Diabetes and foot infection: more than double trouble

Authors

  • Jean-Louis Richard,

    Corresponding author
    • Department of Diabetology and Nutritional Diseases, Medical Centre, University Hospital of Nîmes, Le Grau du Roi, France
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  • Jean-Philippe Lavigne,

    1. Department of Bacteriology, Carémeau University Hospital, Nîmes Cedex 9, France
    2. National Institute of Health and Medical Research, U1047, Montpellier 1 University, Faculty of Medicine, Nîmes Cedex 02, France
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  • Albert Sotto

    1. National Institute of Health and Medical Research, U1047, Montpellier 1 University, Faculty of Medicine, Nîmes Cedex 02, France
    2. Department of Tropical and Infectious Diseases, Carémeau University Hospital, Place du Professeur Robert Debré, Nîmes Cedex 9, France
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Jean-Louis Richard, Department of Diabetology and Nutritional Diseases, Medical Centre, University Hospital of Nîmes, 30240 Le Grau du Roi, France.

E-mail: jean.louis.richard@chu-nimes.fr

Summary

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. Copyright © 2012 John Wiley & Sons, Ltd.

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