Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2023; 14(6): 680-704
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.680
What’s old is new again: Insights into diabetic foot microbiome
Azza A H Rajab, Wael A H Hegazy
Azza A H Rajab, Wael A H Hegazy, Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagzig 44511, Egypt
Author contributions: Hegazy WAH contributed to conceptualization, writing the original draft, and the final revision; Rajab AAH wrote the original draft.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wael A H Hegazy, PhD, Full Professor, Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagzig 44511, Egypt. waelmhegazy@daad-alumni.de
Received: December 26, 2022
Peer-review started: December 26, 2022
First decision: February 20, 2023
Revised: February 20, 2023
Accepted: April 10, 2023
Article in press: April 10, 2023
Published online: June 15, 2023
Abstract

Diabetes is a chronic disease that is considered one of the most stubborn global health problems that continues to defy the efforts of scientists and physicians. The prevalence of diabetes in the global population continues to grow to alarming levels year after year, causing an increase in the incidence of diabetes complications and health care costs all over the world. One major complication of diabetes is the high susceptibility to infections especially in the lower limbs due to the immunocompromised state of diabetic patients, which is considered a definitive factor in all cases. Diabetic foot infections continue to be one of the most common infections in diabetic patients that are associated with a high risk of serious complications such as bone infection, limb amputations, and life-threatening systemic infections. In this review, we discussed the circumstances associated with the high risk of infection in diabetic patients as well as some of the most commonly isolated pathogens from diabetic foot infections and the related virulence behavior. In addition, we shed light on the different treatment strategies that aim at eradicating the infection.

Keywords: Diabetic foot infection, Chronic ulcer, Bacterial biofilm, Multidrug resistance, Methicillin resistant Staphylococcus aureus, Vancomycin resistance

Core Tip: Diabetic foot infection is a common complication of diabetes that can lead to serious consequences, such as amputations and even death. The microbiome of the wound plays a crucial role in the development and progression of diabetic foot ulcer. The current review shed light on the most prevalent bacterial infections and their related virulence factors that are associated with diabetic foot complications. Additionally, various approaches for treatment were explored.