感染症と治療ジャーナル

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Practical and Clinical Aspects of Pseudomonal Diabetic Foot Infections

Laura Soldevila-Boixader, Ilker Uçkay

In Diabetic Foot Infections (DFI), the (empirical) antibiotic therapy bases on the clinical severity of infection, the local epidemiology of pathogens, and their susceptibility patterns. Pseudomonas aeruginosa is a particular microorganism that has a different predominance between the geographical areas. P. aeruginosa also reveals several virulence factors and resistance mechanisms that make it necessary for the clinician to identify it early. Characteristics of pseudomonal DFIs (chronic ulcers, possible greenish color, selection by current antibiotic therapy, maceration, calcaneal localization) might be helpful to think on P. aeruginosa. The ultimate proof, however, remains the deep microbiological cultures. In terms of therapy, available evidence does not seem to require combined regimens or a prolongation of the targeted systemic therapy.