Diagnosing diabetic foot osteomyelitis.
biomarkers
bone biopsy
diabetes mellitus
imaging technique
microbiology
osteomyelitis of the foot
Journal
Diabetes/metabolism research and reviews
ISSN: 1520-7560
Titre abrégé: Diabetes Metab Res Rev
Pays: England
ID NLM: 100883450
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
10
10
2019
accepted:
20
11
2019
pubmed:
18
1
2020
medline:
23
1
2021
entrez:
18
1
2020
Statut:
ppublish
Résumé
Bone involvement during an infection of the diabetic foot represents a serious complication associated with a high risk of amputation, prolonged antibiotic treatment and hospitalization. Diabetic foot osteomyelitis (DFOs) require a multidisciplinary approach given the usual complexity of these situations. DFO should be suspected in most cases especially in the most severe forms of soft tissue diabetic foot infections (DFIs) where the prevalence of bone infection may be up to 60%. Suspicion is based on clinical signs in particular a positive probe-to-bone (PTB) test, elevated inflammatory biomarkers especially erythrocyte sedimentation rate and abnormal imaging assessment using plain X-ray as a first-line choice. The combination of PTB test with plain X-ray has proven effective in the diagnosis of DFO. The confirmation (definite) diagnosis of DFO is based on the results of a bone sample examination obtained by either surgical or percutaneous biopsy. Sophisticated imaging examinations such as Magnetic Resonance Imaging (MRI) and nuclear imaging techniques are useful where doubt persists after first-line imaging assessment. These techniques may also help localize the bone infection site and increase the diagnostic performance of percutaneous bone biopsy. The quality of the microbiological documentation of DFO is likely to improve the adequacy of the antimicrobial therapy especially when medical (ie, no surgical resection of the infected bone tissues) is considered. The use of new (molecular) techniques for the identification of the bone pathogens have not yet proven superiority on classic cultural techniques for the management of such patients.
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e3250Informations de copyright
© 2020 John Wiley & Sons, Ltd.
Références
Lipsky BA, Berendt AR, Deery HG, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004;39:885-910.
Mutluoglu M, Sivrioglu AK, Eroglu M, et al. The implications of the presence of osteomyelitis on outcomes of infected diabetic foot wounds. Scand J Infect Dis. 2013;45:497-503.
Lipsky BA, Berendt AR, Cornia PB, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54:132-173.
Lipsky BA, Aragon-Sanchez J, Diggle M, et al. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev. 2016;32(Suppl 1):S45-S74.
Lipsky BA, Senneville E, Abbas ZG, et al. IWGDF infection working group. IWGDF guideline on the diagnosis and treatment of foot infection in persons with diabetes (2019 update). Diabetes Metab Res Rev. 2020.
Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetes. Diabetes Care. 2006;29:1288-1293.
Weiner RD, Viselli SJ, Fulkert KA, Accetta P. Histology versus microbiology for accuracy in identification of osteomyelitis in the diabetic foot. J Foot Ankle Surg. 2011;50:197-200.
Cecilia-Matilla A, Lázaro-Martínez JL, Aragón-Sánchez J, García-Morales E, García-Álvarez Y, Beneit-Montesinos JV. Histopathologic characteristics of bone infection complicating foot ulcers in diabetic patients. J Am Podiatr Med Assoc. 2013;103:24-31.
Lam K, van Asten SA, Nguyen T, et al. Diagnostic accuracy of probe to bone to detect osteomyelitis in the diabetic foot: a systematic review. Clin Infect Dis. 2016;63:944-994.
Lavery LA, Armstrong DG, Peters EJ, et al. Probe-to-bone test for diagnosing diabetic foot osteomyelitis: reliable or relic? Diabetes Care. 2007;30:270-274.
Mutluoglu M, Uzun G, Sildiroglu O, Turhan V, Mutlu H, Yildiz S. Performance of the probe-to-bone test in a population suspected of having osteomyelitis of the foot in diabetes. J Am Podiatr Med Assoc. 2012;102:369-373.
Zaiton F, Samir AM, Elkamash TH, Tawfik AM, Hadhoud KM. Evaluation of diabetic foot osteomyelitis using probe to bone test and magnetic resonance imaging and their impact on surgical intervention. Egypt J Radiol Nucl Med. 2014;45:795-802.
Morales-Lozano R, González Fernández ML, Martinez Hernández D, et al. Validating the probe-to-bone test and other tests for diagnosing chronic osteomyelitis in the diabetic foot. Diabetes Care. 2010;33:2140-2145.
Aragón-Sánchez J, Lipsky BA, Lázaro-Martínez JL. Diagnosing diabetic foot osteomyelitis: is the combination of probe-to-bone test and plain radiography sufficient for high-risk inpatients? Diabet Med. 2011;28:191-194.
Senneville E. Editorial commentary: probe-to-bone test for detecting diabetic foot osteomyelitis: rapid, safe, and accurate-but for which patients? Clin Infect Dis. 2016;63:949-950.
van Asten SA, Peters EJG, Xi Y, et al. The role of biomarkers to diagnose diabetic foot osteomyelitis; a meta-analysis. Curr Diabetes Rev. 2016;12:396-402.
Lauri C, Tamminga M, Glaudemans AWJM, et al. Detection of osteomyelitis in the diabetic foot by imaging techniques: a systematic review and meta-analysis comparing MRI, white blood cell Scintigraphy, and FDG-PET. Diabetes Care. 2017;40:1111-1120.
Rastogi A, Bhattacharya A, Prakash M, et al. Utility of PET/CT with fluorine-18-fluorodeoxyglucose-labeled autologous leukocytes for diagnosing diabetic foot osteomyelitis in patients with Charcot's neuroarthropathy. Nucl Med Commun. 2016;37:1253-1259.
Aslangul E, M'bemba J, Caillat-Vigneron N, et al. Diagnosing diabetic foot osteomyelitis in patients without signs of soft tissue infection by coupling hybrid 67Ga SPECT/CT with bedside percutaneous bone puncture. Diabetes Care. 2013;36:2203-2210.
Chantelau E, Wolf A, Ozdemir S, et al. Bone histomorphology may be unremarkable in diabetes mellitus. Med Klin (Munich). 2007;102:429-433.
Lavery LA, Sariaya M, Ashry H, Harkless LB. Microbiology of osteomyelitis in diabetic foot infections. J Foot Ankle Surg. 1995;34:61-64.
Kessler L, Piemont Y, Ortega F, et al. Comparison of microbiological results of needle puncture vs. superficial swab in infected diabetic foot ulcer with osteomyelitis. Diabet Med. 2006;23:99-102.
Senneville E, Melliez H, Beltrand E, et al. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis. 2006;42:57-62.
Senneville E, Morant H, Descamps D, et al. Needle puncture and transcutaneous bone biopsy cultures are inconsistent in patients with diabetes and suspected osteomyelitis of the foot. Clin Infect Dis. 2009;48:888-893.
Elamurugan TP, Jagdish S, Kate V, Chandra Parija S. Role of bone biopsy specimen culture in the management of diabetic foot osteomyelitis. Int J Surg. 2011;9:214-216.
Malone M, Bowling FL, Gannass A, Jude EB, Boulton AJ. Deep wound cultures correlate well with bone biopsy culture in diabetic foot osteomyelitis. Diabetes Metab Res Rev. 2013;29:546-550.
Couturier A, Chabaud A, Desbiez F, et al. Comparison of microbiological results obtained from per-wound bone biopsies versus transcutaneous bone biopsies in diabetic foot osteomyelitis: a prospective cohort study. Eur J Clin Microbiol Infect Dis. 2019;38:1287-1291. https://doi.org/10.1007/s10096-019-03547-6.
Senneville E, Gaworowska D, Topolinski H, et al. Outcome of patients with diabetes with negative percutaneous bone biopsy performed for suspicion of osteomyelitis of the foot. Diabet Med. 2012;29:56-61.
Féron F, Kevorkian JP, Roussel R. Bedside blind bone biopsy (B4) for suspected diabetic foot osteitis- A reliable tool to manage medical treatment? Paper presented at: ADA Annual Meeting Orlando FL, USA; 2018; Abstract 112-OR.
Johani K, Fritz BG, Bjarnsholt T, et al. Understanding the microbiome of diabetic foot osteomyelitis: insights from molecular and microscopic approaches. Clin Microbiol Infect. 2018;25:332-339. Epub ahead of print.