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Microbiology and Treatment of Diabetic Foot Infection

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The Diabetic Foot

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

The foot of patients with diabetes mellitus is affected by several processes which not only contribute to the development and progression of infection but on occasion alter the appearance of the foot in ways that may obscure the clinical features of local infection. Neuropathy involving the motor fibers supplying muscles of the foot causes asymmetric muscle strength, which in turn results in foot deformities and maldistribution of weight (or pressure) on the foot surface. Dysfunction of the sensory fibers supplying the skin and deeper structural elements of the foot allows minor and major injury to these tissues to proceed without appreciation by the patient. As a result of neuropathy, the foot may be dramatically deformed, ulcerate in areas of unperceived trauma (mal perforans), and on occasion be warm and hyperemic in response to deep structural injury (acute Charcot’s disease). This warmth and hyperemia may be misinterpreted as cellulitis and an ulceration, while a major portal of entry for infection, may be uninfected. In the patient with diabetes, peripheral neuropathy may develop in isolation or commonly in parallel with atherosclerotic peripheral vascular disease. The latter involves major inflow vessels to the lower extremity but commonly is associated with occlusive lesions of the tibial and peroneal arteries between the knee and ankle. The resulting arterial insufficiency can alter the appearance of the foot and obscure infection. Rubor may reflect vascular insufficiency rather than inflammation and conversely pallor may mute the erythema of acute infection. Gangrene and necrosis may be primarily ischemic or may reflect accelerated ischemia in the setting of infection. In sum, the diagnosis of infection involving the foot in patients with diabetes requires a careful detailed examination of the lower extremity and its blood supply.

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References

  1. Lipsky BA, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54(12):e132–73.

    PubMed  Google Scholar 

  2. Lipsky BA. A report from the international consensus on diagnosing and treating the infected diabetic foot. Diabetes Metab Res Rev. 2004;20(Suppl 1):S68–77.

    PubMed  Google Scholar 

  3. Lavery LA, et al. Risk factors for foot infections in individuals with diabetes. Diabetes Care. 2006;29(6):1288–93.

    PubMed  Google Scholar 

  4. Peters EJ, Lavery LA, Armstrong DG. Diabetic lower extremity infection: influence of physical, psychological, and social factors. J Diabetes Complications. 2005;19(2):107–12.

    PubMed  Google Scholar 

  5. Newman LG, et al. Unsuspected osteomyelitis in diabetic foot ulcers. Diagnosis and monitoring by leukocyte scanning with indium in 111 oxyquinoline. JAMA. 1991;266(9):1246–51.

    CAS  PubMed  Google Scholar 

  6. Grayson ML, et al. Use of ampicillin/sulbactam versus imipenem/cilastatin in the treatment of limb-threatening foot infections in diabetic patients. Clin Infect Dis. 1994;18(5):683–93.

    CAS  PubMed  Google Scholar 

  7. Karchmer AW, Gibbons GW. Foot infections in diabetes: evaluation and management. In: Remington JS, Swartz MN, editors. Current clinical topics in infectious diseases. Boston: Blackwell Scientific Publications; 1994. p. 1–22.

    Google Scholar 

  8. Pittet D, et al. Outcome of diabetic foot infections treated conservatively: a retrospective cohort study with long-term follow-up. Arch Intern Med. 1999;159(8):851–6.

    CAS  PubMed  Google Scholar 

  9. Williams DT, Hilton JR, Harding KG. Diagnosing foot infection in diabetes. Clin Infect Dis. 2004;39(Suppl 2):S83–6.

    PubMed  Google Scholar 

  10. Armstrong DG, et al. Leukocytosis is a poor indicator of acute osteomyelitis of the foot in diabetes mellitus. J Foot Ankle Surg. 1996;35(4):280–3.

    CAS  PubMed  Google Scholar 

  11. Jeandrot A, et al. Serum procalcitonin and C-reactive protein concentrations to distinguish mildly infected from non-infected diabetic foot ulcers: a pilot study. Diabetologia. 2008;51(2):347–52.

    CAS  PubMed  Google Scholar 

  12. Butalia S, et al. Does this patient with diabetes have osteomyelitis of the lower extremity? JAMA. 2008;299(7):806–13.

    CAS  PubMed  Google Scholar 

  13. Hingorani A, et al. The management of diabetic foot: a clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine. J Vasc Surg. 2016;63(2 Suppl):3S–21S.

    PubMed  Google Scholar 

  14. Grayson ML, et al. Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients. JAMA. 1995;273(9):721–3.

    CAS  PubMed  Google Scholar 

  15. Morales Lozano R, et al. Validating the probe-to-bone test and other tests for diagnosing chronic osteomyelitis in the diabetic foot. Diabetes Care. 2010;33(10):2140–5.

    PubMed  PubMed Central  Google Scholar 

  16. Lam K, et al. Diagnostic accuracy of probe to bone to detect osteomyelitis in the diabetic foot: a systematic review. Clin Infect Dis. 2016;63:944.

    PubMed  Google Scholar 

  17. Alvaro-Afonso FJ, et al. Inter-observer reproducibility of diagnosis of diabetic foot osteomyelitis based on a combination of probe-to-bone test and simple radiography. Diabetes Res Clin Pract. 2014;105(1):e3–5.

    PubMed  Google Scholar 

  18. Jeffcoate WJ, Lipsky BA. Controversies in diagnosing and managing osteomyelitis of the foot in diabetes. Clin Infect Dis. 2004;39(Suppl 2):S115–22.

    PubMed  Google Scholar 

  19. Weiner RD, et al. Histology versus microbiology for accuracy in identification of osteomyelitis in the diabetic foot. J Foot Ankle Surg. 2011;50(2):197–200.

    PubMed  Google Scholar 

  20. Senneville E, et al. Culture of percutaneous bone biopsy specimens for diagnosis of diabetic foot osteomyelitis: concordance with ulcer swab cultures. Clin Infect Dis. 2006;42(1):57–62.

    PubMed  Google Scholar 

  21. Wagner FW. The diabetic foot and amputation of the foot. In: Mann RA, editor. Sugery of the foot. St. Louis: C.V. Mosby; 1986. p. 421–55.

    Google Scholar 

  22. Lavery LA, et al. Validation of the Infectious Diseases Society of America’s diabetic foot infection classification system. Clin Infect Dis. 2007;44(4):562–5.

    PubMed  Google Scholar 

  23. Schaper NC. Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes Metab Res Rev. 2004;20(Suppl 1):S90–5.

    PubMed  Google Scholar 

  24. Lipsky BA, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2004;39(7):885–910.

    PubMed  Google Scholar 

  25. Sapico FL, et al. Quantitative aerobic and anaerobic bacteriology of infected diabetic feet. J Clin Microbiol. 1980;12(3):413–20.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Slater RA, et al. Swab cultures accurately identify bacterial pathogens in diabetic foot wounds not involving bone. Diabet Med. 2004;21(7):705–9.

    CAS  PubMed  Google Scholar 

  27. Pellizzer G, et al. Deep tissue biopsy vs. superficial swab culture monitoring in the microbiological assessment of limb-threatening diabetic foot infection. Diabet Med. 2001;18(10):822–7.

    CAS  PubMed  Google Scholar 

  28. Lipsky BA. Medical treatment of diabetic foot infections. Clin Infect Dis. 2004;39(Suppl 2):S104–14.

    PubMed  Google Scholar 

  29. Lipsky BA, et al. Outpatient management of uncomplicated lower-extremity infections in diabetic patients. Arch Intern Med. 1990;150(4):790–7.

    CAS  PubMed  Google Scholar 

  30. Lipsky BA, Pecoraro RE, Wheat LJ. The diabetic foot. Soft tissue and bone infection. Infect Dis Clin N Am. 1990;4(3):409–32.

    CAS  Google Scholar 

  31. Caputo GM, Ulbrecht JS, Cavanagh PR, Juliano PJ. The role of cultures in mild diabetic foot cellulitis. Infect Dis Clin Pract. 2000;9:241–3.

    Google Scholar 

  32. Lipsky BA. Evidence-based antibiotic therapy of diabetic foot infections. FEMS Immunol Med Microbiol. 1999;26(3–4):267–76.

    CAS  PubMed  Google Scholar 

  33. Lipsky BA, et al. Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost. Diabetologia. 2010;53(5):914–23.

    CAS  PubMed  Google Scholar 

  34. Dang CN, et al. Methicillin-resistant Staphylococcus aureus in the diabetic foot clinic: a worsening problem. Diabet Med. 2003;20(2):159–61.

    CAS  PubMed  Google Scholar 

  35. Tentolouris N, et al. Methicillin-resistant Staphylococcus aureus: an increasing problem in a diabetic foot clinic. Diabet Med. 1999;16(9):767–71.

    CAS  PubMed  Google Scholar 

  36. Yates C, et al. Wound chronicity, inpatient care, and chronic kidney disease predispose to MRSA infection in diabetic foot ulcers. Diabetes Care. 2009;32(10):1907–9.

    PubMed  PubMed Central  Google Scholar 

  37. Kandemir O, et al. Risk factors for infection of the diabetic foot with multi-antibiotic resistant microorganisms. J Infect. 2007;54(5):439–45.

    PubMed  Google Scholar 

  38. Scher KS, Steele FJ. The septic foot in patients with diabetes. Surgery. 1988;104(4):661–6.

    CAS  PubMed  Google Scholar 

  39. Citron DM, et al. Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents. J Clin Microbiol. 2007;45(9):2819–28.

    PubMed  PubMed Central  Google Scholar 

  40. Gadepalli R, et al. A clinico-microbiological study of diabetic foot ulcers in an Indian tertiary care hospital. Diabetes Care. 2006;29(8):1727–32.

    PubMed  Google Scholar 

  41. Gerding DN. Foot infections in diabetic patients: the role of anaerobes. Clin Infect Dis. 1995;20(Suppl 2):S283–8.

    PubMed  Google Scholar 

  42. Johnson S, et al. Use of an anaerobic collection and transport swab device to recover anaerobic bacteria from infected foot ulcers in diabetics. Clin Infect Dis. 1995;20(Suppl 2):S289–90.

    PubMed  Google Scholar 

  43. Hartemann-Heurtier A, et al. Diabetic foot ulcer and multidrug-resistant organisms: risk factors and impact. Diabet Med. 2004;21(7):710–5.

    CAS  PubMed  Google Scholar 

  44. Richard JL, et al. Risk factors and healing impact of multidrug-resistant bacteria in diabetic foot ulcers. Diabetes Metab. 2008;34(4 Pt 1):363–9.

    PubMed  Google Scholar 

  45. Liu C, et al. Clinical practice guidelines by the infectious diseases society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis. 2011;52(3):285–92.

    PubMed  Google Scholar 

  46. Hatipoglu M, et al. Causative pathogens and antibiotic resistance in diabetic foot infections: a prospective multi-center study. J Diabetes Complicat. 2016;30(5):910–6.

    PubMed  Google Scholar 

  47. Sugandhi P, Prasanth DA. Microbiological profile of bacterial pathogens from diabetic foot infections in tertiary care hospitals, Salem. Diabetes Metab Syndr. 2014;8(3):129–32.

    CAS  PubMed  Google Scholar 

  48. Lipsky BA, et al. Antibiotic therapy for diabetic foot infections: comparison of two parenteral-to-oral regimens. Clin Infect Dis. 1997;24(4):643–8.

    CAS  PubMed  Google Scholar 

  49. Caputo GM, et al. Assessment and management of foot disease in patients with diabetes. N Engl J Med. 1994;331(13):854–60.

    CAS  PubMed  Google Scholar 

  50. Board NDA. The national long-range plan to combat diabetes. Washington: US Government Printing Office; 1987.

    Google Scholar 

  51. Association, A.D. Consensus development conference of diabetic foot wound care. Diab Care. 1999;22:1354–60.

    Google Scholar 

  52. Tan JS, et al. Can aggressive treatment of diabetic foot infections reduce the need for above-ankle amputation? Clin Infect Dis. 1996;23(2):286–91.

    CAS  PubMed  Google Scholar 

  53. van Baal JG. Surgical treatment of the infected diabetic foot. Clin Infect Dis. 2004;39(Suppl 2):S123–8.

    PubMed  Google Scholar 

  54. McIntyre KE Jr, et al. Guillotine amputation in the treatment of nonsalvageable lower-extremity infections. Arch Surg. 1984;119(4):450–3.

    PubMed  Google Scholar 

  55. Chantelau E, et al. Antibiotic treatment for uncomplicated neuropathic forefoot ulcers in diabetes: a controlled trial. Diabet Med. 1996;13(2):156–9.

    CAS  PubMed  Google Scholar 

  56. Jones EW, Edwards R, Finch R, Jaffcoate WJ. A microbiologic study of diabetic foot lesions. Diab Med. 1984;2:213–5.

    Google Scholar 

  57. Lipsky BA, McDonald D, Litka PA. Treatment of infected diabetic foot ulcers: topical MSI-78 vs. oral ofloxacin. Diabetologia. 1997;40(Suppl 1):482.

    Google Scholar 

  58. Fox HR, Karchmer AW. Management of diabetic foot infections, including the use of home intravenous antibiotic therapy. Clin Podiatr Med Surg. 1996;13(4):671–82.

    CAS  PubMed  Google Scholar 

  59. Lipsky BA, Itani K, Norden C. Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. Clin Infect Dis. 2004;38(1):17–24.

    CAS  PubMed  Google Scholar 

  60. Stevens DL, et al. Linezolid versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections. Clin Infect Dis. 2002;34(11):1481–90.

    CAS  PubMed  Google Scholar 

  61. Arbeit RD, et al. The safety and efficacy of daptomycin for the treatment of complicated skin and skin-structure infections. Clin Infect Dis. 2004;38(12):1673–81.

    CAS  PubMed  Google Scholar 

  62. Lipsky BA, Stoutenburgh U. Daptomycin for treating infected diabetic foot ulcers: evidence from a randomized, controlled trial comparing daptomycin with vancomycin or semi-synthetic penicillins for complicated skin and skin-structure infections. J Antimicrob Chemother. 2005;55(2):240–5.

    CAS  PubMed  Google Scholar 

  63. Stryjewski ME, et al. Telavancin versus vancomycin for the treatment of complicated skin and skin-structure infections caused by gram-positive organisms. Clin Infect Dis. 2008;46(11):1683–93.

    CAS  PubMed  Google Scholar 

  64. Wilcox MH, et al. CANVAS 2: the second Phase III, randomized, double-blind study evaluating ceftaroline fosamil for the treatment of patients with complicated skin and skin structure infections. J Antimicrob Chemother. 2010;65(Suppl 4):iv53–65.

    CAS  PubMed  Google Scholar 

  65. Corey GR, et al. CANVAS 1: the first Phase III, randomized, double-blind study evaluating ceftaroline fosamil for the treatment of patients with complicated skin and skin structure infections. J Antimicrob Chemother. 2010;65(Suppl 4):iv41–51.

    CAS  PubMed  Google Scholar 

  66. Lipsky BA, et al. Ceftaroline fosamil for treatment of diabetic foot infections: the CAPTURE study experience. Diabetes Metab Res Rev. 2015;31(4):395–401.

    CAS  PubMed  Google Scholar 

  67. Selva Olid A, et al. Systemic antibiotics for treating diabetic foot infections. Cochrane Database Syst Rev. 2015;9:CD009061.

    Google Scholar 

  68. Crouzet J, et al. Diabetic foot infection: a critical review of recent randomized clinical trials on antibiotic therapy. Int J Infect Dis. 2011;15(9):e601–10.

    CAS  PubMed  Google Scholar 

  69. Lipsky BA. Empirical therapy for diabetic foot infections: are there clinical clues to guide antibiotic selection? Clin Microbiol Infect. 2007;13(4):351–3.

    CAS  PubMed  Google Scholar 

  70. Beam T, Gutierrez I, Powell S, et al. Prospective study of the efficacy and safety of oral and intravenous ciprofloxacin in the treatment of diabetic foot infections. Rev Infect Dis. 1989;11(Suppl 5):S1163.

    Google Scholar 

  71. Hughes CE, et al. Treatment and long-term follow-up of foot infections in patients with diabetes or ischemia: a randomized, prospective, double-blind comparison of cefoxitin and ceftizoxime. Clin Ther. 1987;10(Suppl A):36–49.

    PubMed  Google Scholar 

  72. Peterson LR, et al. Therapy of lower extremity infections with ciprofloxacin in patients with diabetes mellitus, peripheral vascular disease, or both. Am J Med. 1989;86(6 Pt 2):801–8.

    CAS  PubMed  Google Scholar 

  73. Lipsky BA, et al. Ertapenem versus piperacillin/tazobactam for diabetic foot infections (SIDESTEP): prospective, randomised, controlled, double-blinded, multicentre trial. Lancet. 2005;366(9498):1695–703.

    CAS  PubMed  Google Scholar 

  74. Lipsky BA, et al. Treating diabetic foot infections with sequential intravenous to oral moxifloxacin compared with piperacillin-tazobactam/amoxicillin-clavulanate. J Antimicrob Chemother. 2007;60(2):370–6.

    CAS  PubMed  Google Scholar 

  75. Vick-Fragoso R, et al. Efficacy and safety of sequential intravenous/oral moxifloxacin vs intravenous/oral amoxicillin/clavulanate for complicated skin and skin structure infections. Infection. 2009;37(5):407–17.

    CAS  PubMed  Google Scholar 

  76. Schaper NC, et al. Efficacy and safety of IV/PO moxifloxacin and IV piperacillin/tazobactam followed by PO amoxicillin/clavulanic acid in the treatment of diabetic foot infections: results of the RELIEF study. Infection. 2013;41(1):175–86.

    CAS  PubMed  Google Scholar 

  77. Xu ZR, et al. Ertapenem versus piperacillin/tazobactam for diabetic foot infections in China: a Phase 3, multicentre, randomized, double-blind, active-controlled, non-inferiority trial. J Antimicrob Chemother. 2016;71(6):1688–96.

    CAS  PubMed  Google Scholar 

  78. Vardakas KZ, Horianopoulou M, Falagas ME. Factors associated with treatment failure in patients with diabetic foot infections: an analysis of data from randomized controlled trials. Diabetes Res Clin Pract. 2008;80(3):344–51.

    CAS  PubMed  Google Scholar 

  79. Lauf L, et al. Phase 3 study comparing tigecycline and ertapenem in patients with diabetic foot infections with and without osteomyelitis. Diagn Microbiol Infect Dis. 2014;78(4):469–80.

    CAS  PubMed  Google Scholar 

  80. Cooper G, Platt R. Staphylococcus aureus bacteremia in diabetic patients. Endocarditis and mortality. Am J Med. 1982;73(5):658–62.

    CAS  PubMed  Google Scholar 

  81. Bamberger DM, Daus GP, Gerding DN. Osteomyelitis in the feet of diabetic patients. Long-term results, prognostic factors, and the role of antimicrobial and surgical therapy. Am J Med. 1987;83(4):653–60.

    CAS  PubMed  Google Scholar 

  82. Game FL, Jeffcoate WJ. Primarily non-surgical management of osteomyelitis of the foot in diabetes. Diabetologia. 2008;51(6):962–7.

    CAS  PubMed  Google Scholar 

  83. Senneville E, et al. Outcome of diabetic foot osteomyelitis treated nonsurgically: a retrospective cohort study. Diabetes Care. 2008;31(4):637–42.

    PubMed  Google Scholar 

  84. Senneville E, et al. Rifampicin-ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis. J Antimicrob Chemother. 2001;48(6):927–30.

    CAS  PubMed  Google Scholar 

  85. Ha Van G, et al. Treatment of osteomyelitis in the diabetic foot. Contribution of conservative surgery. Diabetes Care. 1996;19(11):1257–60.

    CAS  PubMed  Google Scholar 

  86. Berendt AR, et al. Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment. Diabetes Metab Res Rev. 2008;24(Suppl 1):S145–61.

    PubMed  Google Scholar 

  87. Acharya S, et al. Conservative management of diabetic foot osteomyelitis. Diabetes Res Clin Pract. 2013;101(3):e18–20.

    CAS  PubMed  Google Scholar 

  88. Lazaro-Martinez JL, Aragon-Sanchez J, Garcia-Morales E. Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis: a randomized comparative trial. Diabetes Care. 2014;37(3):789–95.

    PubMed  Google Scholar 

  89. Lesens O, et al. Staphylococcus aureus-related diabetic osteomyelitis: medical or surgical management? A French and Spanish retrospective cohort. Int J Low Extrem Wounds. 2015;14(3):284–90.

    PubMed  Google Scholar 

  90. Tone A, et al. Six-week versus twelve-week antibiotic therapy for nonsurgically treated diabetic foot osteomyelitis: a multicenter open-label controlled randomized study. Diabetes Care 2015;38:302–307. Diabetes Care. 2015;38(4):735.

    PubMed  Google Scholar 

  91. Berendt AR, et al. Specific guidelines for treatment of diabetic foot osteomyelitis. Diabetes Metab Res Rev. 2008;24(Suppl 1):S190–1.

    PubMed  Google Scholar 

  92. Lipsky BA. Osteomyelitis of the foot in diabetic patients. Clin Infect Dis. 1997;25(6):1318–26.

    CAS  PubMed  Google Scholar 

  93. Eneroth M, van Houtum WH. The value of debridement and vacuum-assisted closure (V.A.C.) therapy in diabetic foot ulcers. Diabetes Metab Res Rev. 2008;24(Suppl 1):S76–80.

    PubMed  Google Scholar 

  94. Chen S, Giurini JM, Karchmer AW. Invasive systemic infection following hospital treatment for diabetic foot ulcer: risk of occurrence and effect on mortality. Boston: Beth Israel Deaconess Medical Center; 2016.

    Google Scholar 

  95. Gibbons GW, Eliopoulos GM. Infections of the diabetic foot. In: Kozak GP, Hoar Jr CS, Rowbotham RL, editors. Management of diabetic foot problems. Philadelphia: Saunders; 1984. p. 97–102.

    Google Scholar 

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Authors and Affiliations

  1. Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Mary T. LaSalvia MD, MPH & Adolf W. Karchmer MD

  2. Harvard Medical School, Boston, MA, USA

    Mary T. LaSalvia MD, MPH & Adolf W. Karchmer MD

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  1. Mary T. LaSalvia MD, MPH
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  2. Adolf W. Karchmer MD
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Correspondence to Adolf W. Karchmer MD .

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Editors and Affiliations

  1. Rongxiang Xu, MD, Professor of Surgery, Harvard Medical School Director, The Rongxiang Xu, MD, Center for Regenerative Therapeutics Research Director, Joslin-Beth Israel Deaconess Foot Center Beth Israel Deaconess Medical Center, Boston, MA, USA

    Aristidis Veves

  2. Chief, Division of Podiatry, Beth Israel Deaconess Medical Center, Associate Professor of Surgery, Harvard Medical School, Co-director, Joslin-Bl Deaconess Diabetic Foot Center Consultant, Joslin Diabetes Center, Boston, MA, USA

    John M. Giurini

  3. Associate Professor of Surgery, Harvard Medical School, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Joslin Diabetes Center, Boston, MA, USA

    Raul J. Guzman

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LaSalvia, M.T., Karchmer, A.W. (2018). Microbiology and Treatment of Diabetic Foot Infection. In: Veves, A., Giurini, J., Guzman, R. (eds) The Diabetic Foot. Contemporary Diabetes. Humana, Cham. https://doi.org/10.1007/978-3-319-89869-8_17

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