Evidence mapPaperPMID 35869352Full record

ArticleInfection2023

The association between bacteria and outcome and the influence of sampling method, in people with a diabetic foot infection.

Meryl Cinzía Tila Tamara Gramberg, Shaya Krishnaa Normadevi Mahadew, Birgit Ilja Lissenberg-Witte, Marielle Petra Bleijenberg, Jara Rebekka de la Court, Jarne Marijn van Hattem, Louise Willy Elizabeth Sabelis, Rimke Sabine Lagrand, Vincent de Groot, Martin Den Heijer and 1 more

Open access · hybridFull text read
In one paragraph

Article in Infection, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. A Survey of the Microbiome, Culturome and ARG Profile of a Cohort of Chronic Diabetic Foot Lesions.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Meryl Cinzía Tila Tamara GrambergAmsterdam UMC Location Vrije Universiteit Amsterdam, Infectious Diseases, De Boelelaan 1117, Amsterdam, The Netherlands. m.gramberg@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-5805-2212
Shaya Krishnaa Normadevi MahadewAmsterdam UMC Location Vrije Universiteit Amsterdam, Infectious Diseases, De Boelelaan 1117, Amsterdam, The Netherlands.
Birgit Ilja Lissenberg-WitteAmsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands.
Marielle Petra BleijenbergAmsterdam UMC Location Vrije Universiteit Amsterdam, Infectious Diseases, De Boelelaan 1117, Amsterdam, The Netherlands.
Jara Rebekka de la CourtAmsterdam UMC Location Vrije Universiteit Amsterdam, Infectious Diseases, De Boelelaan 1117, Amsterdam, The Netherlands.
Jarne Marijn van HattemAmsterdam UMC Location University of Amsterdam Medical Microbiology and Infection Prevention, Meibergdreef 9, Amsterdam, The Netherlands.
Louise Willy Elizabeth SabelisAmsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
Rimke Sabine LagrandAmsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
Vincent de GrootAmsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
Martin Den HeijerAmsterdam UMC Location Vrije Universiteit Amsterdam, Endocrinology, De Boelelaan 1117, Amsterdam, The Netherlands.
Edgar Josephus Gerardus PetersAmsterdam UMC Location Vrije Universiteit Amsterdam, Infectious Diseases, De Boelelaan 1117, Amsterdam, The Netherlands.
Amsterdam University Medical Centers · NLAmsterdam Neuroscience · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDifferent bacteria lead to divers diabetic foot infections (DFIs), and some bacteria probably lead to higher amputation and mortality risks. We assessed mortality and amputation risk in relation to bacterial profiles in people DFI and investigated the role of sampling method.

methodsWe included people (> 18 years) with DFI in this retrospective study (2011-2020) at a Dutch tertiary care hospital. We retrieved cultures according to best sampling method: (1) bone biopsy; (2) ulcer bed biopsy; and (3) swab. We aggregated data into a composite determinant, consisting of unrepeated bacteria of one episode of infection, clustered into 5 profiles: (1) Streptococcus and Staphylococcus aureus; (2) coagulase-negative Staphylococcus, Cutibacterium, Corynebacterium and Enterococcus; (3) gram-negative; (4) Anaerobic; and (5) less common gram-positive bacteria. We calculated Hazard Ratio's (HR's) using time-dependent-Cox regression for the analyses and investigated effect modification by sampling method.

resultsWe included 139 people, with 447 person-years follow-up and 459 episodes of infection. Sampling method modified the association between bacterial profiles and amputation for profile 2. HR's (95% CI's) for amputation for bacterial profiles 1-5: 0.7 (0.39-1.1); stratified analysis for profile 2: bone biopsy 0.84 (0.26-2.7), ulcer bed biopsy 0.89 (0.34-2.3), swab 5.9*(2.9-11.8); 1.3 (0.78-2.1); 1.6 (0.91-2.6); 1.6 (0.58-4.5). HR's (95% CI's) for mortality for bacterial profiles 1-5: 0.89 (0.49-1.6); 0.73 (0.38-1.4); 2.6*(1.4-4.8); 1.1(0.58-2.2); 0.80(0.19-3.3).

conclusionsIn people with DFI, there was no association between bacterial profiles in ulcer bed and bone biopsies and amputation. Only in swab cultures, low-pathogenic bacteria (profile 2), were associated with a higher amputation risk. Infection with gram-negative bacteria was associated with a higher mortality risk. This study underlined the possible negative outcome of DFI treatment based on swabs cultures.

Indexed as

Communicable DiseasesDiabetes MellitusDiabetic FootStaphylococcal InfectionsAnti-Bacterial AgentsBacteriaHumansRetrospective StudiesUlcerAnti-Bacterial AgentsAmputationBacteriaDiabetes mellitusDiabetic foot infectionMortality

Identifiers

PMID35869352
PMCPMC10042898
OpenAlexW4286560699

What Socratic holds

Textfull text, public
LicenceCC BY
measurements read15
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.