Infected puncture wounds in diabetic and nondiabetic adults

L. A. Lavery, S. C. Walker, L. B. Harkless, K. Felder-Johnson

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

OBJECTIVE - To evaluate bone and soft tissue pathogens resulting from puncture wounds among diabetic and nondiabetic adults. RESEARCH DESIGN AND METHODS - We used a case-control design to compare bacterial pathogens in diabetic and nondiabetic subjects with foot infections precipitated by puncture injuries. We used ICD-9-CM code E920.8 to identify 77 diabetic and 69 nondiabetic patients admitted to the hospital for infected puncture wounds. We identified surgical bone and soft tissue cultures and number and type of organisms per culture. RESULTS - Nondiabetic subjects had significantly less osteomyelitis (13 vs. 35%, P < 0.01) than diabetic subjects and were infected by fewer organisms. Pseudomonas was the most common cause of osteomyelitis among nondiabetic subjects (P < 0.001). Staphylococcus aureus was more common in diabetic bone (P < 0.001) and soft tissue (P < 0.001) infections. Polymicrobial osteomyelitis was more common in diabetic subjects. There was a longer delay until diabetic subjects received medical treatment compared with nondiabetic subjects (8.7 vs. 5.3 days, P < 0.002). Diabetic subjects were more likely to have neuropathy (P < 0.001) and to have sustained their injuries while barefoot (P < 0.006). CONCLUSIONS - Puncture wounds in diabetic subjects were commonly associated with polymicrobial infections Pseudomonas was the most common cause of nondiabetic osteomyelitis. These results have implications for differential emergent and chronic treatment of puncture wounds in diabetic versus nondiabetic subjects.

Original languageEnglish (US)
Pages (from-to)1588-1591
Number of pages4
JournalDiabetes care
Volume18
Issue number12
DOIs
StatePublished - Dec 1995

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Fingerprint Dive into the research topics of 'Infected puncture wounds in diabetic and nondiabetic adults'. Together they form a unique fingerprint.

  • Cite this

    Lavery, L. A., Walker, S. C., Harkless, L. B., & Felder-Johnson, K. (1995). Infected puncture wounds in diabetic and nondiabetic adults. Diabetes care, 18(12), 1588-1591. https://doi.org/10.2337/diacare.18.12.1588