Diabetic Foot Infections in the Era of Antimicrobial Resistance: Integrating Microbiological Insights with Stewardship Practices

DOI

10.2991/978-94-6239-756-9_9How to use a DOI?

Keywords

Diabetic foot; Diabetic foot infections; Multidrug-resistant organisms; MRSA; ESBL

Abstract

Background

Diabetic foot infections (DFIs) present significant challenges due to their polymicrobial nature and rising multidrug resistance.

Objective

To analyze the microbiological profile, antimicrobial resistance, and clinical features of DFIs.

Materials and Methods

A prospective study of 114 patients with DFIs was conducted, with microbial identification and susceptibility testing performed per CLSI guidelines.

Results

Most patients were male (70.2%) and over 50 years old (71.9%), with poor glycemic control (36%). Comorbidities included hypertension (56.1%), diabetic peripheral neuropathy (69.3%), dyslipidemia (59.6%), and peripheral arterial disease (45.6%). Osteomyelitis was present in 20.2% of patients, and 30.7% had a history of prior foot ulcers. The infection severity varied, with mild (36.8%), moderate (33.3%), and severe/septic (29.8%) cases. Gram-negative bacteria predominated (78.1%), including Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae. ESBL production was observed in 47.19% of isolates, notably in E. coli (87.5%) and Klebsiella pneumoniae (78.57%). MBL production was detected in Klebsiella pneumoniae (64.2%) and E. coli (25%) isolates. Among the S. aureus isolates, 77% were MRSA, with 23% exhibiting inducible clindamycin resistance. The detection of Clostridium perfringens highlights the role of anaerobes in DFI.

Conclusion

The high burden of multidrug-resistant organisms highlights the need for antimicrobial stewardship and personalized therapy in managing DFIs warranted.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Kalpana Angadi
AU  - Anusha Girish Virkar
AU  - Sumit Chavan
AU  - Savita Jadhav
PY  - 2026
DA  - 2026/08/31
TI  - Diabetic Foot Infections in the Era of Antimicrobial Resistance: Integrating Microbiological Insights with Stewardship Practices
BT  - Proceedings of the Conference on Bioengineering for Global Health (SYMRESEARCH 2.0 2025)
PB  - Atlantis Press
SP  - 104
EP  - 117
SN  - 2468-5747
UR  - https://doi.org/10.2991/978-94-6239-756-9_9
DO  - 10.2991/978-94-6239-756-9_9
ID  - Angadi2026
ER  -