The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades

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, L...

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Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/222104
Acceso en línea:https://hdl.handle.net/2445/222104
Access Level:acceso abierto
Palabra clave:Enterobacteriàcies
Peu diabètic
Osteomielitis
Enterobacteriaceae
Diabetic foot
Osteomyelitis
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repository_id_str
spelling The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decadesSoldevila-Boixader, LauraMurillo Rubio, ÓscarWaibel, Felix W. A.Schöni, MadlainaAragón Sánchez, JavierGariani, KarimLebowitz, DanErtuğrul, BülentLipsky, Benjamin A.Uçkay, IlkerEnterobacteriàciesPeu diabèticOsteomielitisEnterobacteriaceaeDiabetic footOsteomyelitisObjectives: 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.Elsevier BV2025202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion7 p.application/pdfhttps://hdl.handle.net/2445/222104Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1016/j.ijid.2025.107843International Journal of Infectious Diseases, 2025, vol. 154, p. 107843https://doi.org/10.1016/j.ijid.2025.107843cc by-nc-nd (c) Soldevila Boixader, Laura et al.,2025http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2221042026-05-29T05:05:01Z
dc.title.none.fl_str_mv The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
title The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
spellingShingle The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
Soldevila-Boixader, Laura
Enterobacteriàcies
Peu diabètic
Osteomielitis
Enterobacteriaceae
Diabetic foot
Osteomyelitis
title_short The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
title_full The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
title_fullStr The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
title_full_unstemmed The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
title_sort The increasing prevalence of Enterobacteriaceae as pathogens of diabetic foot osteomyelitis: A multicentre European cohort over two decades
dc.creator.none.fl_str_mv 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
author Soldevila-Boixader, Laura
author_facet 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
author_role author
author2 Murillo Rubio, Óscar
Waibel, Felix W. A.
Schöni, Madlaina
Aragón Sánchez, Javier
Gariani, Karim
Lebowitz, Dan
Ertuğrul, Bülent
Lipsky, Benjamin A.
Uçkay, Ilker
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Enterobacteriàcies
Peu diabètic
Osteomielitis
Enterobacteriaceae
Diabetic foot
Osteomyelitis
topic Enterobacteriàcies
Peu diabètic
Osteomielitis
Enterobacteriaceae
Diabetic foot
Osteomyelitis
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/222104
url https://hdl.handle.net/2445/222104
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.ijid.2025.107843
International Journal of Infectious Diseases, 2025, vol. 154, p. 107843
https://doi.org/10.1016/j.ijid.2025.107843
dc.rights.none.fl_str_mv cc by-nc-nd (c) Soldevila Boixader, Laura et al.,2025
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Soldevila Boixader, Laura et al.,2025
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 7 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier BV
publisher.none.fl_str_mv Elsevier BV
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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