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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/222104
The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
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Objectives: To investigate the microbiological trends of community-acquired diabetic foot osteomyelitis (DFO) over the past two decades in specialized academic centres in Switzerland, Spain, and Turkey. Methods: A retrospective analysis of DFO cohorts (2000-2019) from five centres (Geneva, Zurich, Las Palmas, Barcelona, Istanbul) stratified into four periods (P1-P4) to assess microbiological changes. Results: Among 1379 DFO episodes (76% male, median age 67 years; 90% type 2 diabetes, median duration 17 years), gram-positive bacteria were identified in 82%, including Staphylococcus aureus (47%). Methicillin-resistant S. aureus (MRSA) was more prevalent in Barcelona (36%), Las Palmas (24%), and Geneva (29%) than in Zurich (7%). Over time, gram-positive bacteria remained stable or decreased, particularly in Las Palmas (83% to 65%, P = 0.03). The proportion of MRSA decreased in Geneva (39% to 16%) and Las Palmas (37% to 9%), but remained stable in Barcelona. Enterobacteriaceae prevalence increased, notably in Geneva (16% to 39%, P < 0.01) and Las Palmas (27% to 41%, P < 0.01). Among gram-negative pathogens quinolone resistance was 12.5%. Enterobacteriaceae-DFO was associated with ischemic necrosis (OR 1.65), Las Palmas cohort (OR 3.14), and 2016-2019 period (OR 2.68). Conclusions: A significant increase in Enterobacteriaceae-related DFOs was observed from 2016 to 2019, particularly in Mediterranean Europe. (c) 2025 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
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SOLDEVILA-BOIXADER, Laura, MURILLO RUBIO, Óscar, WAIBEL, Felix w. a., SCHÖNI, Madlaina, ARAGÓN SÁNCHEZ, Javier, GARIANI, Karim, LEBOWITZ, Dan, ERTUĞRUL, Bülent, LIPSKY, Benjamin a., UÇKAY, Ilker. The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades. _International Journal of Infectious Diseases_. 2025. Vol. 154, núm. 107843. [consulta: 23 de gener de 2026]. ISSN: 1201-9712. [Disponible a: https://hdl.handle.net/2445/222104]