Evaluating diagnostic approaches for diabetic foot infections: A systematic review

• Author Details:   
• J Bindhu ^*
• R Umashankar
• Ramesh Vasudevan
• B. Mahalakshmi
• Sovan Bagchi
• Wethroe Kapfo
• Abida Khan
• Suria Prabha
• Muthu Prasanna

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Diabetic neuropathy, a major complication of diabetes mellitus, encompasses disorders affecting the somatic and autonomic nervous systems. Among its clinical manifestations is diabetic foot (DF), characterized by structural and functional foot changes, including ulceration, infection, and gangrene. These issues often arise from prolonged hyperglycemia, neuropathy, and peripheral vascular disease and can progress to severe complications such as foot ulcers, Charcot osteoarthropathy, and limb amputation. Diabetic foot infections (DFIs), a serious complication, impose a significant burden on global healthcare systems. Peripheral neuropathy and arterial disease contribute to ulceration, impaired wound healing, and infection. Staphylococcus aureus is a common pathogen, though microbial profiles vary with geography, patient characteristics, and local resistance patterns. Effective management of DFIs relies on prompt diagnosis, guided by imaging and deep tissue cultures, to inform surgical and antimicrobial strategies. Surgical debridement and, in cases of osteomyelitis, excision of infected bone is critical for reducing recurrence and amputation risk. Antibiotic therapy should be tailored to culture results to optimize outcomes and curb resistance. Preventative measures, such as patient education, regular foot care, and specialized clinics, are essential in mitigating DFI risk. This systematic review consolidates findings from early reported studies, analyzing microbial profiles, antibiotic resistance trends, and clinical practice guidelines for diabetic foot management. It highlights the need for integrated approaches to improve patient outcomes and reduce the global burden of DFIs.

Keywords: Diabetes, Diabetic foot infections, Foot ulcers, Systematic review.