The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis

Suzanne A V Van Asten, Adam Nichols, Javier La Fontaine, Kavita Bhavan, Edgar J G Peters, Lawrence A. Lavery

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. PCT levels in the osteomyelitis group were significantly higher at baseline than in the group with no osteomyelitis (P = 0·049). There were no significant differences between the two groups in the levels of the other markers. CRP, ESR, PCT and IL-6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP-1 increased (P = 0·002). TNFα and MIP1α levels were below range in 80 out of 97 samples and therefore not reported. Our results suggest that PCT might be useful to distinguish osteomyelitis in infected foot ulcers. CRP, ESR, PCT and IL-6 are valuable when monitoring the effect of therapy.

Original languageEnglish (US)
Pages (from-to)40-45
Number of pages6
JournalInternational Wound Journal
Volume14
Issue number1
DOIs
StatePublished - Feb 1 2017

Fingerprint

Diabetic Foot
Osteomyelitis
Calcitonin
Blood Sedimentation
C-Reactive Protein
Foot Ulcer
Chemokine CCL3
Interleukin-6
Chemokine CCL2
Tumor Necrosis Factor-alpha
Therapeutics
Interleukin-8
Bone and Bones

Keywords

  • Biomarkers
  • Diabetic foot infection
  • Erythrocyte sedimentation rate
  • Osteomyelitis
  • Procalcitonin

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis. / Van Asten, Suzanne A V; Nichols, Adam; La Fontaine, Javier; Bhavan, Kavita; Peters, Edgar J G; Lavery, Lawrence A.

In: International Wound Journal, Vol. 14, No. 1, 01.02.2017, p. 40-45.

Research output: Contribution to journalArticle

@article{5bffe75ed726474a814693f012aa5713,
title = "The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis",
abstract = "In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. PCT levels in the osteomyelitis group were significantly higher at baseline than in the group with no osteomyelitis (P = 0·049). There were no significant differences between the two groups in the levels of the other markers. CRP, ESR, PCT and IL-6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP-1 increased (P = 0·002). TNFα and MIP1α levels were below range in 80 out of 97 samples and therefore not reported. Our results suggest that PCT might be useful to distinguish osteomyelitis in infected foot ulcers. CRP, ESR, PCT and IL-6 are valuable when monitoring the effect of therapy.",
keywords = "Biomarkers, Diabetic foot infection, Erythrocyte sedimentation rate, Osteomyelitis, Procalcitonin",
author = "{Van Asten}, {Suzanne A V} and Adam Nichols and {La Fontaine}, Javier and Kavita Bhavan and Peters, {Edgar J G} and Lavery, {Lawrence A.}",
year = "2017",
month = "2",
day = "1",
doi = "10.1111/iwj.12545",
language = "English (US)",
volume = "14",
pages = "40--45",
journal = "International Wound Journal",
issn = "1742-4801",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis

AU - Van Asten, Suzanne A V

AU - Nichols, Adam

AU - La Fontaine, Javier

AU - Bhavan, Kavita

AU - Peters, Edgar J G

AU - Lavery, Lawrence A.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. PCT levels in the osteomyelitis group were significantly higher at baseline than in the group with no osteomyelitis (P = 0·049). There were no significant differences between the two groups in the levels of the other markers. CRP, ESR, PCT and IL-6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP-1 increased (P = 0·002). TNFα and MIP1α levels were below range in 80 out of 97 samples and therefore not reported. Our results suggest that PCT might be useful to distinguish osteomyelitis in infected foot ulcers. CRP, ESR, PCT and IL-6 are valuable when monitoring the effect of therapy.

AB - In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. PCT levels in the osteomyelitis group were significantly higher at baseline than in the group with no osteomyelitis (P = 0·049). There were no significant differences between the two groups in the levels of the other markers. CRP, ESR, PCT and IL-6 levels significantly declined in the group with osteomyelitis after starting therapy, while MCP-1 increased (P = 0·002). TNFα and MIP1α levels were below range in 80 out of 97 samples and therefore not reported. Our results suggest that PCT might be useful to distinguish osteomyelitis in infected foot ulcers. CRP, ESR, PCT and IL-6 are valuable when monitoring the effect of therapy.

KW - Biomarkers

KW - Diabetic foot infection

KW - Erythrocyte sedimentation rate

KW - Osteomyelitis

KW - Procalcitonin

UR - http://www.scopus.com/inward/record.url?scp=85008395319&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008395319&partnerID=8YFLogxK

U2 - 10.1111/iwj.12545

DO - 10.1111/iwj.12545

M3 - Article

C2 - 26634954

AN - SCOPUS:85008395319

VL - 14

SP - 40

EP - 45

JO - International Wound Journal

JF - International Wound Journal

SN - 1742-4801

IS - 1

ER -