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Diabetes and foot infection: more than double trouble
Jean-Louis Richard1, Jean-Philippe Lavigne, Albert Sotto
1Department of Diabetology and Nutritional Diseases, Medical Centre, University Hospital of Nîmes, 30240, Le Grau du Roi, France. jean.louis.richard@chu-nimes.fr
Background:
Infection of foot ulcers is a common, often severe and costly complication in diabetes. Many factors linked to the host, mainly immune defects, neuropathy and arteriopathy, as well as bacteria-related factors, interact in a complex way and account for the susceptibility of diabetic individuals to foot infections, the severity of such infections and difficulty to treat them.
Methods:
This article reviews these factors, in the light of data from the literature and from our own results.
Results:
DFIs are not as simple as previously suggested, and new concepts must be considered, especially the virulence potential of isolates and bacterial communications through biofilms.
Conclusion:
The development of new tools from molecular biology is a critical step to better understand and manage these infections.
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