Introduction & Objective: There are few published studies concerning blood stream infections (BSI) in diabetic foot infections (DFI). Our objective was to evaluate the incidence and risk factors for BSI and endocarditis in diabetic patients admitted to the hospital with moderate and severe DFI. Our secondary aim was to evaluate the correlation of blood cultures and intraoperative wound cultures.
Methodology: This was a meta-analysis with pooled patient level data from 3 RTCs. Moderate and severe infection was based on criteria of the International Working Group on the Diabetic Foot classification. BSI was defined as a positive blood culture upon admission. Endocarditis was diagnosed by echocardiogram. We compared isolates from blood cultures and intraoperative wound cultures. Concordance was defined as any single pathogen isolated in wound cultures also isolated from blood cultures. We used χ2 and t-test for comparison of clinical events, with alpha of <0.05.
Results: We evaluated 227 patients with blood cultures; (n=45) 19.8% had BSI. One (2.2%) patient had endocarditis. The concordance of wound cultures and blood culture pathogens was 66.7%. Polymicrobial infections were significantly more common in DFI vs BSI (48.7% vs 11.1%, p=<0.001)
Conclusion: The incidence of BSI in people with DFI is very high (19.8%). There is a high concordance of BSI and DFI bacterial pathogens.
M.C. Reyes: None. A. Tarricone: None. E.J. Peters: None. L.C. Rogers: None. L.A. Lavery: None.
