Mohamed Al-Mayahi1, Anais Cian1, Benjamin Kressmann1,2, Benedicte de Kalbermatten3, Peter Rohner4, Michael Egloff3, Jafaar Jafaar3, Sarah Malacarne3, Hermes H Miozzari1, Ilker Uçkay1,2. 1. a From the Orthopedic Surgery Service, Geneva University Hospitals & Faculty of Medicine, University of Geneva , Geneva , Switzerland. 2. b Service of Infectious Diseases, Geneva University Hospitals & Faculty of Medicine, University of Geneva , Geneva , Switzerland. 3. c Service of Diabetology and Endocrinology, Geneva University Hospitals & Faculty of Medicine, University of Geneva , Geneva , Switzerland. 4. d Coding Office, Geneva University Hospitals & Faculty of Medicine, University of Geneva , Geneva , Switzerland.
Abstract
BACKGROUND: Clinical experience suggests that a high proportion of orthopaedic infections occur in persons with diabetes. METHODS: We reviewed several databases of adult patients hospitalized for orthopaedic infections at Geneva University Hospitals from 2004 to 2014 and retrieved 2740 episodes of infection. RESULTS: Overall, diabetes was noted in the medical record for 659 (24%) of these cases. The patients with, compared with those without, diabetes had more than five times more foot infections (274/659 [42%] vs 155/2081 [7%]; p < 0.01) and a significantly higher serum C-reactive protein level at admission (median 96 vs 70 mg/L; p < 0.01). Diabetic patients were older (median 67 vs 52 years; p < 0.01), more often male (471 [71%] vs 1398 [67%]; p = 0.04), and had more frequent polymicrobial infections (219 [37%] vs 353 [19%]; p < 0.01), including more gram-negative non-fermenting rods (90 [15%] vs 168 [9%]; p < 0.01). Excluding foot infections from these analyses did not change the statistically significant differences. Diabetes was present in 17% of all infected orthopaedic patients without foot involvement. In Geneva canton, the overall prevalence of diabetes is estimated at 5.1%, while we have found that the prevalence is 13% in our hospitalized adults. CONCLUSIONS: Diabetes is present in 24% of all adult patients hospitalized for surgery for an orthopaedic infection, a prevalence that is several times higher than for the general population and twice as high as that for the population of hospitalized patients. Compared with non-diabetics, patients with diabetes have significantly more infections that are polymicrobial, including gram-negative non-fermenting rods.
BACKGROUND: Clinical experience suggests that a high proportion of orthopaedic infections occur in persons with diabetes. METHODS: We reviewed several databases of adult patients hospitalized for orthopaedic infections at Geneva University Hospitals from 2004 to 2014 and retrieved 2740 episodes of infection. RESULTS: Overall, diabetes was noted in the medical record for 659 (24%) of these cases. The patients with, compared with those without, diabetes had more than five times more foot infections (274/659 [42%] vs 155/2081 [7%]; p < 0.01) and a significantly higher serum C-reactive protein level at admission (median 96 vs 70 mg/L; p < 0.01). Diabeticpatients were older (median 67 vs 52 years; p < 0.01), more often male (471 [71%] vs 1398 [67%]; p = 0.04), and had more frequent polymicrobial infections (219 [37%] vs 353 [19%]; p < 0.01), including more gram-negative non-fermenting rods (90 [15%] vs 168 [9%]; p < 0.01). Excluding foot infections from these analyses did not change the statistically significant differences. Diabetes was present in 17% of all infected orthopaedic patients without foot involvement. In Geneva canton, the overall prevalence of diabetes is estimated at 5.1%, while we have found that the prevalence is 13% in our hospitalized adults. CONCLUSIONS:Diabetes is present in 24% of all adult patients hospitalized for surgery for an orthopaedic infection, a prevalence that is several times higher than for the general population and twice as high as that for the population of hospitalized patients. Compared with non-diabetics, patients with diabetes have significantly more infections that are polymicrobial, including gram-negative non-fermenting rods.
Authors: Cristiana M Toscano; Tatiana H Sugita; Michelle Q M Rosa; Hermelinda C Pedrosa; Roger Dos S Rosa; Luciana R Bahia Journal: Int J Environ Res Public Health Date: 2018-01-08 Impact factor: 3.390
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Authors: Céline S Moret; Madlaina Schöni; Felix W A Waibel; Elin Winkler; Angelina Grest; Bettina S Liechti; Jan Burkhard; Dominique Holy; Martin C Berli; Benjamin A Lipsky; Ilker Uçkay Journal: BMC Res Notes Date: 2022-07-27