quantitative and percentage distribution of microbial species isolated from wounds in patients with DFU in both study groups
| Microorganism | Number/percent |
|---|---|
| Aerobic and facultatively anaerobic Gram-negative rods: in total 187/48,44% | |
| Enterobacterales: | 145/37.56% |
| 1. Enterobacteriaceae | 41/10.62% |
| E. coli * including 1 strain ESBL(+) | 15/3,89% |
| E. cloacae * including 2 strains ESBL(+) | 9 |
| Enterobacter spp. | 2 |
| E. amnigenus | 1 |
| K. oxytoca | 5 |
| K. pneumoniae * including 2 strains ESBL(+) | 3 |
| C. freundii | 5 |
| C. braakii | 1 |
| 2. Yersiniaceae | 49/12.69% |
| S. marcescens | 48/12,43% |
| Serratia spp. | 1 |
| 3. Hafniaceae | 1/0.26% |
| H. alvei | 1 |
| 4. Morganellaceae | 54/13.99% |
| P. mirabilis | 27 |
| P. vulgaris | 9 |
| P. penneri | 1 |
| M. morganii | 14 |
| P. stuartii | 2 |
| P. rettgeri | 1 |
| Pseudomonas aeruginosa | 27/6.99% |
| * including 3 strains resistant to carbapenems, 3 strains resistant to ≥2 antibiotics | |
| Acinetobacter spp. | 9/2.33 % |
| A. baumannii * including 2 strains resistant to carbapenems,3 strains resistant to ≥2 antibiotics | 7 |
| A. haemolyticus | 1 |
| A. pittii | 1 |
| Other Gram-negative rods: A. hydrophila, A. faecalis, P. multocida, B. cepacia | 6/1.55% |
| Fungi: in total 3/0.78% | |
| Candida spp. | 3/0.78% |
| C. albicans | 2 |
| C. parapsilosis | 1 |
| Facultatively anaerobic Gram-positive bacteria: in total 113/29,27% | |
| Staphyloccous aureus | 46/11.92 % |
| * including 14 (3.63%) MRSA strains Coagulase negative staphylococci | |
| S. epidermidis | 11/2.85 % |
| S. simulans | 7 |
| S. haemolyticus | 2 |
| S. cohnii | 1 |
| Streptococcus spp. | 1 |
| S. agalactiae | 34/8.81 % |
| Streptococcus spp. | 9 |
| β-haemolytic streptococci group C, | 7 |
| G and F | 5 |
| S. dysgalactiae | |
| S. oralis | 4 |
| S. intermedius | 4 |
| S. mitis, S. anginosus, S. sanguinis | 2 |
| Enterococcus spp. | 3 |
| E. faecalis | 12/3.11% |
| E. faecium | 11/2,85% |
| Other Gram-positive bacteria: | 1 |
| Corynebacterium spp., Leuconostoc spp., D. hominis, H. kunzi, M. luteus | 10/2.59% |
| Anaerobes: in total 83/21.5% | |
| Peptostreptococcus spp. | 21/5.44 % |
| F. magna | 11/2.85 % |
| B. fragilis | 5 |
| B. thetaiotaomicron | 4 |
| B. ovatus | 1 |
| Prevotella spp. | 7 |
| Peptoniphilus spp. | 7 |
| Anaerococcus spp. | 7 |
| Peptococcus spp. | 6 |
| Fusobacterium spp. | 5 |
| Veillonella spp. | 4 |
| Actinomyces spp. | 2 |
| Porphyromonas spp. | 1 |
Percentage distribution of HbA1c values in patients with selected microorganisms isolated in the culture
| Microorganism | Hba1c mean value | HBA1c ± SD | HbA1c <8 | HbA1c 8-12,3 | Lack of HbA1c measurements |
|---|---|---|---|---|---|
| Pseudomonas aeruginosa | 7.2 | 0.9 | 71.4% | 14.3% | 14.3% |
| Peptostreptococcus spp. | 7.4 | 1.1 | 66.7% | 23.8% | 9.5% |
| Serratia marcescens | 7.5 | 1.1 | 62.0% | 32.0% | 6.0% |
| Proteus mirabilis | 7.7 | 1.0 | 42.9% | 39.3% | 17.8% |
| Staphylococcus aureus MSSA* | 7.9 | 1.4 | 59.1% | 38.6% | 2.3% |
| Escherichia coli | 8.1 | 1.5 | 43.75% | 50.0% | 6.25% |
| Morganella morganii | 8.8 | 1.1 | 18.75% | 56.25% | 25.0% |
Median and interquartile range and minimum and maximum values of HBA1c concentration in groups of patients infected with different strains of bacteria
| Bacteria | N | Mean ± SD | Median | Min | Max | CV* [%] | SEM** |
|---|---|---|---|---|---|---|---|
| Serratia marcescens | 47 | 7.5 ± 1.1 | 7.4 | 5.2 | 9.7 | 14.9 | 0.2 |
| MSSA | 43 | 7.9 ± 1.4 | 7.7 | 5.7 | 12.3 | 18.1 | 0.2 |
| Pseudomonas aeruginosa | 24 | 7.2 ± 0.9 | 7.3 | 6.1 | 9.0 | 12.4 | 0.2 |
| Proteus mirabilis | 23 | 7.6 ± 1 | 7.4 | 5.9 | 9.1 | 13.7 | 0.2 |
| Peptostreptococcus spp. | 19 | 7.4 ± 1.1 | 7.4 | 6.0 | 9.6 | 14.9 | 0.3 |
| Escherichia coli | 15 | 8.1 ± 1.5 | 8.2 | 5.9 | 11.1 | 18.5 | 0.4 |
| Morganella morganii | 12 | 8.8 ± 1.1 | 8.7 | 7.2 | 11.1 | 12.5 | 0.3 |
Microorganisms isolated from clinical samples obtained from patients with DFU in various geographical zones
| Publication | I | II | III | IV | V | VI | VII | VIII | IX | X | XI |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Year of publication | 2006 | 2007 | 2009 | 2011 | 2011 | 2014 | 2014 | 2015 | 2016 | 2018 | 2020 |
| Number of patients | 80 | 433 | 379 | 434 | 440 | 196 | 102 | 41 | 447 | 261 | 137 |
| Microorganism in | |||||||||||
| Staphylococcus aureus MSSA* | 13.7 | 14.3 | 17.3 | 13.8 | 3.0 | 21.0 | 13.6 | 30.0 | 9.6 | 26.9 | 8.3 |
| Staphylococcus aureus MRSA** | 4.4 | 11.3 | N/A | 8.0 | N/A | 1.0 | N/A | 1.8 | 3.6 | ||
| Streptococus spp. | N/A | 15.5 | 12.6 | 3.0 | 4.0 | 4.7 | 3.0 | 9.0 | 7.2 | 1.7 | 8.8 |
| Enterococcus spp. | 11.5 | 13.6 | 7.7 | 9.5 | 6.0 | 3.4 | 16.0 | N/A | 4.4 | 12.7 | 3.1 |
| coagulase-negative Staphylococci | 6.6 | 15.2 | 14.9 | 5.0 | 0.5 | N/A | 11.5 | N/A | 1.3 | N/A | 2.8 |
| Escherichia coli | 12.0 | 1.7 | N/A | 16.1 | 6.0 | 28.6 | 7.0 | 4.5 | 15.0 | 12 | 3.9 |
| Proteus mirabilis | 12.6 | 2.1 | N/A | 8.8 | 6.0 | 4.2 | 7.6 | 11.0 | 9.6 | 3.1 | 7.0 |
| Pseudomonas aeruginosa | 9.8 | 3.5 | 6.9 | 16.9 | 17.0 | N/A | 7.5 | 4.5 | 12.4 | 20.9 | 7.0 |
| Acinetobacter spp. | 9.3 | 1.1 | N/A | 3.7 | N/A | 4.2 | 2.0 | N/A | 2.8 | 1 | 2.3 |
| Klebsiella spp. | 6.6 | 2.2 | N/A | 6.7 | 5.0 | 14.3 | 3.5 | N/A | 3.4 | 9.5 | 2.1 |
| Serratia marcescens | N/A | 1.2 | N/A | N/A | 2.0 | N/A | 2.0 | N/A | 1.6 | 0.3 | 12.4 |
| Morganella morganii | N/A | N/A | N/A | N/A | 3.0 | N/A | 1.5 | N/A | 4.9 | N/A | 3.6 |
| Peptostreptococcus spp. | 1.6 | N/A | N/A | N/A | N/A | N/A | 1.5 | N/A | N/A | N/A | 5.4 |
| Bacteroides fragilis | 1.6 | 4.1 | N/A | N/A | N/A | N/A | 1.0 | N/A | N/A | N/A | 1.3 |