Multifaceted Antibiotic Resistance in Diabetic Foot Infections: A Systematic Review

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Diabetic foot infections (DFIs) are a severe diabetes complication, leading to amputation and mortality.
• Antibiotic resistance complicates DFIs, necessitating updated treatment strategies.
• DFIs result from neuropathy, poor circulation, and immune impairment, increasing infection risk.

Purpose of the Study:

• To systematically review and meta-analyze bacterial profiles and antibiotic resistance patterns in DFIs.
• To identify prevalent resistant pathogens and their resistance trends between 2014 and 2024.
• To analyze correlations between comorbidities and antibiotic resistance in DFI patients.

Main Methods:

• Systematic review and meta-analysis of 28 studies published between 2014 and 2024.
• Searched databases: PubMed, Google Scholar, EBSCOhost, ScienceDirect.
• Synthesized data on microbial isolates, antibiotic resistance, and specific bacterial strains (e.g., E. coli, S. aureus).

Main Results:

• Cataloged resistance patterns for key pathogens like Escherichia coli, Enterobacter spp., Proteus spp., Pseudomonas spp., and Staphylococcus aureus.
• Detailed resistance to specific antibiotics (amoxicillin/clavulanate, trimethoprim/sulfamethoxazole, ciprofloxacin) and multi-drug resistance.
• Identified correlations between patient comorbidities and multiple antibiotic resistance.

Conclusions:

• Rising antibiotic resistance in DFIs requires urgent attention.
• Antibiotic stewardship programs are crucial to reduce resistance spread and improve outcomes.
• Tailored antibiotic therapy based on culture and sensitivity testing is essential for effective DFI management.