Diabetes and foot infection: more than double trouble
Jean-Louis Richard, Department of Diabetology and Nutritional Diseases, Medical Centre, University Hospital of Nîmes, 30240 Le Grau du Roi, France.
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.
This article reviews these factors, in the light of data from the literature and from our own 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.
The development of new tools from molecular biology is a critical step to better understand and manage these infections. Copyright © 2012 John Wiley & Sons, Ltd.